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目標：針對精神病患出院後門診追蹤與轉介精神復健機構治療之成本效益進行探討。方法：採全民健保資料庫2000年百萬歸人檔資料，篩選2004年1月1日至2008年12月31日期間，首次於精神科出院之病患，將出院病患分為門診追蹤治療組與精神復健治療組，針對病患出院後2年期間之醫療資源使用，以卡方檢定、獨立樣本t檢定、二項對數迴歸分析及成本效益評估指標，進行成本效益分析。結果：本研究以健康保險支付者為觀點，採醫療直接成本，以申報點數加以計算，經傾向分數配對，兩組各取326人為研究樣本，結果發現，門診追蹤治療的成本效益優於精神復健治療。結論：精神復健治療與門診追蹤治療相較，雖未有明顯的成本效益之優勢，但由精神科住院醫療費用統計資料發現，門診追蹤治療組不論在平均醫療費用或總醫療費用部分，第二年均較第一年增加，因此，建議拉長追蹤年數，以瞭解兩組成本效益之趨勢變化。

Objectives: This study investigated the cost-benefit analysis of psychiatric patients discharged from hospitals and either followed-up in outpatient departments or transferred to institutions for psychiatric rehabilitation. Methods: The data were obtained from the Normalized Million People File on 2000, National Health Insurance Research Database. We selected psychiatric in-patients who were discharged from 2004.1.1 ~ 2008.12.31. The cases were divided into a group that received outpatient follow-up and a group which had psychiatric rehabilitation. We investigated the cost-benefit analysis of these two groups within 2 years after discharge, using chi-square t-tests, independent t-tests, binary logistic regression analysis, and the indicators of cost-benefit analysis. Results: From the point of view of health insurance payers, the costs were direct and analyzed by reporting points of NHI. By using propensity score matching, we selected 326 cases from each group for study. From the indicators of cost-benefit an

The nurses as front liners caring for mental health care users (MHCUs) at mental health institutions are susceptible to adverse physical and psychological effects as a result of hostile behaviors of mentally ill patients. Most nurses suffer from stress that is caused by management’s lack of support, working overtime, lack of recognition by supervisors, and lack of skills and knowledge on how to handle aggressive mental health care users. The present study aims to develop a model to promote the mental health of nursing staff providing care to individuals with mental disorders at mental health institutions. Phase 1, the empirical face, will employ a qualitative, exploratory, and descriptive design focusing on nurses’ experiences caring for MHCUs and their views on improving their mental health. Information will be gathered using unstructured individual interviews with nurses purposefully sampled at selected mental health institutions. The study will apply procedures to safeguard trustworthiness and moral principles during the study. Phase 2 will focus on developing a model, and in phase 3, the developed model will be validated. The findings of the study will determine recommendations.

Background Dual diagnosis accounts for about 50% of the population of persons with mental disorders. Research on nurses caring for inpatients detected with dual diagnosis is limited and the perceptions on the current nursing care of patients identified with dual diagnosis in psychiatric hospitals in Ghana is unknown. The purpose of this study was to explore and describe the perceptions of nurses on the current nursing care of patients classified with dual diagnosis in psychiatric hospitals in Ghana. Methods An exploratory-descriptive qualitative research design was used. Twenty-three participants working at the three public psychiatric hospitals of Ghana were recruited using purposive sampling technique. Individual, semi-structured interviews were used to collect data which was analysed through thematic analysis. Results Three main themes emerged namely: (1) Current nursing care of patients with dual diagnosis (2), Challenges in caring for patients with dual diagnosis (3), Support for improving caring for patients with dual diagnosis. Conclusion This study highlights the challenges and potential solutions in caring for patients with dual diagnosis in Ghana. It emphasises the need for improved training, collaboration, infrastructure, and policy support for nurses. Addressing these gaps are essential for better patient outcomes and nurses’ well-being, offering important insights for global mental health care in resource-constrained settings. Clinical trial number Not applicable.

