Hospital-in-the-Home as a Model for Mental Health Care Delivery: A Narrative Review

Matthew Towicz, M.B.B.S. [email protected], Wei Xiao Yang, B.A., Steven Moylan, M.B.B.S., Ph.D., Rachel Tindall, B.N., Ph.D., and Michael Berk, M.B.B.Ch., Ph.D.Authors Info & Affiliations

Publication: Psychiatric Services

Volume 72, Number 12

https://doi.org/10.1176/appi.ps.202000763

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Abstract

Objective: Hospital-in-the-home (HITH) is a service model widely adopted in medical specialties to help alleviate pressure on the availability of inpatient beds and allow patients to receive acute care in familiar surroundings. To date, such models are not widely utilized in mental health care. The authors review existing HITH-type mental health services, focusing on the domains of design, implementation, and outcomes.

Methods: An electronic database search was conducted of MEDLINE, PsycINFO, CINAHL, Embase, Scopus, Web of Science, and Google Scholar. Fifty-six studies were eligible for inclusion in this review. Because of heterogeneous methods and outcome reporting in the available research, a narrative approach was used to highlight key themes in the literature.

Results: Mental health HITH services exist under a wide range of names with differing theoretical origins and governance structures. Common characteristics and functions are summarized. The authors found moderate evidence for a reduced number and length of hospital admissions as a result of mental health HITH programs. HITH is likely to be cost-effective because of these effects. Limited evidence exists for clinical measures, consumer satisfaction, and effects on caregivers and staff.

Conclusions: Mental health HITH services are an effective alternative to inpatient admission for certain consumers. The authors propose a definition of HITH as any service intended to provide inpatient-comparable mental health care in the home instead of the hospital. Standardized studies are needed for systematic analysis of key HITH outcomes.

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Information & Authors

Information

Published In

Psychiatric Services

Volume 72 • Number 12 • December 01, 2021

Pages: 1415 - 1427

PubMed: 34106743

History

Received: 16 October 2020

Revision received: 14 January 2021

Accepted: 12 February 2021

Published online: 9 June 2021

Published in print: December 01, 2021