Patients’ experiences and satisfaction with home treatment for acute mental illness: a mixed-methods retrospective study

Abstract

Background

Home treatment (HT) has been proposed as a patient-centred alternative to acute mental inpatient care although evidence of patient-reported outcomes has remained limited.

Aims

The aim of this study was to examine patient experiences and satisfaction with HT.

Methods

This retrospective mixed-methods study included telephone interviews of 159 patients receiving HT between 2016 and 2019. Associations between patients’ characteristics and global satisfaction (ZUF-8 scale) were assessed. Differences between HT patients and inpatients were tested on a propensity score -matched inpatient sample. Qualitative analyses were conducted using thematic analysis.

Results

Global satisfaction with HT was slightly higher than in the inpatient sample (p = 0.019). There was no relationship between satisfaction and patients’ characteristics, such as gender, age, main psychiatric diagnosis, and treatment duration, but satisfaction was higher for patients who perceived HT as their only treatment option. Participants particularly appreciated the person-centred care and practical support whereas staff continuity and medical treatment were main sources of dissatisfaction.

Conclusion

The results indicate that HT seems to be a more patient-centred alternative to inpatient treatment and might close a gap in the psychiatric care of patients who preferred not to use inpatient services but needed higher treatment intensity than outpatient treatment.

Keywords:

• Home treatment
• acute psychiatric care
• crisis
• outreach services
• mental health services
• patient satisfaction

Ethical approval

This study does not fall within the scope of the Swiss Human Research Act and, therefore, ethical authorisation was not required. The local ethics committee of the Canton of Zurich provided a declaration of non-competence for this study (req-2019-00058). All participants agreed to participate in the interview and gave written consent at the beginning of their HT that their medical routine data could be used for evaluation purposes.

Disclosure statement

The authors declare that research was conducted without the presence of any personal, professional or financial relationships that could potentially be a conflict of interest.

Data availability statement

Due to data sensitivity, data cannot be shared publicly.