A crisis planning and monitoring intervention to reduce compulsory hospital readmissions (FINCH study): protocol for a randomised controlled feasibility study.

Background: Rates of compulsory (also known as involuntary) detention under mental health legislation have been rising over several decades in countries including England. Avoiding such detentions should be a high priority given their potentially traumatic nature and departure from usual ethical principles of consent and collaboration. Those who have been detained previously are at high risk of being detained again, and thus a priority group for preventive interventions.

Crisis-focused Cognitive Behavioural Therapy for psychosis (CBTp) in acute mental health inpatient settings (the CRISIS study): protocol for a pilot randomised controlled trial.

Background: Cognitive Behavioural Therapy for psychosis (CBTp) has an established evidence base and is recommended by clinical guidelines to be offered during the acute phases of psychosis. However, few research studies have examined the efficacy of CBTp interventions specifically adapted for the acute mental health inpatient context with most research trials being conducted with white European community populations.

Aims: The aim of this study is to conduct a pilot randomised controlled trial (RCT), which incorporates the examination of feasibility markers, of a crisis-focused CBTp intervention adapted for an ethnically diverse acute mental health inpatient population, in preparation for a large-scale randomised controlled trial.

Referral to aftercare following inpatient withdrawal treatment and readmission: retrospective chart review of patients with substance use disorders.

Aims Of The Study: Aftercare following inpatient withdrawal treatment improves the prognosis and prevents future readmissions in patients with substance use disorders. According to the stepped care approach, the setting and intensity of aftercare should be adjusted to the patients' specific needs and resources. This study evaluated the real-life referral to different types of aftercare in Switzerland and the rate of inpatient readmission within a 1-year follow-up.

Sociodemographic and Clinical Predictors of the Length of Psychiatric Inpatient Stay of Immigrants in Switzerland.

Immigrants with mental disorders have consistently been reported to spend shorter time in the psychiatric hospital compared to native patients. The aim of this study was to identify sociodemographic, clinical and migration-related predictors of a shorter length of psychiatric inpatient stay among immigrants in Switzerland. All patients of a foreign nationality admitted for inpatient treatment in the year 2016 ( = 279) were included in this study.

Patient-Level Predictors of Psychiatric Readmission in Substance Use Disorders.

Repeated psychiatric readmissions are a particular challenge in the treatment of substance use disorders and are associated with substantial burden for patients and their associates and for healthcare providers. Factors affecting readmission rates are heterogeneous and need to be identified to better allocate resources. Within the Swiss healthcare system, such data on substance use disorder patients are largely missing.

Predictors of Compulsory Re-admission to Psychiatric Inpatient Care.

This prospective study addresses risk factors of compulsory re-admission focusing on the role of the patient's subjective symptom distress and perceived social support, based on comprehensive patient and external (clinicians, study staff) assessments. Of the baseline sample, 168 (71%) patients with serious mental disorders, who had been compulsorily admitted to psychiatric inpatient care, were followed over 24 months after discharge within the framework of a RCT. During this time 36% had compulsory re-admissions; risk was highest immediately after discharge.

Preventing Compulsory Admission to Psychiatric Inpatient Care: Perceived Coercion, Empowerment, and Self-Reported Mental Health Functioning after 12 Months of Preventive Monitoring.

Objective: To evaluate the effects of a preventive monitoring program targeted to reduce compulsory rehospitalization and perceived coercion in patients with severe mental disorder. We analyze patient outcomes in terms of perceived coercion, empowerment, and self-reported mental health functioning at 12 months.

Methods: The program consists of individualized psychoeducation, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring.

[Crisis Cards for the Prevention of Compulsory Hospitalization].

Objective: To assess early signs of mental-health crises, treatment-specific demands and individual coping strategies from the subjective patients' perspective, and to categorize these specifications on the patients' crisis cards.

Methods: A sample of 108 psychiatric patients with severe mental disorders is currently taking part in an intervention programme targeting the reduction of compulsory re-admission to psychiatry. As part of the programme, patients fill in a crisis card.

Preventing compulsory admission to psychiatric inpatient care using psycho-education and monitoring: feasibility and outcomes after 12 months.

The aim of this study was to evaluate an intervention programme for people with severe mental illness that targets the reduction in compulsory psychiatric admissions. In the current study, we examine the feasibility of retaining patients in this programme and compare outcomes over the first 12 months to those after treatment as usual (TAU). Study participants were recruited in four psychiatric hospitals in the Canton of Zurich, Switzerland.

Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness.

Compulsory admission to psychiatric inpatient treatment can be experienced as disempowering and stigmatizing by people with serious mental illness. However, quantitative studies of stigma-related emotional and cognitive reactions to involuntary hospitalization and their impact on people with mental illness are scarce. Among 186 individuals with serious mental illness and a history of recent involuntary hospitalization, shame and self-contempt as emotional reactions to involuntary hospitalization, the cognitive appraisal of stigma as a stressor, self-stigma, empowerment as well as quality of life and self-esteem were assessed by self-report.

Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring.

Background: The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients.

[Psychiatric hospitalisation across the life span].

Objective: The study addresses changes in the use of inpatient psychiatric treatment during the life course in various mental disorders.

Methods: We analysed inpatient admissions from a defined catchment area (1.3 mill.

Trends in psychiatric hospitalisation of people with schizophrenia: a register-based investigation over the last three decades.

The number of psychiatric beds has declined considerably in many countries over the past decades. Long-term studies on the impact of these health care changes for the severely mentally ill, however, are still scarce. This epidemiological study investigates the use of inpatient psychiatric services by people with schizophrenia, compared to that by people with other mental disorders.

Mental hospital admission rates of immigrants in Switzerland.

Purpose: This epidemiological study aims to assess the utilisation of inpatient psychiatric services by immigrants. Specifically, we address the question of gender-specific differences in immigrants and compare the population-based rates of males and females from different countries of origin.

Methods: We analysed inpatient admission rates from a defined catchment area over a 6-year period by means of psychiatric register data.

Utilisation of inpatient psychiatric services by people with illicit substance abuse in Switzerland.

Questions Under Study: The study aims to examine the utilisation of inpatient psychiatric services by people with substance use disorders (SUD), and to identify factors that predict inpatient service use.

Methods: Out of a sample of consecutively referred first-admitted patients from a catchment area in Switzerland, a cohort of 563 individuals with behavioural and mental disorders due to (illicit) substance use was followed over a period of 5 years by means of register data.

Results: Every fourth individual of the first-admission sample was admitted for a SUD.

Homeless people at disadvantage in mental health services.

Objective: The aims of this study are threefold: to depict characteristics of homeless at discharge from a psychiatric hospital; to describe the utilisation of inpatient care and treatment measures during hospitalisation; and to analyse to what extent psychiatric disorders and clinical variables contribute to the risk for homelessness at discharge.

Methods: Based on case register data we analysed all 28,204 people consecutively referred in 1996-2001 to psychiatric hospitals of a well-defined catchment area in Switzerland.

Results: 1% (N=269) of all admissions were homeless at discharge (mean age: 32.

Home treatment for children and adolescents with psychiatric disorders.

The study examines the effectiveness of home treatment in 70 children and adolescents (aged 6-17 years) with heterogeneous psychiatric disorders. Home treatment was offered to parents/children as an alternative to inpatient treatment (no randomized group assignment). Interventions were carried out by psychiatric nurses (n = 38) and medical students (n = 32) under the supervision of experienced child psychiatrists.

Length of first admission and treatment outcome in patients with unipolar depression.

Background: Unipolar depression is among the most common reasons for psychiatric hospitalisation. But only few studies focussed on inpatient treatment and its impact on short- or long-term outcome in these patients. Thus, we studied as to what extent patients with unipolar depression use psychiatric inpatient resources, and examined whether the length of stay is associated with short-term improvement and rehospitalisation.

Prediction of in-patient use in first-admitted patients with psychosis.

Purpose: The aim of this study is to examine the utilization of psychiatric services for inpatients with psychosis over a period of five years after first admission, and to identify factors that contribute to intensive service use in terms of cumulative length of in-patient treatment and readmission rate.

Methods: A cohort of 424 patients with psychotic disorders (out of a sample of 2565 first-admitted patients from a catchment area in Switzerland) was examined by means of register data.

Results: Patients admitted for psychosis spent the longest time in hospital compared to other diagnoses, but there was considerable within-sample variation, and most patients (60.

Patterns of inpatient care for immigrants in Switzerland: a case control study.

Background: Migration has become a major political and social concern in West European societies.

Methods: A case-control method was used to analyse the utilisation of inpatient mental health services by immigrants from a catchment area in Switzerland over a 7-year period.

Results: Compared to natives, immigrants had fewer psychiatric hospitalisations, but more emergency and compulsory admissions.

Homelessness among people with severe mental illness in Switzerland.

Questions Under Study: This study addresses socio-demographic and clinical characteristics among homeless people in Switzerland admitted to inpatient care, the use of and pathways to inpatient care by this group and, the extent to which psychiatric disorders contribute to the risk of homelessness.

Methods: Based on data of a psychiatric case register we analysed 16247 people consecutively referred to psychiatric hospitals of a catchment area in Switzerland between 1998 and 2001.

Results: 1.

Is there a sex-specific difference in onset age of schizophrenia that started before age 18?

Schizophrenia in male adults starts on average 4-5 years earlier than in females. The lifetime risk for both sexes is equal. It is still unknown, whether this observation is also valid for children and adolescents.