[Person-Centered Psychosocial Complex Care for People with Severe Mental Illness: Implementation and Evaluation of a Cross-Sectoral Care Model at a Psychiatric Hospital].

Aim Of The Study: Implementation and evaluation of a cross-sectoral complex care model for persons with severe mental illness (SMI).

Methods: The care model was implemented at a psychiatric-psychotherapeutic specialized clinic. Within this patient-centered and needs-oriented complex care model, intensive case management was applied to transition persons with SMI between inpatient and outpatient mental health care. Evaluation was conducted using a matched control group design (n = 46/21).

Results: According to clinical assessment, two thirds of the patients benefited from the care model. In the course of treatment, the patients showed a significant reduction in the use of inpatient psychiatric care structures and an improvement in clinical symptoms.

Conclusion: For people with SMI, there is a care gap in the in the transition from inpatient to outpatient care, which could be partially closed.