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Ambulatory offers for help

Crisis centres and emergency services

Crises and emergencies in the course of psychotic or bipolar illnesses are considered to be very dramatic for the persons affected, their relatives or other individuals involved, and demand immediate help. Despite these clear demands, the psychiatric health-care system is generally only prepared insufficiently for such crises or emergencies. The primary burden associated with ambulatory emergency care still continues to lie on the shoulders of relatives, passersby, the police, the drivers of ambulances, public affairs offices or the psychosocial services (PSS). This is especially debatable, since the first contact to psychiatry, for many affected persons and their relatives, is made during crises and emergency situations, and the experiences involving insufficient help can influence one's trust in the psychiatric help system both negatively and long-term.
Especially in these emergency situations and during crises, such specialist psychiatric help is frequently lacking. The ambulatory offers for help are naturally also responsible for such crisis situations, although only during daytime office hours. Generally, however, emergencies occur during the night and on weekends. At unfavourable times, the offers for assistance are very limited, especially for those who are affected and who tend to refuse all kinds of help. The following offers for help are then available:

1. The psychosocial services (PSS)
Especially for emergency assistance in the ambulatory field, the psychosocial services play a very important role. The responsibility of the individual psychosocial service is differentiated regionally, that is to say, for example, according to boroughs of a city, districts, etc. Through this regional responsibility, the staff members are frequently very well informed about the local offers for help, clinics, doctors, etc. They make house calls and offer on-site acute crisis interventions.

2. Assertive Community Treatment (ACT) teams
Assertive Community Treatment is an interventional form of therapy which has rarely been introduced in Germany to date. ACT enables an acute and also a more long-term form of intervention to be offered by a team of psychosis experts even at home. The ACT is a multiprofessional team and is made up of specialists, psychologists and/or specialist nursing care professionals. It is active seven days a week, 24 hours a day and offers around-the-clock crisis intervention.

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