Day hospital as one of structural links in hospital replacing psychiatric care

Ter-Israelyan Alexey Yurievich, Evdokimova Tatiana Egorovna, Pechenkina Anna Alexeevna

Topicality. For the last ten years there is an ongoing reform in Moscow psychiatric care service, its paradigm is about to change fundamentally, increased attention is given to non-hospital care, that is, to outpatient local psychiatric care service, day hospitals with new medical care structures, such as intensive psychiatric care and medical care and rehabilitation departments. Purpose of research. The article presents the analysis of non-hospital link – a day hospital – for the 2016-2018 period. It analyzes the patient population admitted for treatment to day hospital, shows their age and gender composition, the cases of short-term incapacity to work, their interaction with new non-hospital facilities - intensive psychiatric care and medical care and rehabilitation departments. Results. In the course of reforms in psychiatric service with redistribution of load to hospital-replacing structures, including day hospital, the number of re-treatinig patients remains rather high. In the period of 2016 -2018 this category of patients has been represented by the following numbers: 2016 – 969 persons (15,0%) of all those treated at the medical faclility, 2017 - 982 persons (14,8%), 2018 – 847 persons (14,7%). Two per cent of the patients having undergone day hospital treatment, have been admitted there in the following numbers: in 2016 - 15 persons (1,5%), in 2017 – 12 persons (1,2%), in 2018 – 10 persons (1,1%). The numbers of patients having taken part in psychological educational programs is the following: in 2016 - 76 patients (7,8%), in 2017 – 78 patients (7,9%), in 2017 – 77 patients (9,1%). Conlusions. In this way, positive developments have been made in the work of day hospital and other new hospital replacing facilities. There is still a need to implement further reforms.

Keywords:Day psychiatric hospital, paradigm, stigmatization, resistance, intensive psychiatric care department, medical care and rehabilitation department.