Introduction In 2016 a new form of integrated community treatment for patients with serious mental illnesses was implemented in two neighborhoods in the city of Utrecht (335000 inhabitants) in the Netherlands. Treatment is characterized by close collaboration of psychiatric care, somatic care (i.e. general practitioner, nurse practitioner), supported housing and other facilities, i.e. the police officer, and is provided in the direct neighborhood of the patients. This ‘neighborhood based integrated mental health care’ should not contribute solely to clinical recovery, but also specifically to social and personal recovery. Objectives The aim of this research was to investigate the experience of patients with serious mental illnesses themselves receiving this new form of neighborhood-based integrated mental health care. More specific the question is studied if and how neighborhood-based integrated mental health care supports personal and social recovery. Methods To assess the experience of patients in depth qualitative semi-structured interviews were conducted with 20 patients. Patients were asked to participate in interviews directly by the researchers, by their case managers and by experts by experience. Interview topics included personal and social recovery, resilience and self-efficacy related to the collective effort of caregivers. Qualitative data was analyzed by three independent researches with the qualitative computer program Tarzan. Strategies to enhance quality of data analysis (respondent validation) and validity (attention to negative cases) were used. Results The study will be finished in January 2019. Conclusions The results, a brief description of the collaborative care methodology offered and experiences of patients, and conclusions will be presented at the ENMESH conference.
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The design of healthcare facilities is a complex and dynamic process, which involves many stakeholders each with their own set of needs. In the context of healthcare facilities, this complexity exists at the intersection of technology and society because the very design of these buildings forces us to consider the technology–human interface directly in terms of living-space, ethics and social priorities. In order to grasp this complexity, current healthcare design models need mechanisms to help prioritize the needs of the stakeholders. Assistance in this process can be derived by incorporating elements of technology philosophy into existing design models. In this article, we develop and examine the Inclusive and Integrated Health Facilities Design model (In2Health Design model) and its foundations. This model brings together three existing approaches: (i) the International Classification of Functioning, Disability and Health, (ii) the Model of Integrated Building Design, and (iii) the ontology by Dooyeweerd. The model can be used to analyze the needs of the various stakeholders, in relationship to the required performances of a building as delivered by various building systems. The applicability of the In2Health Design model is illustrated by two case studies concerning (i) the evaluation of the indoor environment for older people with dementia and (ii) the design process of the redevelopment of an existing hospital for psychiatric patients.
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Bipolar disorder is a severe mental illness with serious consequences for daily living of patients and their caregivers. Care as usual primarily consists of pharmacotherapy and supportive treatment. However, a substantial number of patients show a suboptimal response to treatment and still suffer from frequent episodes, persistent interepisodic symptoms and poor social functioning. Both psychiatric and somatic comorbid disorders are frequent, especially personality disorders, substance abuse, cardiovascular diseases and diabetes. Multidisciplinary collaboration of professionals is needed to combine all expertise in order to achieve high-quality integrated treatment. 'Collaborative Care' is a treatment method that could meet these needs. Several studies have shown promising effects of these integrated treatment programs for patients with bipolar disorder. In this article we describe a research protocol concerning a study on the effects of Collaborative Care for patients with bipolar disorder in the Netherlands.
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