Caring for people with serious mental disorders in their environment

The entire team meets every morning to share information, explain the evolution of each person being cared for and assess the next interventions. In this way, each of them has the necessary information when they visit the person and can work together and multidisciplinary with them.

The people treated, mainly referred from the Adult Mental Health Center or other facilities such as the Acute or Emergency Unit, will receive this intensive care at home for a maximum of three months , with 3 visits a week . In this way, hospitalization is avoided and important aspects can be worked on, such as bonding with the community and the family environment. A large proportion of these people have psychotic and affective disorders, but with the pandemic, anxiety disorders have increased.

Although the agendas are perfectly planned, the five professionals are aware that they can change quickly, and flexibility is the order of the day.

After the morning meeting, it's time to get moving. Each of them has three or four visits scheduled each day . Sometimes, when the situation requires it, they form a tandem. Today, Patrícia Membrive (nurse) and Lucía Rodríguez (psychiatrist) take the car from Sant Joan de Déu to see one of the people being treated together.

The rest of the team will travel by their vehicle or by public transport, depending on the destination address of the four towns they serve: El Prat de Llobregat, Viladecans, Gavà and Castelldefels.

Lucía and Patricia arrive at the home of Víctor, a twenty-year-old boy who has had his first psychotic episode and lives with his family.

"A visit to a home is equivalent to five in a mental health center," the two professionals say. At home, they can see some important things about the person being cared for and their daily behavior: "Whether or not they dress to receive us; whether they have the blinds down; who they live with and how they relate to them; whether what they tell us is consistent with their way of life; etc."

With each person treated, through weekly visits from different professionals, various clinical, psychoeducational and social support aspects are worked on: medication and adherence to treatment; clinical evolution; healthy habits; relaxation and anxiety control; support needs; accompaniment to carry out procedures and procedures; links to community resources; etc. And we also work with the family, a key piece in recovery.

This is the first visit of the morning, but a busy day awaits them, with two more people scheduled.

The rest of the team has also gone to make their visits, three or four each, depending on the day. On many occasions, it will be important to leave the house to be able to work on behavioral and physical activation with the affected person. Take a walk, sit on a bench to talk, accompany them to do some management, link them to community resources, etc. "On the street, you can work on anxiety and fear problems with people who have difficulty leaving the house, or deal with delusional ideas, for example," they tell us. "It allows us to normalize everyday situations, be with the person and simply deal with how they feel, how they face these situations, what are the symptoms they are experiencing...".

All of them have made interventions at home and outings on the street today. In the case of Sandra Monfort , the social worker, one of her tasks is to investigate what the needs are of the person and accompany them, if necessary, to carry out some management or procedure. It is important to empower the people served so that they can use the resources of the community, create a network and can develop autonomously.

Once the visits are done, all that remains is to record the work of the entire day , a task that takes a good amount of time. The five professionals connect via a laptop from wherever it is most practical for them to do so, starting from the last visit. It is also the time to coordinate electronically with other professionals or services and to answer emails.

The day doesn't end there, however, because there is always a query via WhatsApp, a question that they answer or some management that needs to be done to have everything ready for the next day.

Every day is different for this team of professionals who are used to adapting to guarantee the best care for people who are at a very vulnerable time in their lives.