Criteria for evaluating the effectiveness of psychiatric home care-mobile team: A systematic review of the literature

AIM

To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades.

DESIGN

Systematic review of the literature.

METHODS

We included 24 studies published between January 2010 and October 2023.

DATA SOURCES

CINAHL, APA PsycInfo, Embase, Scopus and PubMed.

RESULTS

The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network.

CONCLUSION

The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork.

IMPACT

Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction.

REPORTING METHOD

The authors adhered to PRISMA guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

[Addictions in the elderly: the viewpoint of an IPA working in EMPSA]

Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers.

[From palliative care... to the palliative approach in paediatrics: 10 years on]

There are 24 regional pediatric palliative care resource teams (ERSP) in metropolitan and overseas France. An initial review of the ERSPs was carried out in 2015. The ERSP commission of the Société française de soins palliatifs pédiatriques (French Society for Pediatric Palliative Care) wanted to review the situation again, ten years after the creation of these teams. This article presents the main findings.

[Weaving with Ti-Sage]

The Ti-Sage mobile geronto-psychiatry team provides semi-emergency care in the Sud Bretagne public mental health establishment sector. The system favours fluidity and responsiveness. Requests can be made by telephone without filling in a form. The multidisciplinary team assesses the disorders, directs and ensures follow-up as close as possible (living and care areas), quickly (within forty-eight hours), with the aim of forging links and avoiding inappropriate hospitalisations. Interventions are carried out in all the geriatric care structures in the area, by visit or telemedicine. The team works in a network to coordinate care with care partners and offer support to carers.

Toward Cholera Elimination, Haiti

This study describes the apparent discontinuation of cholera transmission in Haiti since February 2019. Because vulnerabilities persist and vaccination remains limited, our findings suggest that case-area targeted interventions conducted by rapid response teams played a key role. We question the presence of environmental reservoirs in Haiti and discuss progress toward elimination.

[The philosopher to the aid of the anxious caregiver in the time of COVID-19]

Based on a clinical situation of a patient infected with COVID-19, the caregivers of the Saint-Étienne mobile psychiatric team describe their anxieties. Are the procedures carried out appropriate? Did we respect the safety measures? Are we at risk of contracting the virus and contaminating other people? The scientific discourse of "experts", who used to guide our actions, has throughout this crisis been inadequate and people's beliefs have crumbled. This abandonment is a source of anxiety for everyone, an anxiety about death. However, this reflection should kindle hope, a precious emotion for those working with patients in psychiatry.

[Nurse in a mobile psychiatric team for the elderly, an area of expertise within a network]

The elderly subject's mobile psychiatric team goes to meet the patient out of hospital. Its aim is to assess patients, guide their care, and train health professionals and social workers in the psychiatry of the elderly patient. The nurse's autonomy and expertise are essential to her functioning. Feedback from the Corentin-Celton Hospital in Issy-les-Moulineaux (Assistance Publique-Hôpitaux de Paris, 92).

[Nursing practice in the mobile old age psychiatry team]

Since 2015, the mobile old age psychiatry team of the Maison-Blanche public health facility has been providing mental health and psychiatric services to the population aged 70 and over in three districts of Paris and four psychiatric sectors. The team's nurses actively take part in delivering care in the home and in maintaining the autonomy of elderly patients suffering from mental health disorders. They provide global care, both somatic and psychiatric, and offer, through their assessments, an initial response to the suffering expressed by the patients and their family.

[Softly-softly]

The missions of the mobile psychiatric team in Lyon involve reaching out to vulnerable people to guide them towards the most appropriate care. Establishing a bond and finding the right words to engage with them constitute a balancing act which the caregiver must undertake with the homeless. It is important to try and understand the situation, the person's life story, invent alternatives, while refraining from pushing them too much, in order to maintain their trust.

[Psychiatry and palliative care, collaboration for the benefit of the patient]

As palliative care units continue to develop, the provision of end-of-life care for patients with a chronic mental illness needs to be addressed. Aside from the somatic comorbidities to which these patients are particularly exposed and in view of the specificity of psychiatric treatment, the forms of end-of-life support for a patient with schizophrenia are described here, based on the experience of a psychiatric unit in the Var region.

[Telepsychiatry and cooperation between professionnals in a mobile team]

Telepsychiatry in a mobile team uses advanced technology for the benefit of healthcare. It requires a high level of cooperation between the different players. In a nursing home, ilt provides patients with access to psyhiatric care despite the distance or the difficulties involved in travelling to an appointment.

[Family competence, an ally in patient home care]

Systemic therapy allows collective awareness with respect to a designated individual problematic. This approach, which can take place at the family home, allows everyone to exploit possible areas of expression and speak freely. Account of a mobile unit care in Paris.

[Inter-disciplinary approach of a mobile team specialised in geriatric oncology]

Ageing is an individual process. Chronological age does not reflect life expectancy or functional capacity. That is why, in geriatric oncology, the estimation of this capacity is a determining factor. An inter-disciplinary approach is necessary in order to coordinate the different players in the care and optimise the hospitalisation of elderly patients with multiple pathologies, all the more so when they are suffering from cancer.