Criteria for evaluating the effectiveness of psychiatric home care-mobile team: A systematic review of the literature.

AIM: To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades. DESIGN: Systematic review of the literature. METHODS: We included 24 studies published between January 2010 and October 2023. DATA SOURCES: CINAHL, APA PsycInfo, Embase, Scopus and PubMed. RESULTS: The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network. CONCLUSION: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork. IMPACT: Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction. REPORTING METHOD: The authors adhered to PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

[The new nursing professions in psychiatry: One man's dream, another man's nightmare?] / Les nouvelles professions infirmières en psychiatrie, rêve des uns, cauchemar des autres ?

The deployment of case management and advanced nursing practice is shaking up the roles of the various professionals on mental health teams, and the usual organization of care in psychiatry. These changes can be perceived as either positive or worrying, depending on each individual's role and position. For the past 3 years, the mobile teams of the Centre rive gauche cluster at Le Vinatier hospital have been organized according to the principles of Flexible Assertive Community Treatment, and include an advanced practice nurse (APN) on their staff. The roles of the case manager and the APN have been rethought. A number of measures have facilitated the implementation of these new functions.

[Addictions in the elderly: the viewpoint of an IPA working in EMPSA]. / Les addictions chez le sujet âgé : regard d'une IPA exerçant en EMPSA.

Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers.

[Activities of the "Amae" mobile team for early intervention in perinatal care]. / Activités de l'équipe mobile d'intervention précoce en périnatalité "Amae".

In 2023, the "Amae" mobile perinatal early intervention team in the child psychiatry department of the Pitié-Salpêtrière hospital followed 49 families for almost 412 home visits. The coexistence of biopsychosocial vulnerability factors was the rule. Generally requested by maternity hospitals (45% in antenatal care), the team offers care focused on parent-child bonds during visits at home, and facilitates the articulation of the different fields involved in contexts at high risk of care breakdown.

[Perinatal homecare in a context of adversity]. / Le travail à domicile en périnatalité dans un contexte d'adversité.

The parent-baby unit at the Jean-Verdier hospital in Seine-Saint-Denis offers outpatient and mobile care. Migrant families in extremely precarious situations, often with traumatic histories, are met. Home visits facilitate access and continuity of care. Nonetheless, this work and the broader context in which it is carried out have an impact on the therapists' experience and care methods. This makes it all the more essential to have a co-therapy system in place, to take primary needs into account and to support mothering care in therapeutic work.

Mobile care - a possible future for emergency care in Sweden.

INTRODUCTION: Provision of mobile care at the home of patients appears to become necessary as the population becomes increasingly older. But there are challenges in moving emergency care from hospitals to the home of patients. The aim of the study was therefore to describe the experiences of the mobile care in Sweden. METHOD: Semi structured interviews were conducted with 12 persons with experience of mobile care in Sweden, such as nurses, physicians, civil servants and politicians. Qualitative latent content analysis was used as an analysis method. RESULT: The results show that cooperation is of utmost importance to achieve functioning mobile care. Cooperation both on an inter-organizational level and on a close team-work is required for all of the involved parties in mobile care to take on a joint responsibility for the patient. As mobile care is primarily provided to elderly multimorbid patients, a comprehensive view on patient care is required in which the patient and their relatives experience security. CONCLUSION: Mobile care is seen as a moving care that comes to the seeking person and not the other way around. The resources are distributed where they make the most use, that is, closest to the individual. Mobile care is seen as a complement to the traditional hospital care. This means a different way of working that requires close collaboration between different categories of personnel and organizations, where there should not be any discussions about boundaries, rather, the discussion should include patient's needs and situation instead.

[Mobile child psychiatric team in French Guiana: Analyzing Amerindian teenager issues]. / Équipe mobile de pédopsychiatrie en territoire guyanais : questionnement de l'adolescent amérindien.

