[AKuT outpatient clinic: cross-sectoral crisis intervention for borderline personality disorder and trauma-related disorders at the Central Institute of Mental Health in Mannheim].

BACKGROUND: Patients with borderline personality disorder or trauma-related disorders often experience psychosocial crises. Due to a lack of promptly available outpatient treatment options, acute care is often provided in a psychiatric emergency department or an inpatient setting. This impedes treatment continuity and fosters hospitalization.

OBJECTIVE: Development and implementation of a hospital-wide treatment concept for crisis intervention at the Central Institute of Mental Health (CIMH) in Mannheim that overcomes sectoral boundaries.

MATERIAL AND METHODS: Presentation of the new patient care concept, which reflects typical clinical challenges during treatment of acute crises. Description of the relation to a treatment model with three pathways, central principles underlying treatment and interfaces with other services.

RESULTS: Disorder-specific treatment strategies from dialectical behavior therapy (DBT) enable a focused, low-threshold crisis intervention and foster the transition to disorder-specific psychotherapy. A central structure is the cross-sectoral outpatient clinic for crisis intervention and therapy commitment (AKuT outpatient clinic) that serves as an interface between inpatient crisis treatment in acute psychiatry and disorder-specific treatment offers in the department of psychosomatic medicine. This establishes a continuum of care from crisis intervention to disorder-specific psychotherapy.

CONCLUSION: Challenges during implementation in an acute psychiatric hospital and possible effects on treatment continuity and hospitalization are critically discussed.