Adolescent Medicine & Child Psychology

Biography

Biography: Nikolaus Blatter

Abstract

Since the 1980s the treatment-first paradigm has dominated the support of clients with mental and drug disorders in Austria. The access-threshold for social service was high for the patient, especially for client with pronounced symptoms whose support was difficult. This led to a considerable number of people who are affected by homelessness. As a result they get treated in the homeless treatment sector. In 2014 the policy of Vorarlberg (Austria) implemented the “psychiatry concept 2015-2025” which includes ten projects to improve the support of community psychiatry. “Psychiatric home care service” was one of these projects and started in 2015. The aim of this present long-term study was to evaluate the C O M E program which started in 2016 and included 52 probands. Our hypothesis was that the C O M E program enables clients to live a more independent life including permanent housing, decrease stays in hospital, improve a long-term mental stability and encourage them in the development of alternative assistance for mutual support. Moreover this support program should enable the caregiver in their daily work. The C O M E program is based on the theoretical foundation of housing first and treatment first. The abbreviation stands for: cooperation, observation, mutual-support and evaluation. A crucial part of the data collection is done by the assessment sheet which is scored at least one time a week. The data collection also includes report-data and medical history. Over a time-period of 42 weeks we found that continuous abstinence from drugs and alcohol is an important criterion for a better cooperation between client and caregiver. Abstinence is not a necessary requirement to get a care-giver-support in the C O M E program. Finally, it is necessary to keep the contact, even if the client denies the contact.