COMMENTARY

Residential Alternatives to Psychiatric Hospital Admission

Peter Yellowlees, MBBS, MD

Disclosures

January 26, 2010

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. Reducing the use of hospital inpatient facilities and improving their quality are central aims of mental health service policy. There is little available evidence, however, on the effectiveness of residential alternatives to standard acute psychiatric inpatient care. Now 4 investigators,[1] from University College London, have undertaken a systematic review to assess the effectiveness, the cost-effectiveness, and the satisfaction with residential alternatives to standard acute in-patient mental health services. A systematic literature search was undertaken and 27 relevant studies were identified. These were assessed for methodological quality and results from the 9 higher quality studies were discussed. These studies provided no contraindication to the identified alternative community-service models and limited preliminary evidence that they may be cheaper, and individuals may be more satisfied with them. The authors suggested that more research is needed to establish the effectiveness of service models and target populations for residential alternatives to standard acute inpatient facilities. They concluded that community-based residential crisis services may provide a feasible and acceptable alternative to hospital admission for some people with acute mental illness. This article is selected from Medscape Best Evidence. I'm Dr. Peter Yellowlees.

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