Providing individualised and better care at home for people with mental health issues
“I am visiting the people. They are still the boss in their own house, apartment or room in the nursing home. Here, you can concentrate much more on the person and his or her disease, everything is tailor-made and geared to this person,” is how an employee of the Pfalzklinikum describes her work in the home treatment team. After more than 20 years on the ward, she completely switched to an outpatient outreach setting.
This was made possible by the model project according to § 64 b SGB V (Social Code Book), which has been implemented at the Pfalzklinikum since January 2020. It is the largest in Germany and will run for eight years with the aim of treating children, adolescents and adults with mental health issues in a more needs-oriented manner. In particular, the elimination of sectoral boundaries makes it possible to treat patients individually and oriented towards their life reality. To this end, bureaucratic hurdles are being removed to enable a seamless transition between the various treatment settings – from inpatient to day-care or outpatient and back. Fixed reference persons remain across the different settings. In the course of this, multiprofessional teams are increasingly being established in outpatient outreach settings, both for acute treatment and for follow-up care. The Corona pandemic accelerated the expansion of home treatment teams, some of which jumped in at the deep end. For example, there were no home treatment teams in the services for elderly users before the model project: “The service has only existed for a year, and there is still a lot of tinkering and building going on here. Of course, this gives us a lot of possibilities. On the other hand, there is a lack of security and support that one would have with a ready-made concept. There are guidelines and limits to one’s own work and concept. This sometimes causes difficulties, but understandably takes time. I am sure that this will develop”, an employee describes her experiences in the home treatment team. In other areas, such as the Clinic for Psychiatry, Psychosomatics and Psychotherapy, outpatient outreach work has been going on for a longer time, resulting in only marginal changes for the staff, for example in the billing of services.
The employees of the various clinics agree that the new form of treatment makes sense. “I hope that we can continue and expand [home-based treatment] in this way, because it is very well received by the users. In my opinion, it’s a very useful tool: users stay stable for a longer period of time and don’t have to be admitted to hospital as often. That’s why I hope that the health insurance companies will continue to support it,” says one employee, expressing his wishes for the future.
Text: Melanie Minges