Background: Mental health care users (MHCUs) are usually admitted to mental health care facilities when they relapse. MHCUs who abuse illicit substances get admitted to a special ward in the hospital specifically for drug detoxification for six weeks. Despite thorough recovery programs, there is still rapid post-discharge relapse among MHCUs with high accessibility to substances. The study was conducted at a psychiatric hospital, in South Africa. It is suggested that MHCUs relapse due to the easy availability of substances and association with negative friends. Two themes emerged: MHCU related challenges and MHCU support system challenges. It is evident that MHCUs frequently relapse in the absence of support. Community Psychiatric nurses are to oversee, assist and follow up with MHCUs after rehabilitation. Further studies are needed to strengthen interprofessional community programs for aftercare treatment to monitor recovering MHCUs.The results demonstrate the influence of unfavourable social networks and substance accessibility affecting the therapy.

Background Current outcomes for mental illness are widely regarded as poor. Since the introduction of psychotropic medications in the mid 1950’s, previous psychosocial practices were minimized in favor of medication focused treatment. The majority of large U.S. state hospitals have closed with records destroyed or in storage, inaccessible to researchers. This creates barriers to studying and comparing outcomes before and after this shift in treatment practices. Aims The study aim was to examine discharge outcomes in relation to length of stay and diagnosis in one U.S. state hospital. Methods This case series study examined 5618 medical records of participants admitted to one state hospital from 1945 to 1954, the decade prior to adoption of psychotropic medications. Results Of the 3332 individuals who left the facility, over half (59.87%) of first episode hospitalizations were discharged within 1 year, and 16.95% were hospitalized for more than 5 years. 46.17% of all admissions were discharged from hospital with no readmission. The most common diagnoses included schizophrenia, other forms of psychosis, and alcoholism. In the decade before the introduction of psychotropic medications, participants were often admitted for a single episode and returned to their homes within several years. Conclusions Although limited to one site, findings suggest that discharge outcomes prior to psychotropic medication as a primary treatment for mental illness may be more positive than previously understood.

Purpose In Germany, return to work (RTW) after inpatient treatment for common mental disorders (CMDs) is a complex process at the intersection of the mental healthcare system and the workplace. This study examined (1) the time to first and full RTW and (2) associated factors among employees receiving inpatient treatment for CMDs. Methods In this prospective cohort study, employees receiving inpatient psychiatric or medical rehabilitation treatment for CMDs were interviewed by phone during their last week before discharge. Follow-up interviews were conducted after 6, 12, and 18 months. Health-, personal, and work-related factors were used from baseline measurement. Parametric survival analysis was conducted to identify factors associated with time to first and full RTW. Results A total of N = 269 participants who stayed at a psychiatric clinic or a medical rehabilitation facility were included. Almost all participants (n = 252, 94%) from both treatment settings reported a first RTW and a full RTW. The time to first and full RTW was shortest among participants from medical rehabilitation (both median 6 days) and longer among participants from psychiatric treatment (median 17 days to first RTW and 73 days to full RTW). While only health-related and personal factors were associated with time to first RTW, leadership quality and needed individual RTW support were associated with time to full RTW. Conclusions More attention to work accommodation needs for RTW in clinical practice and coordinated actions towards RTW in collaboration with key RTW stakeholders in the workplace may support a timely RTW.Clinical Registration Number DRKS00010903, retrospectively registered.

