Abstracts
Résumé
Un petit centre (38 lits) de soins tertiaires en santé mentale, situé dans la communauté, a été développé à la suite de la réduction et du remplacement d’un grand hôpital psychiatrique provincial en Colombie-Britannique. Sa mise en place s’est élaborée en deux phases : un projet pilote initial comprenant 12 lits dans deux unités ouvertes (1994-2002) puis la construction d’un établissement de 38 lits qui incluait deux unités sécuritaires (2002-2005). Le projet tentait de démontrer qu’il est possible d’intégrer la réadaptation à un programme qui soigne des patients tenus pour très difficiles à traiter. Cet article en présente la planification et la philosophie, les patients, le programme et le personnel soignant ainsi que les résultats de la phase 1 et certains résultats d’une évaluation formelle échelonnée sur cinq ans pour la phase 2.
Abstract
This article describes a small (38 bed) tertiary mental health facility in the community developed as part of the downsizing and replacement of a large provincial mental hospital in British Columbia. Development took place in two phases : an initial pilot project comprised of 12 beds in two open units (1994-2002) and the subsequent rebuilding as a 38 bed facility which included two secure units (2002 — present). The project has attempted to demonstrate the feasibility of integrating a rehabilitation focus into a program that treats some of the most difficult patients. The planning process and philosophy, the patients, program and staffing are reported, together with the informal results from phase 1 and some of the early results from a formal 5-year evaluation of phase 2.
Resumen
Después de la reducción y el reemplazo de un gran hospital psiquiátrico provincial en Columbia Británica, se desarrolló un pequeño centro de atención terciaria de salud mental (38 camas), situado en la comunidad. Su instalación se realizó en dos fases: un proyecto piloto inicial que comprendía 12 camas en dos unidades abiertas (1994-2002), después, la construcción de un establecimiento de 38 camas que incluía dos unidades de seguridad (2002-2005). El proyecto intentaba demostrar que es posible integrar la readaptación a un programa que atienda a los pacientes considerados muy difíciles de tratar. Este artículo presenta la planificación y la filosofía de dicho proyecto, los pacientes, el programa y el personal de atención, así como los resultados de la fase 1 y ciertos resultados de una evaluación formal escalonada en cinco años para la fase 2.
Resumo
Um pequeno centro (38 leitos) de atendimento terciário em saúde mental, situado na comunidade, foi desenvolvido após a redução e a substituição de um grande hospital psiquiátrico provincial na Colúmbia-Britânica. Sua criação foi elaborada em duas fases: um projeto-piloto inicial que compreendia 12 leitos em duas unidades abertas (1994-2002), em seguida, a construção de um estabelecimento de 38 leitos que incluía duas unidades seguras (2002-2005). O projeto tentava demonstrar que é possível integrar a readaptação a um programa que atende pacientes identificados como de tratamento muito difícil. Este artigo apresenta o planejamento e a filosofia do projeto, assim como os pacientes, o programa e os funcionários, além dos resultados da fase 1 e alguns resultados de uma avaliação formal dividida em cinco anos para a fase 2.
Appendices
Références
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