INTRODUCTION: Since their French naturalization in 1969, Amerindians of French Guiana have been facing a full and fast reorganization of their way of life. Teenagers, at the forefront of this cultural transition, are challenging French school institutions, as well as cultural society and care system organizations in Amazonian French remote villages. Rates of autolytic behaviors such as toxic substance abuse or suicide attempts, but mostly completed suicides, are alarming among this adolescent population. To improve care delivery to those teenagers, a mobile child psychiatric team was implemented in 2013. METHODS: We describe this device, its activities and the problematics encountered. RESULTS: This team's purpose is to lead a psychiatric evaluation of teenagers in order to determine a possible psychiatric diagnosis and elaborate a care plan. Although the results are mostly encouraging, this device seems to show some limitations: lack of time dedicated to these interventions, lack of psychiatric care available for follow-up in these villages, tremendous numbers of social distress situations implicated in psychological issues. Moreover, it appears that cultural aspects must be considered in the analysis of the Amerindian adolescent population's issues and the determination of providing care. CONCLUSION: Implementation of actions based on more educational and social levels might be a solution.

[Caregiver in a mobile geriatric team, a new profession]. / Aide-soignante en équipe mobile de gériatrie, un nouveau métier.

The caregiver plays a key role in the mobile geriatric team. She has a very varied activity. She performs geriatric assessments, evaluates toilets, transmits geriatric culture, maintains the city-hospital link, intervenes in residential facilities for dependent elderly people (Ehpad), performs post-emergency telephone interviews and provides training to paramedics. Testimonial.

[The transitional mobile team, psychiatric care upon release from prison]. / L'équipe mobile transitionnelle, des soins psychiatriques en sortie de prison.

The "transitional mobile team" has been developed to optimize the management of the transition from prison to the community for people with psychiatric disorders in France. The objectives are to limit the risk of relapse and death during this high-risk period and to ensure the links between psychiatry in prison and community psychiatry.

[From palliative care... to the palliative approach in paediatrics: 10 years on]. / Des soins palliatifs... à la démarche palliative en pédiatrie : état des lieux 10 ans après.

There are 24 regional pediatric palliative care resource teams (ERSP) in metropolitan and overseas France. An initial review of the ERSPs was carried out in 2015. The ERSP commission of the Société française de soins palliatifs pédiatriques (French Society for Pediatric Palliative Care) wanted to review the situation again, ten years after the creation of these teams. This article presents the main findings.

[Weaving with Ti-Sage]. / Tisser avec Ti-Sage.

The Ti-Sage mobile geronto-psychiatry team provides semi-emergency care in the Sud Bretagne public mental health establishment sector. The system favours fluidity and responsiveness. Requests can be made by telephone without filling in a form. The multidisciplinary team assesses the disorders, directs and ensures follow-up as close as possible (living and care areas), quickly (within forty-eight hours), with the aim of forging links and avoiding inappropriate hospitalisations. Interventions are carried out in all the geriatric care structures in the area, by visit or telemedicine. The team works in a network to coordinate care with care partners and offer support to carers.

Toward Cholera Elimination, Haiti.

This study describes the apparent discontinuation of cholera transmission in Haiti since February 2019. Because vulnerabilities persist and vaccination remains limited, our findings suggest that case-area targeted interventions conducted by rapid response teams played a key role. We question the presence of environmental reservoirs in Haiti and discuss progress toward elimination.

[Nurse in a mobile psychiatric team for the elderly, an area of expertise within a network]. / Infirmier en équipe mobile de psychiatrie, une expertise au sein d'un réseau.

The elderly subject's mobile psychiatric team goes to meet the patient out of hospital. Its aim is to assess patients, guide their care, and train health professionals and social workers in the psychiatry of the elderly patient. The nurse's autonomy and expertise are essential to her functioning. Feedback from the Corentin-Celton Hospital in Issy-les-Moulineaux (Assistance Publique-Hôpitaux de Paris, 92).

[The philosopher to the aid of the anxious caregiver in the time of COVID-19]. / Le philosophe au chevet du soignant angoissé en période de Covid-19.

