Conversion of a psychiatric hospital into a community network of mental health and psychiatric care

Abstract

The article describes the process that is taking place in the Hospital Psiquiátrico El Peral in the last 15 years and particularly since 1998. Being the second biggest psychiatric hospital in the country, it has incentivated a process of reconverting functions and resources towards a community model organized within the general health network with the respective social supports for the people with psychic disability, in the framework of the National Plan of Mental Health and Psychiatry of the Health Ministry. The process has advanced along three axis: 1) generation of medium stay programs for the treatment of the most seriously ill patients, with psychosis and pervasive development disorders, that lived in long stay services with the goal of achieving their discharge from the hospital. 2) exit of patients to alternative residential structures (mainly sheltered homes) in the community and 3) transfer of resources for the creation of clinic services inserted in the general health network. Up to date, the population in the long stay services of the hospital, has been reduced by 50%, and technical solutions exist that allow us to be sure that it is possible and desirable to do without the psychiatric hospital as a structure and to convert its functions and resources in a territorial network of services integrated within the general health structure. Today, the main obstacles are the lack of enough resources for the uniform implementation of the model, not only in the health services related to this hospital but throughout the country.