Effectiveness of Two Hospitalization Alternatives Compared to Psychiatric Admission: An Ecological Longitudinal Study

Introduction: Although community mental healthcare has been rapidly developing, hospital-based psychiatric admissions are still highly prevalent worldwide. Aims: In this study, we aimed to assess the long-term effectiveness of two novel alternatives to psychiatric admission: Soteria homes and technologically assisted intensive home treatment (TAIHT) compared to hospital admission. Method: A three-center, open-label, longitudinal ecological study was employed in the Sheba psychiatric wards, the Sheba TAIHT, and Soteria houses. Patients (N = 214) were measured for distress, anxiety, depression, quality of life, level of functioning, and psychotic symptoms at admission, discharge, and 3- and 6-month postdischarge. A multilevel modeling (MLM) approach was utilized to assess differences in changes from pre- to posttreatment. Outcome measures included symptom distress (Outcome Questionnaire-45 (OQ-45)), anxiety and depression symptoms (Hopkins Symptoms Checklist-11 (HSCL-11)), psychotic symptoms (Positive and Negative Syndrome Scale-6 (PANSS-6)), quality of life (Manchester Short Assessment of Quality of Life (MANSA)), and functioning (Global Assessment of Functioning (GAF)). Results: Patients in the psychiatric ward demonstrated significantly greater reductions of distress compared to those treated with TAIHT (b = −5.18, p = 0.042) but showed similar levels to Soteria. Soteria exhibited significantly greater improvement of psychotic symptoms compared to TAIHT (b = −2.057, p = 0.0076) but not compared to the psychiatric ward. The psychiatric ward (b = 3.49, p = 0.0068) and Soteria (b = 5.35, p < 0.0001) both demonstrated significantly greater improvements in functioning compared to TAIHT, with no significant differences between them. Conclusion: The findings underscore the effectiveness of psychiatric hospitalization alternatives yet call for the need to investigate further the effectiveness of technologically guided approaches to psychiatric hospitalization. Trial Registration: ClinicalTrials.gov identifier: NCT05431231.