The alternative to a psychiatric hospital admission or to give the necessary support at home for early discharge.
BREVIN Live-In is a unique service in the private sector delivering specialist mental health nursing at home when inpatient admission is being considered or for inpatients treated in hospital but who wish, and are able, to be discharged home.
Round the clock 24/7, live-in or 12hr specialist mental health nursing
The viable alternative to inpatient hospital treatment
Expert aftercare helping to expedite discharge from hospital
Reduced risk of readmission to hospital upon discharge
The benefits of home care
A small proportion of patients with mental illness develop very severe symptoms, where standard outpatient treatment and brief nursing visits delivered by BREVIN Home Treatment are insufficient (see BREVINHome Treatment). Their condition graduates to a degree where there may be an elevated risk of further deterioration of health & self-neglect, or of self-harm or harm to others, which may become manifest if left unsupervised or untreated.
Strong relational security - the professional bond between the member of staff and the patient - enabling development of a safe, therapeutic and trusting relationship, helping to overcome common challenges e.g. motivating a patient, persuading them to adhere to the treatment plan, swaying them from acting is a reckless way
Stable, pro-recovery physical environment in the least-restrictive location
If treatment is delivered by a clinical entity, policies and procedures that maintain safe, effective, well-led, responsive and caring services
Mental health nurses carry out the greater part of this work, whether in a hospital setting or at home, regularly reviewing the patient’s mental state and monitoring their risks, supporting patients and responding to circumstances, engaging and observing them, and liaising with the patient’s doctor to make necessary medication and care plan changes.
The aim with these patients is to safely manage and treat them in the least restrictive environment. The choice of where treatment takes place - whether in hospital or at home - will depend on, amongst other factors:
Patient or carer preference
Illness type and severity
Nature of potential risks
Rate at which illness is changing or responding to treatment
Household make-up (e.g. presence of relatives, carers or young children)
Personal financial circumstances and local resources
Experience of treating clinicians
Thus, a rapidly deteriorating patient who does not consent to voluntary treatment and presents high, unpredictable risks is less likely to be managed outside a psychiatric hospital. Some will need inpatient admission under the Mental Health Act. However, many patients with severe mental illnesses for whom private psychiatric hospital is being considered may not present these risks or, if they exist, are manageable with 1:1 mental health nursing support at home.
Their consultant psychiatrists may be unaware of BREVIN Live-In; patients may prefer to remain at home and continue to have their relatives around them, providing support and caring for them.
2-3 weekly visits by a psychiatrist at set times
24/7 nursing care
Group therapy sessions
Structure/Containment in a group environment
Removal from social and biological stressors
Patients have little control over which professionals are involved in their care
Nurses have: • multiple non-care related and administrative tasks • allocated caseloads of between 4-6 patients • often less experience
If patients present a high risk, an additional nurse may need to be allocated at a further significant daily cost
Hospital surroundings are often not agreeable to many patients
Patients have little influence on their environment or patient composition
Group therapy can be undesirable due to group size, suitability of subject, frequency of sessions, being too unwell or preferring individual therapy
Individual therapy is not generally available
Patients with existing community-based therapists are unable to access their support.
Flexible nursing care, from 12hr, 24hr and live-in
Structure/Containment provided on individual basis
Reviews by psychiatrist as required
Psychiatrist available for advice (as in hospital)
Broader range of individual therapy and other treatments
Patients have more control & choice
Individualised treatment plan, team composition & frequency of sessions
Stronger therapeutic relationships with 1:1, often more experienced staff
Personal management and co-ordination of care
Familiar home surroundings, less disruption & distress
I think I have a mental illness, what do I do?
Brevin’s team of community psychiatric nurses, consultant psychiatrists and psychological wellbeing practitioners can help.