GOOD SUCCESSES WITH PSYCHIATRIC DISEASES IN CHILDREN & ADOLESCENTS THROUGH HOME TREATMENT

GOOD SUCCESSES WITH PSYCHIATRIC DISEASES IN CHILDREN & ADOLESCENTS THROUGH HOME TREATMENT

Austrian Institute for Health Technology Assessment (AIHTA) publishes study on international experience and provides recommendations for Austria

Vienna (Austria), 19. January 2021: The treatment of psychiatric diseases of children and adolescents in their own homes (home treatment) is used successfully internationally and could also be established in Austria if important recommendations are taken into account. These are the core statements of a recently published study by the Austrian Institute for Health Technology Assessment (AIHTA). In this study, 6 international models from 4 countries for such a home-based form of therapy were evaluated which showed clear advantages, especially in the psychosocial field. For an implementation of such a form of treatment in Austria, the AIHTA recommends the coordination with existing therapy offers, the qualification of necessary personnel as well as a necessary resource planning.

Many children and adolescents in Austria are mentally ill, but few are treated adequately: More than one third of 10 to 18 year olds suffer from mental illnesses at some point in their youth, but only for half of them the age-appropriate treatment capacities are available. The treatment of affected persons in their own homes by appropriately qualified persons offers a possibility to relieve treatment resources and to achieve equivalent or even better success. The Austrian Institute for Health Technology Assessment (AIHTA) has analysed the international evidence and now published the results in a recent study.

"HOME REMEDY"

The study compared 6 international home treatment models from 4 countries (3 x from Germany, 1 x each from the Netherlands, the USA and Canada). The children and adolescents in the models were predominantly between 5 - 18 years old, the majority of the models included all psychiatric diagnoses and spanned a treatment duration of 3 - 4 months. The results of an analysis of the effectiveness of these models were then surprisingly clear, as Priv. Doz. Dr Claudia Wild, Director of the AIHTA, comments: "It was clearly shown that home treatment leads to an improvement in the psychopathological symptoms of the children and adolescents. Especially in the case of psychosocial disorders, this form of treatment can make a great contribution. We even found that it can be superior to inpatient treatment in terms of effectiveness. It was also shown that home treatment required fewer hospital stays for the children and adolescents and that these could be of shorter duration. Dr. Wild adds: "However, it is also important to note that not all psychiatric illnesses are equally suitable for treatment at home. It must also be clarified in advance whether the family environment could possibly have a negative influence on the course of the illness. In this case, inpatient treatment would of course be advantageous.

Basis for these clear results was the collection of scientific evidence for the effectiveness of the home treatment within the framework of the models. This evidence focused on changes in symptoms and any need for hospitalisation as well as on the treatment satisfaction of those affected and the need for further treatment. The clear result of the evaluation of these 6 international models and the scientific evaluations makes home treatment a real alternative or supplement to inpatient treatment in the eyes of the AIHTA.

ALSO IN AUSTRIA?

With these facts in mind, the AIHTA, together with multidisciplinary experts, is considering the implementation of home treatment in Austria. The results of this process are also included in the report that has now been published and lead to clear recommendations by the AIHTA. Dr. Wild's team considers the coordination of home treatment with the numerous existing child and adolescent psychiatric services in Austria to be essential. The staff entrusted with home treatment would also have to be trained accordingly and the necessary resources would have to be planned. In order to promote evidence-based development in the field of child and adolescent psychiatry, the AIHTA also recommends an accompanying evaluation of the introduction of home treatment in Austria.

Overall, with this report, the AIHTA shows a practicable and potentially resource-saving way out of the current misery that nationwide care for children and adolescents with psychiatric problems is facing in Austria. In fact, many of them have to be treated in adult psychiatry. Yet, as the AIHTA report shows, the better is so close at hand - namely in the homes of those affected.

Original Publication (in German only. With english executive summary): Wolf, S. und Grössmann, N. (2020): Home-Treatment in der Kinder- und Jugendpsychiatrie: Eine Analyse zur Wirksamkeit und möglichen Implementierung in Österreich. HTA-Projektbericht 129. https://eprints.aihta.at/1275/1/HTA-Projektbericht_Nr.129.pdf

Austrian Institute for Health Technology Assessment Priv. Doz. Dr. phil. Claudia Wild Director Garnisongasse 7/20

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