Community-Based Discharge Planning Improves Health Services

Basing discharge services in the community has improved services for people transitioning out of an acute care mental healthcare facility. It has also reduced readmissions rates, curbing the demand for inpatient services at the hospital level.York's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c

Men Are More Likely to Be Homeless Than Women

Gender has an impact on people with mental illnesses. Men are more likely to be homeless than women. More social support needs to be provided to members of both gendersYork's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c

How Does Diversity Affect Homelessness?

Diversities such as social class, culture, sexual orientation, disabilities and psychiatric conditions impact poverty and homelessness.York's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c

Discharge of Psychiatric Patients to Shelters Increases Homelessness

A comprehensive care plan for patients, including at least income support and assistance resettling in the community, will prevent homelessness.York's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c

The Transitional Discharge Model: Comparing Implementation in Canada and Scotland

Effective discharge planning is needed to facilitate clients\u27 transition from psychiatric hospital wards to community care. Previous studies have shown that client outcomes can be improved by using a Transitional Discharge Model (TDM) that includes peer support and an extension of inpatient-practitioner relationships that are introduced prior to discharge. However, countries vary in many ways that may affect implementation of the model. This article describes some of the similarities and differences related to introducing transitional discharge in two countries: Canada and Scotland. It is important to elucidate facilitators and challenges in implementing the TDM to identify and disseminate strategies to aid implementation. Implications for future implementation of the model are also discussed

Transitional Discharge Based on Therapeutic Relationships: State of the Art

The Transitional Discharge Model (TDM) has been used to facilitate effective discharge from psychiatric hospital to community. A summary of the research to date on TDM is given. The model is based on the provision of therapeutic relationships to provide a safety net throughout the discharge and community reintegration processes. These relationships include both staff and peer involvement; hospital inpatient staff continue to remain involved with the client until a therapeutic relationship is established with a community care provider, and peer support is offered from a former consumer of mental health services who is currently living in the community. Studies found that the TDM facilitates increased discharge rates, lower readmission rates, and cost savings--making it a collaborative, cost-effective method of providing quality patient care and positive health care outcomes. The TDM Plan of Research is presented and reflects the collaboration between stakeholders and the integration of consumer advocacy, clinical practice, education, policy, and research in various countries

Psychiatric Crisis Services in Three Communities

This study compared communities with three models of crisis service: (a) police as part of a specialized mental health team, (b) mental health worker as part of a specialized police team, and (c) informal relationship between police and mental health crisis service. Rural and urban areas were examined and compared. Data included focus groups and participant observation. Analysis revealed that while all communities valued their crisis services, all identified limitations in responsiveness, access, and systems-related issues. Quick access to psychiatric beds was important to services. Rural communities had no public transportation, and an important police role was safe transportation. In rural communities, mental health workers were generalists because they had to be able to address situations on their own. In urban areas, transportation was more readily available, and more specialization developed among mental health team members. Cette étude canadienne a comparé des communautés utilisant 3 modèles différents du service de crise: (a) la police faisant partie de l\u27équipe de crise spécialisée en santé mentale; (b) un travailleur ou une travailleuse en santé mentale faisant partie de l\u27équipe spécialisée de la police; (c) un rapport informel entre la police et le service de crise en santé mentale. Les régions tant rurales qu\u27urbaines ont été examinées et la comparaison a été fait entre les deux. Les groupes de discussion et l\u27observation participante ont servi d\u27outils de collecte de données. Les analyses ont révélé que měme si toutes les communautés évaluaient positivement leurs services de crise, des limites reliées à la réceptivité, à l\u27accessibilité et aux problèmes systémiques ont été identifiées. L\u27accès rapide aux lits psychiatriques était important pour la livraison des services. Les communautés rurales n\u27ayant pas de transport public, le transport sécuritaire était un rôle important de la police. Dans les communautés rurales, les travailleurs et travailleuses de santé mentale était des généralistes, étant donné qu\u27un seul membre du personnel devaient adresser des situations diverses. Dans les zones urbaines, le transport était plus disponible, et les membres des équipes de santé mentale se spécialisaient davantage

Integrating an Evidenced-Based Research Intervention in the Discharge of Mental Health Clients

The purpose of this Canadian qualitative study was to explore the experiences of clinical staff who implemented a research intervention: the Transitional Discharge Model (TDM). The TDM provided mental health clients who were hospitalized with peer support and an inpatient staff member to bridge the therapeutic transitioning from hospital staff to the community care provider. Staff from three tertiary care mental health facilities in Canada identified their learning needs in regard to providing the intervention. An educational program was developed and delivered to the clinical staff to support and facilitate the implementation of the new TDM. The extent of the utilization of knowledge and implementation of the TDM varied across the three tertiary care mental health facilities. Focus groups (N=49) with clinical staff were conducted to explore various factors related to the training process as well as the challenges and benefits of implementing the TDM. Data were analyzed using Leininger\u27s Phases of Ethnonursing Qualitative Data Analysis [Leininger, M. (2002). The theory of culture care and the ethnonursing research method. In M. Leininger & M. McFarland (eds.), Transcultural nursing: Concepts, theories, research, and practice (3rd ed.). New York: McGraw-Hill]. Findings revealed that clinical staff experienced challenges in roles and responsibilities, relationships with others, values and beliefs of clients, staff and community, resources, and the processes of care. From the findings, strategies were identified to support the integration of knowledge about the TDM into practice and to increase clinical staff\u27s skills in implementing research interventions. These included support from others, as well as support of practice, policy, and education