A sample group of 39 new patients with acute and severe crises underwent a 4-year follow-up study at the community mental health center in Trieste (CMHC). The CMHC is a full-time service, open 24 hours a day and 7 days a week, and is fully integrated into a network of services which has completely replaced the preexisting mental hospital.
Evaluation shows: 1) a generally good outcome of the initial crisis; 2) a low relapse rate; 3) a tendency towards favourable long-term outcomes.
In terms of practice, voluntary and compulsory hospitalization were avoided in favor of short-term day and night support in the CMHC. There were no suicides, no crimes, no drop-outs. Social adjustment remained unchanged.
Accessibility and continuity of care were favored by not separating special crisis services. Instead, crisis intervention was integrated into a comprehensive Mental Health Service offering a wide range of preventive and rehabilitative responses.
The study demonstrates that the mental health services in Trieste are able to cope with acute crises without psychiatric hospitalization.
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