[The importance of community services for rehabilitation and social support to decrease psychiatric hospitalization].

GOAL: The evaluation of community services for social support concerning minimalization of psychiatric hospitalizations.

METHOD: Mean duration, global time and the number of stays in hospital ward, day treatment ward and "home hospitalisation"; in two year periods before and after their admission to an Occupational Therapy Workshop (O.T.W.), a Community Home Of Mutual Help (C.H.O.M.H.) or to Community Specialised Social Help Services (C.S.S.H.S.) at home were compared in the group of 73 chronic patients.

RESULTS: In two years after the admission to the social support units, the number of all the hospitalizations was decreased (twice or three times). A mean duration of stay in the hospital ward and in the day treatment ward shortened (from 101 days to 48.4 days, from 108 days to 73.3 days), and "home hospitalisation" prolonged (from 112 days to 190 days). The global time of stay in the hospital and in the day ward became significantly shorter (by 12.2% and 5.1%), but "home hospitalisation" did not change significantly. The most effective was the care of specialised services at home connected with the participation at the same time in one of the day units O.T.W. or the C.H.O.M.H. (16 persons). The minimalization of the number (3x) and the time of staying in the day treatment ward referred to the participants of the O.T.W. or the C.H.O.M.H. (by 7.2%, 7.9%), but not of the C.S.S.H.S. at home.

CONCLUSIONS: Introducing of O.T.W., C.H.O.M.H. and C.S.S.H.S. resulted in a significant reduction of hospital stays. The best results come from the combination of the care given by the daily units (O.T.W. or C.H.O.M.H.) with specialised services at home. The care supplied at the O.T.W. or the C.H.O.M.H. reduced the number and time of staying in the day treatment ward.