Question

How to set up relays within the network to consolidate the gains of an intensive accompanying by a crisis team over the long term and to avoid relapses ?

Problem description

We do not succeed easily in mobilising the available resources around the user and team EMSI

Impact - effect

It becomes difficult to limit the objectives of an intensive accompanying and to relay them, and to avoid problems caused by a strong dependency relationship

To do

To explore :

- Consider an intensive accompanying not as ‘for a duration of 30 days’ but as ‘up to 30 days’, in order to establish relays earlier

- Do not want to be useful for the user, but make efforts to improve the competencies of the network et carers

- Evoke the end of the 2a-intervention from the first contact

- Engage more professionals and family members, search for already present partners, reinforce the priority role of the network (carers, professionals) in the long run

- Maintain your working framework of mobilising family, when the user is reluctant to this way of working

- Maintain, reinforce follow-up contacts 15 days after the 2a intervention.

- Maintain, reinforce the relay contacts in collaboration with professionals working in the continuing care pathway (GP, 2B-team, psychologists…), reinforce consultations

- Continue to build a joint crisis plan, in collaboration with the user and carers

Theme

Starting up and further development/deployment of mobile teams

Topic

critical success factors for starting up and further development/deployment

Reference -  contact

Nicolas Berghe, Dr Virginie Jeanmart

Mobile team

2a

Project

Hainaut Occidental

local support - expert

Frédéric Mauriac

Date

September 2014