Welcome to the letter O post in the #AtoZChallenge on mental health. Here goes.
Observation is an essential part of a patient’s care in a mental hospital. In other countries, I’ve heard staff are supposed to check on patients every fifteen minutes or so. Not here. In the Netherlands, if a patient is in their room all day – and yes, most mental hospitals allow this -, no-one cares whether they’re in bed or engaged in some type of activity. Even if patients are in the day room, nurses are more often than not in the office doing their business. As such, I have experienced that nurses “observe” that I had a good day while I was in bed feeling too low to get out all day. Then of course when patients are acting out, nurses have to intervene and “observe” the patients’ misbehavior. This is a pretty sad reality.
One-on-one care is where a staff member is assigned to just one patient who needs a lot of care. This is sometimes also called hand-in-hand care. Few mental health units in the Netherlands offer true one-on-one care even to the sickest of patients. Usually, when a patient needs one-on-one support, they are in a seclusion room most of the time and are allowed out to get their one-on-one attention. I’ve heard about real one-on-one care in other countries. Wonder how they fund it.
Outpatient treatment is often defined as treatment for which the patient has to come to the mental hospital at fixed times during the week or month. However, home treatment, where the mental health provider comes to the patient’s home, is becoming more and more used especially for severely mentally ill people.
Often, care for mentally ill people starts with outpatient treatment. The last step in treatment, after the patient is discharged from the hospital, is also outpatient treatment. This is called stepped care: a person is only stepped up from outpatient to partial hospitalization or inpatent treatment if they need it and is stepped down to outpatient care as soon as possible.