A Controlled Trial of Home-Based Acute Psychiatric Services

Abstract

While research has shown community-based psychiatric care to be as good as, or better than, hospital-based care, generalisation to clinical practice has been difficult. This prospective, randomised controlled study examined a community-based approach feasible within NHS conditions. Ninety-four patients were randomly allocated to experimental and 78 to control treatments and followed for one year. The groups were well matched apart from an excess of psychotic control patients. No differences in clinical or social functioning outcome were found. Both groups improved substantially on clinical measures in the first six weeks, with some slow consolidation thereafter. There were three suicides in the control group and one in the experimental group. Access to care was better in the experimental group (93% attended assessment) than in the control group (75% attended assessment).

Effective patient–clinician interaction to improve treatment outcomes for patients with psychosis: a mixed-methods design

“…There is widespread evidence in medicine that more comprehensive assessments can lead to more effective treatments. [18][19][20] Second, clinicians asked patients to indicate their satisfaction and wishes. Thus, it focuses the communication on the patient's views and makes it patient-centred.…”

Community mental health teams (CMHTs) for people with severe mental illnesses and disordered personality

“…It did, however, still allow comparison between the two large groups for some outcomes such as death. In the update of this review, two of the studies mentioned adequate concealment of allocation (Burns 1993 while Merson 1992b, did not make this clear.…”

Developments in mental health policy in the United Kingdom

“…Another comparison of home-based care compared to routine hospital based care, in London found similar clinical and social outcomes (Burns et al, 1993a). Access to care was better in the group receiving early home assessments.…”