Regionalised tertiary psychiatric residential facilities

Area of Science:

• Psychiatry
• Mental Health Services Research
• Health Services Administration

Background:

• Psychiatric hospitals have historically provided long-term mental health care, but community-based alternatives are increasingly developed.
• Despite downsizing, psychiatric hospitals persist globally, necessitating diverse care models.
• Community residential alternatives vary in staffing, from full-time professionals to on-call services.

Purpose of the Study:

• To review characteristics of community-based psychiatric residential care facilities as an alternative to long-term hospitalization.
• To identify key factors for decision-makers in establishing these facilities.

Main Methods:

• Literature review of community-based psychiatric residential care.
• Analysis of five critical factors: need for places, staffing, physical setting, programming, and governance/financing.

Main Results:

• Italy has developed facilities with full-time staff for patients transitioning from hospitals.
• The UK and Australia have shown success with small-scale, home-like facilities for difficult-to-place patients.
• Canada's British Columbia developed Tertiary Psychiatric Residential Facilities (TPRFs) to regionalize services and close its psychiatric hospital.

Conclusions:

• Community-based residential care is essential for a balanced mental health system, complementing other services.
• Tertiary Psychiatric Care Facilities can serve as hubs for treatment, rehabilitation, and coordination for severely mentally ill individuals.
• These facilities also hold potential for research and training within regional mental health plans.