The aim of this study is to identify (1) the extent of work-related stress and (2) stressors associated with cognitive and behavioral stress reactions, burnout symptoms, health status, quality of sleep, job satisfaction, and intention to leave the organization and the profession among health professionals working in acute care /rehabilitation hospitals, psychiatric hospitals, nursing homes, and home care organizations. Background Health professionals are faced with various stressors at work and as a consequence are leaving their profession prematurely. This study aimed to identify the extent of work-related stress and stressors associated with stress reactions, job satisfaction, and intention to leave and health-related outcomes among health professionals working in different healthcare sectors (acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organizations). Methods This study is based on a repeated cross-sectional design, which includes three data measures between 2017 and 2020 and 19,340 participating health professionals from 26 acute care / rehabilitation hospitals, 12 psychiatric hospitals, 86 nursing homes and 41 home care organizations in Switzerland. For data analysis, hierarchical multilevel models (using AIC) were calculated separately for hospitals, nursing homes, and home care organizations, regarding health professionals’ stress symptoms, job satisfaction, intention to leave the organization / profession, general health status, burnout symptoms, and quality of sleep. Results The main findings reveal that the incompatibility of health professionals’ work and private life was significantly associated ( p  < 0.05) with their stress reactions, job satisfaction, intention to leave, and health-related outcomes in all the included work areas. The direct supervisor’s good leadership qualities were also associated with health professionals’ job satisfaction regarding all work areas (B ≥ 0.22, p  = 0.000). In addition, a positive perceived bond with the organization (B ≥ 0.13, p  < 0.01) and better development opportunities (B ≥ 0.05, p  < 0.05) were associated with higher job satisfaction and a lower intention to leave the organization and profession among health professionals. Also, a younger age of health professionals was associated with a higher intention to leave the organization and the profession prematurely in all the included work areas. High physical (B ≥ 0.04, p  < 0.05) and quantitative demands (B ≥ 0.05, p  = 0.000) at work were also associated with negative health-related outcomes.

PurposeUp to now there are only few studies and no RCT comparing efficacy or effectiveness of supported housing (SH) versus residential care (RC) in severe mental illness (SMI) without homelessness. Here we present an observational follow-up study in SMI subjects, who entered SH or RC, to compare clinical and functional outcomes 2 years later.MethodsIn this prospective study in more than 30 locations throughout a German federal state, we included SMI subjects, who entered SH (n = 153) or RC (n = 104). About one quarter suffered from each substance use, psychotic, affective, or other disorders. To avoid sampling bias, we used the propensity score matching method to establish a quasi-experimental design. Outcome measures were social functioning (SFS), the number of psychiatric hospitalisations, psychopathology (SCL-9-K), and quality of life (MANSA). Apart from descriptive methods we analysed primarily using repeated-measures ANOVAS.ResultsOur analyses revealed significant effects of time for all outcomes in both study groups. However, there were not any group differences of outcome measures, i.e., not any significant effects of group or interactional effects of group x time. Moreover, these results hold true for intent-to-treat and per-protocol sample analyses.ConclusionThe results show, that SH and RC for non-homeless people with SMI achieve the same clinical and psychosocial outcomes across a 2-year period. Taking into account the users’ preferences, the present findings should give reason to ensure the availability of affordable housing and to support the expansion of supported housing approaches.

The rising prevalence of physical comorbidities among patients with mental illness has increased the relevance of physical rehabilitation within psychiatric care. However, specific physical rehabilitation practices in specialized psychiatric hospitals in Japan remain insufficiently documented. This exploratory and descriptive study aimed to characterize the rehabilitation content provided and to categorize patient characteristics and comorbidities in a single specialized psychiatric hospital using an expert-led consensus approach. Clinical data from 150 patients (median age 71.0 years) who received physical rehabilitation were retrospectively analyzed. Patient categorization was conducted through a multidisciplinary consensus-building process involving an expert panel of physical therapists, occupational therapists, psychiatrists, and nurses, each with over 10 years of clinical experience. Using a hierarchical rule set based on International Classification of Diseases, 10th Revision (ICD-10) codes and clinical referral data, five distinct categories were identified: Disuse Syndrome (41%), Neurologic Disorders (20%), Lower Limb Lesions (18%), Parkinson’s Syndrome (15%), and Upper Limb Lesions (6%). Across all categories, rehabilitation interventions focused on foundational motor therapies, such as range of motion (27%) and strength training (23%). Mobility-oriented interventions were selectively provided to patients with high bedridden status based on clinical potential. Overall, practices in this setting primarily targeted disuse syndrome and maintenance of basic motor function and were delivered with input from multiple professional disciplines; such practices may inform future research on structured multidisciplinary rehabilitative approaches, especially for aging psychiatric populations.