Based on a clinical situation of a patient infected with COVID-19, the caregivers of the Saint-Étienne mobile psychiatric team describe their anxieties. Are the procedures carried out appropriate? Did we respect the safety measures? Are we at risk of contracting the virus and contaminating other people? The scientific discourse of "experts", who used to guide our actions, has throughout this crisis been inadequate and people's beliefs have crumbled. This abandonment is a source of anxiety for everyone, an anxiety about death. However, this reflection should kindle hope, a precious emotion for those working with patients in psychiatry.

Do Home-Based Psychiatric Services for Patients in Medico-Social Institutions Reduce Hospitalizations? Pre-Post Evaluation of a French Psychiatric Mobile Team.

World Health Organization recommends the implementation of alternatives to full-time hospitalizations. Psychiatric home-care has known a worldwide development in the last 20 years. The psychiatric mobile team for social and medico-social institutions in Saint-Etienne, France, (Equipe mobile d'intervention en établissements Sociaux et Médico-sociaux, ESMS) aims to support professionals from medico-social housing institutions (MSHI) in order to maintain people in housing. The objective of the study was to evaluate the efficiency of home-based interventions to reduce hospitalizations and improve collaboration between psychiatric hospital facilities and MSHI. We used a pre-post study design. A same cohort of patients living in a MSHI one year before intervention and one year after implementation of the ESMS was studied. Hospitalizations were compared between the two periods. A survey was conducted for qualitative evaluation among professionals in MHSI. Sixty-three patients were included. Most patients suffered from psychotic disorders (71%). We found a significant decrease in the mean number of admissions per year from 2,06 to 1,48 (Wilcoxon signed rank test; df64; p = 0,01). Mobile-team interventions included answering phone calls, home visits, coordination meetings, or clinical interviews with patients in inpatient and outpatient services, with an average of 9,3 interventions per patient (SD = 11,4). ESMS was evaluated as "essential" for 73% of 11 professionals from MSHI who answered the questionnaire in May 2017. Assertive Community Treatment and Crisis Resolution Teams are the most studied home-care models in psychiatry. Our results tend to show the efficiency of mobile-team interventions in MSHI, to enhance partnerships.

[Softly-softly]. / L'air de rien.

The missions of the mobile psychiatric team in Lyon involve reaching out to vulnerable people to guide them towards the most appropriate care. Establishing a bond and finding the right words to engage with them constitute a balancing act which the caregiver must undertake with the homeless. It is important to try and understand the situation, the person's life story, invent alternatives, while refraining from pushing them too much, in order to maintain their trust.

[Nursing practice in the mobile old age psychiatry team]. / L'exercice infirmier en équipe mobile de psychiatrie du sujet âgé.

Since 2015, the mobile old age psychiatry team of the Maison-Blanche public health facility has been providing mental health and psychiatric services to the population aged 70 and over in three districts of Paris and four psychiatric sectors. The team's nurses actively take part in delivering care in the home and in maintaining the autonomy of elderly patients suffering from mental health disorders. They provide global care, both somatic and psychiatric, and offer, through their assessments, an initial response to the suffering expressed by the patients and their family.

[Developing the valuable contribution of the nursing role in a palliative care mobile team]. / Valoriser la richesse du rôle infirmier en équipe mobile de soins palliatifs.

A Swiss palliative care mobile team shares its atypical experience resulting from the lack of a permanent doctor within the team because of recruitment difficulties, over a 16-month period. The positive result of this situation was the development of the nursing team's expertise and the experience of a remote constructive cross-discipline approach.

[Psychiatry and palliative care, collaboration for the benefit of the patient]. / Psychiatrie et soins palliatifs, une collaboration au service du patient.

As palliative care units continue to develop, the provision of end-of-life care for patients with a chronic mental illness needs to be addressed. Aside from the somatic comorbidities to which these patients are particularly exposed and in view of the specificity of psychiatric treatment, the forms of end-of-life support for a patient with schizophrenia are described here, based on the experience of a psychiatric unit in the Var region.

[Family competence, an ally in patient home care]. / La compétence familiale, une alliée dans la prise en charge des patients au domicile.

Systemic therapy allows collective awareness with respect to a designated individual problematic. This approach, which can take place at the family home, allows everyone to exploit possible areas of expression and speak freely. Account of a mobile unit care in Paris.