Revolving door phenomenon: the effect of application of community-based mental health services model at acute psychiatric hospitalization

Objective: 'Revolving door' phenomenon describes patients with severe mental illness who are frequently admitted to hospital. The availability of better resources in the community, particularly outreach programs may play a significant role in reducing relapse and readmission. In this study, we aimed to give brief information about the effect of Zeytinburnu Community Mental Health Center (ZCMHC) organization on the need of acute psychiatric hospitalization. Methods: In order to evaluate the effect of ZCMHC organization, registered patients were investigated for the number of acute hospitalizations. Patients who met the criteria for revolving door phenomenon were followed at least 18 months and the number of previous hospitalizations was compared within 18 months follow-up period. Results: From 18 patients with a previous hospitalization due to revolving door phenomenon, we recorded only 5 hospitalizations were during our follow-up period, while previous hospitalizations were totally 49 in previous 18 months; this difference was also statistically significant. Also some remission has been achieved in positive and negative symptoms and social functionality without a change in the ratio of the use of depot treatment and clozapine. Discussion: Patient follow-up with CMHC system may reduce the number of acute hospitalizations. ZCMHC has adopted a holistic approach in the treatment of patients which has an important role to reach this result.