A recovery-oriented day hospital in psychiatry: A springboard for reintegration

Encephale. 2024 May 23:S0013-7006(24)00092-7. doi: 10.1016/j.encep.2024.02.004. Online ahead of print.

Abstract

Psychiatric disorders are common and can cause psychological disabilities. While the creation of day hospitals (DHs) was intended to direct psychiatric care towards community settings, they may have paradoxically contributed to a form of chronicity. Furthermore, the heterogeneity and lack of evaluation of care within DHs prevent the availability needed to collect objective data on users outcomes. In this article, we aim to describe and measure the effects of a transformation of practice within a sector-based DH initially focused on traditional institutional psychiatry towards a rehabilitation model of care which offers different therapeutic tools, structured in three stages, and whose main objective is professional integration. This retrospective mirror study compares, before and after the transformation of this DH, several indicators including the rate of professional integration and its maintenance after two years. We found that this psychosocial rehabilitation model for care allowed a very clear increase in the professional integration rate and its maintenance at two years while reducing the length of stay to around 18 months. These promising results therefore highlight the pivotal role of DHs as "stepping stones" in addressing psychological disabilities towards recovery.

Keywords: Day hospital; Hôpital de jour; Professional integration; Psychosocial rehabilitation; Recovery; Réhabilitation psychosociale; Réinsertion professionnelle; Rétablissement; Vocational reintegration.