[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.