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High and Intensive Care in Psychiatry: A New Model for Acute Inpatient Care
Yolande Voskes1, Anne Laura van Melle1, Guy A M Widdershoven1
1Department of Ethics, Law, and Humanities, Amsterdam University Medical Centers, Amsterdam (Voskes, van Melle, Widdershoven); GGZ Breburg, Tilburg, the Netherlands (Voskes); Reinier van Arkel, 's-Hertogenbosch, the Netherlands (van Mierlo); Frits & Gijs, Rotterdam, the Netherlands (Bovenberg); Parnassia Psychiatric Institute, and Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands (Mulder). Kathleen M. Pike, Ph.D., and Pamela Scorza, Sc.D., M.P.H., are editors of this column.
Abstract:
In response to three reforms in Dutch mental health care, an organizational framework, including methods and interventions, was developed as part of a new model for acute inpatient care. Core elements of high and intensive care (HIC) include preventing seclusion by means of a stepped-care principle; a six-step process of admission, treatment, and care; combining medical and recovery approaches; combining professional and experiential knowledge; and providing a healing environment. The HIC model differs from the utilization of psychiatric intensive care units in that it focuses on collaboration with outpatient care; establishing contact between staff, patients, and relatives; and minimizing coercion.
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