- Implementation of a recovery-oriented model in a sub-acute Intermediate Stay Mental Health Unit (ISMHU)
- Frost, Barry G.; Turrell, Megan; Sly, Ketrina A.; Lewin, Terry J.; Conrad, Agatha M.; Johnston, Suzanne; Tirupati, Srinivasan; Petrovic, Kerry; Rajkumar, Sadanand
- BMC Health Services Research Vol. 17, Issue 1, p. 1-12
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- BioMed Central
- Resource Type
- journal article
- Background: An ongoing service evaluation project was initiated following the establishment of a new, purpose-built, 20-bed sub-acute Intermediate Stay Mental Health Unit (ISMHU). This paper: provides an overview of the targeted 6-week program, operating within an Integrated Recovery-oriented Model (IRM); characterises the clients admitted during the first 16 months; and documents their recovery needs and any changes. Methods: A brief description of the unit’s establishment and programs is initially provided. Client needs and priorities were identified collaboratively using the Mental Health Recovery Star (MHRS) and addressed through a range of in-situ, individual and group interventions. Extracted client and service data were analysed using descriptive statistics, paired t-tests examining change from admission to discharge, and selected correlations. Results: The initial 154 clients (165 admissions, average stay = 47.86 days) were predominately male (72.1%), transferred from acute care (75.3%), with schizophrenia or related disorders (74.0%). Readmission rates within 6-months were 16.2% for acute and 3.2% for sub-acute care. Three MHRS subscales were derived, together with stage-of-change categories. Marked improvements in MHRS Symptom management and functioning were identified (z-change = −1.15), followed by Social-connection (z-change = −0.82) and Self-belief (z-change = −0.76). This was accompanied by a mean reduction of 2.59 in the number of pre-action MHRS items from admission to discharge (z-change = 0.98). Clinician-rated Health of the Nation Outcome Scales (HoNOS) improvements were smaller (z-change = 0.41), indicative of illness chronicity. Staff valued the elements of client choice, the holistic and team approach, program quality, review processes and opportunities for client change. Addressing high-levels of need in the 6-week timeframe was raised as a concern. Conclusions: This paper demonstrates that a recovery-oriented model can be successfully implemented at the intermediate level of care. It is hoped that ongoing evaluations support the enthusiasm, commitment and feedback evident from staff, clients and carers.
- health service evaluation; inpatients; mental disorders; mental health services; recovery; rehabilitation; serious mental illness; sub-acute
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