This study measured social functioning, treatment satisfaction and hospital utilization of 88 patients with chronic psychoses before and after a 1-year community mobile team programme, following most of the principles of assertive community treatment. The intervention had a positive impact in all measures. A clinically significant improvement of social functioning, as measured by Birchwood's Social Functioning Scale, was noted in 56% of patients, and 81% of subjects showed a clinically significant increase in satisfaction level. Time hospitalized decreased fourfold and number of admissions decreased twofold. To be certain that the changes found were due to the intervention and not other factors, further prospective studies of mobile community teams versus traditional care are indicated.
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References
1.
Audini, B., Marks, I.M., Lawrence, R.E., Connolly, J. & Watts, V. (1994) Home-based versus outpatient/in-patient care for people with serious mental illness. Phase II of a controlled study. British Journal of Psychiatry, 165, 204-210.
2.
Birchwood, M., Smith, J., Cochrane, R., Wetton, S. & Copestake, S. (1990) The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry, 157, 853-859.
3.
Burns, B.J. & Santos, A.B. (1995) Assertive community treatment: An update of randomized trials. Psychiatric Services, 46, 669-675.
4.
Chandler, D., Meisel, J., Hu, T., McGowen, M. & Madison, K. (1996) Client outcomes in a three-year controlled study of an integrated service agency model. Psychiatric Services , 47, 1337-1343.
5.
Dincin, J., Wasmer, D., Witheridge, T.F., Sobeck, L., Cook, J. & Razzano, L. (1993) Impact of assertive community treatment on the use of state hospital inpatient bed-days. Hospital & Community Psychiatry, 44, 833-838.
6.
Hafner, H. & van der Heiden, W. (1991) Evaluating effectiveness and cost of community care for schizophrenic patients. Schizophrenia Bulletin, 17, 441-453.
7.
Hoult, J., Rosen, A. & Reynolds, I. (1984) Community orientated treatment compared to psychiatric hospital orientated treatment. Social Science and Medicine , 18, 1015-1020.
8.
Ignaczak, M. (1990) Kwestionariusz A-B i skala S - narzedzia do pomiaru satysfakcji pacjentów z opieki psychiatrycznej i odwykowej. Konstrukcja kwestionariusza satysfakcji, parametry psychometryczne. (Questionnaire A-B and S scale - tools for measurement of satisfaction with psychiatric treatment. Questionnaires construction and psychometric properties). Biuletyn Instytutu Psychiatrii i Neurologii, 3/4(80-81)/90, 61-105.
9.
Knapp M., Beecham, J., Koutsogeorgopoulou, V., Hallam, A., FENYO, A. Marks, I.M., Connolly, J., Audini, B. & Muijen, M. (1994) Service use and costs of home-based versus hospital-based care for people with serious mental illness. British Journal of Psychiatry, 165, 195-203.
10.
Konieczynska, Z., Pietrzykowska, B. & Zaborowski, B. (1997) Badania katamnestyczne pacjentów psychotycznych leczonych w oddziale pelnodobowym lub w alternatywnych formach leczenia psychiatrycznego. (A follow-up study of psychotic patients receiving inpatient treatment or alternative forms of psychiatric care). Psychiatria Polska, 5, 615-624.
11.
Lafave, H.G., De Souza, H.R. & Gerber, G.J. (1996) Assertive community treatment of severe mental illness: A Canadian experience. Psychiatric Services, 47, 757-759.
12.
Marks, I.M., Connolly, J., Muijen, M., Audini, B., McNamee, G. & Lawrence, R.E. (1994) Home-based versus hospital-based care for people with serious mental illness. British Journal of Psychiatry, 165, 179-194.
13.
McGrew J.H., Bond, G.R., Dietzen, L., McKasson, M. & Miller, L.D. (1995) A multisite study of client outcomes in assertive community treatment. Psychiatric Services, 46, 696-701.
14.
Prot-Herczynska, K. (1995) Wplyw róznych form opieki pozaszpitalnej na koszty leczenia pacjentów z rozpoznaniem schizofrenii. (The effect of extramural care type on the costs of treatment of schizophrenic patients). Postepy Psychiatrii i Neurologii, 4, 299-313.
15.
Santos, A.B., Hawkins, G.D., Julius, B., Deci, P.A., Hiers, T.H. & Burns, B.J. (1993) A pilot study of assertive community treatment for patients with chronic psychotic disorders. American Journal of Psychiatry,150, 501-504.
16.
Santos, A.B., Deci, P.A., Lachance, K.R., Dias, J.K., Sloop, T.B., Hiers, T.G. & Bevilacqua, J.J. (1993) Providing assertive community treatment for severely mentally ill patients in a rural area. Hospital Community Psychiatry, 44, 34-39.
17.
Santos, A.B., Henggeler, S.W., Burns, B.J., Arana, G.W. & Meisler, N. (1995) Research on field-based services: Models for reform in the delivery of mental health care to populations with complex clinical problems. American Journal of Psychiatry,152, 1111-1123.
18.
Slupczynska-Kossobudzka, E. (1987) Badania nad skutecznoscia oparcia spolecznego. (Research on effectiveness of social support programs). Biuletyn Instytutu Psychiatrii i Neurologii, 4(68), 33-45.
19.
Weisbrod, B., Test, M. & Stein, I. (1980) Alternative to mental hospital treatment. 2. Economic cost benefit analysis. Archives of General Psychiatry,37, 400-405.
