Complex Patients

PMHNP10 · Jun 16, 2005

I'm wondering if any of my international colleagues can help..... In the mental health service I work in we are looking to develop a service which specialises in placing difficult complex patients with enduring problems. Due to the level of need these people often end up stuck in acute psychiatric inpatient facilities long after they need to be there. The idea is to look at each case with fresh eyes and try and come up with some creative solutions. People referred to this service will have been referred to other agencies for placement etc.... and knocked back as they didnt meet the criteria.
My question is this, is anyone aware of any service anywhere which fulfills a similar role... it doesnt matter where it is I'd like to contact and discuss them to see how they function and ideas they may have.
regards StuPer

I don't know if I can be of much help, but could you please specify what you mean by "complex patients with enduring problems." If you mean depressed patients who don't seem to respond to therapy/meds, ECT might be an answer. For bipolar patients who frequently present in the ER, med compliance might be an issue; same with schizophrenics. For patients have been diagnosed with an Axis II d/o, studies have shown that partial hospitalization is better for the patient than inpatient treatment. And then there are some patients who need long term inpatient care, like a nursing home, but for psych patients.

StuPer · Jun 17, 2005

Sorry for the misunderstanding, what I actually mean't was a service for patients who have been in acute inpatient facilities long after they need to be there, but because of ongoing issues (eg med compliance, behaviour problems) they cannot be managed in other facilities. This has led to the Area Health Service to look at a service which will look hard at the placement of these patients with a view to developing some form of discharge plan, either through providing another area with the resources to manage that patient or by looking at more creative (read-expensive) options. We are in the planning and implementation stage and are wondering if anywhere else had set up a similar service.

regards StuPer

grannynurse FNP · Jun 17, 2005

Sorry for the misunderstanding, what I actually mean't was a service for patients who have been in acute inpatient facilities long after they need to be there, but because of ongoing issues (eg med compliance, behaviour problems) they cannot be managed in other facilities. This has led to the Area Health Service to look at a service which will look hard at the placement of these patients with a view to developing some form of discharge plan, either through providing another area with the resources to manage that patient or by looking at more creative (read-expensive) options. We are in the planning and implementation stage and are wondering if anywhere else had set up a similar service.
regards StuPer

From the use of your terminology, Area Health Services, I am assuming you are in Britian, correct? I am living in SW Florida. One of the programs I am aquainted with, in a day treatment operation. It allows patients to be discharge back into their community, either to a group home or their own home. They are picked up and transported back to the facility and attend day treatment prorams, including therapy sessions, OT, life skills, bio-feedback, etc. And their medication is provided for them while at the day program. Patients remain in the program for anywhere from 6, 12, 24,36 months.

Grannynurse :balloons: