Foresight - “There's no place like home”: Testing the cost-effectiveness of home treatment for acute mental illness in Ticino

In 2016, the cantonal psychiatric hospital in Ticino closed an acute care unit, and a psychiatric home care service was set up to replace. Studies show that the integration of psychiatric care in the community reduces the number of psychiatric hospitalizations, and favors the process of de-institutionalization. This study aims to analyse the feasibility, acceptance and cost-effectiveness of home treatment for acute psychotic and severl mental disorders crises. The objective is to reduce the risk of relapse while reducing the costs of psychiatric treatment. The study combines three methodological approaches. First, clinical effectiveness of home care will be evaluated by means of quasi-experiments. Patients from the Bellinzona and Valli region will be assigned to the intervention group, those from the Lugano region to the control group (inpatient care). For each group, the number of days of care (stationary) as well as the direct costs of care will be identified and compared. Secondly, the complex interactions between patients, the specialists involved and relatives will be examined using a qualitative approach. Third, the direct and indirect costs (sick days) of the intervention and control groups will be tracked and compared. This study will contribute to a better understanding of the clinical and financial potential of home treatment for acute mental health crisis resolution. It will provide information on the conditions necessary for the success of the treatment, in particular from the point of view of organisation, training of specialists, integration of psychiatric care, and so on.