How are Ambulatory Treatment and Personalised Care Being Implemented in Psychiatry? An Analysis of Eight Years of Activity Records of a Belgian Mobile Crisis Team Developed in the Context of the 'Psy 107' Reform.

Abstract

Since 2009, the 'Reform 107' has been carrying out a substantial transformation of mental healthcare in Belgium, underpinned by two high ideals: ambulatory treatment and personalised care. Whilst there is broad support for the reform, its implementation is not without its problems and little data exists as to its effects. With that in mind, this article endeavours to assess the care provided by a Brussels-based mobile crisis team. Established by funding generated for the reform, this team has taken these ideals fully on board and, as a crisis response measure providing intensive and short-term care, is playing a central role in the organisation and management of mental healthcare across its territory. Therefore, with an approach at the intersection of the sociology of health and the sociology of public action, this article asks the following question: how are these ambitions- ambulatory treatment and personalised care- enacted in concrete terms in this mobile crisis team's care provision practices? The analysis, based on eight years of activity records of this team, has brought to light that, on the one hand, the care interventions provided and patient referrals, when they occur, are for the most part ambulatory, but that hospitalisations still play a prominent role. On the other hand, this mobile team's care provision is personalised, in particular regarding its duration. It emerges that this duration is correlated with certain individual characteristics, but the analyses nevertheless highlight the presence of other circumstantial determinants, calling for more research to be carried out as to their impact.