Regionalised tertiary psychiatric residential facilities.

摘要: Aims – Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread closures and downsizing, no country that built asylums in last century has done away with them entirely recent exception of Italy. Differentiated community-based residential alternatives have been developed over past decades, staffing levels range from full-time professional, to daytime only, part-time/on-call. Methods This paper reviews characteristics psychiatric facilities as an alternative hospitals. It describes five factors decision makers should consider: 1. number places needed; 2. levels; 3. physical setting; 4. programming; 5. governance financing. Results In Italy, professional staff since mid-1990s accommodate cohorts patients discharged United Kingdom, experiments hostel wards 1980s shown home-like, small-scale intensive treatment rehabilitation programming can be effective most difficult-to-place patients. More recently Australia, Community Care Units (CCUs) applying this concept. Canadian province British Columbia (BC), Tertiary Residential Facilities (TPRFs) part effort regionalise social services downsize ultimately close its only hospital. Conclusions type service must further addition need forensic, acute-care intermediate-level beds, well such assertive community case management. All these types services, together care, constitute elements a balanced system. As region's plan, potential act hubs expertise not treatment, rehabilitation, integration ser-vice co-ordination severely mentally ill, but also research training. Declaration Interest : None.