Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial

Simpson, Chris; Seager, C. P.; Robertson, J. A.

doi:10.1192/bjp.162.2.239

Cited by 18 publications

(32 citation statements)

References 5 publications

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“…This study indicated that the HoVI provided a model to ensure continuous treatment, in which the re-hospitalization rate, average days of hospitalization, and NHI costs were lower than the non-HoVI group. These results were similar to previous research studies (Muijen et al 1992;Simpson et al 1993;Audini et al 1994;Singh et al 2010;Hoult et al 1984;Pelosi and Jackson 2000;Knapp et al 1994, 1998, Burns and Raftery 1991.…”

Section: Discussionsupporting

confidence: 95%

Effects of Home Visit Intervention on Re-hospitalization Rates in Psychiatric Patients

Chang

Chou

2015

Community Ment Health J

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To examine the home visit intervention (HoVI) effects on the re-hospitalization rate and medical costs in patients with schizophrenia or other psychiatric disorders. The subjects who received more than 3 HoVIs were defined as the HoVI group, whereas the subjects who received equal to or less than 3 HoVIs were defined as the HoVI < 4 group; the subjects who had never received an HoVI were defined as the non-HoVI group. Differences in the re-hospitalization rates and National Health Insurance (NHI) costs among the three groups were examined. The re-hospitalization rate of the HoVI group was significantly lower than that of the non-HoVI group. The hospitalization days and the NHI costs of the HoVI group were also lower than those of the non-HoVI group. However, the HoVI < 4 group was not different than the non-HoVI group regarding the re-hospitalization rate or the hospitalization days. The re-hospitalization rate was significantly higher before compared with after the HoVIs. The NHI costs were significantly higher before compared with after the HoVIs. HoVIs (More than 3 HoVIs) produced a lower re-hospitalization rate, number of hospitalization days, and NHI costs in patients who received care through the Home Visit. Project to strengthen the Community Rehabilitation Program.

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Section: Discussionsupporting

confidence: 95%

Effects of Home Visit Intervention on Re-hospitalization Rates in Psychiatric Patients

Chang

Chou

2015

Community Ment Health J

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“…After the 2010 update the total number of included studies has increased to eight. These eight studies randomised a total of 1144 people (Fenton 1979; Fenton 1998; Hoult 1983; Howard 2010; Johnson 2005; Muijen 1992; Pasamanick 1964a; Stein 1975). Please also see Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of participants were psychotic (most suffering from schizophrenia), but there was a substantial representation of other diagnoses such as depression and severe neuroses. Three studies stated how they had used diagnostic criteria for diagnosis (Fenton 1979; Hoult 1983; Muijen 1992). All included people aged 18 years and above of both sexes (except Howard 2010 who included women only).…”

Section: Resultsmentioning

confidence: 99%

Crisis intervention for people with severe mental illnesses

Murphy

Irving

Adams

et al. 2012

Cochrane Database of Systematic Reviews

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Background A particularly difficult challenge for community treatment of people with serious mental illnesses is the delivery of an acceptable level of care during the acute phases of severe mental illness. Crisis intervention models of care were developed as a possible solution. Objectives To review the effects of crisis intervention models for anyone with serious mental illness experiencing an acute episode, compared with ‘standard care’. Search methods We updated the 1998, 2003 and 2006 searches with a search of the Cochrane Schizophrenia Group’s Register of trials (2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE, and PsycINFO. Selection criteria We included all randomised controlled trials of crisis intervention models versus standard care for people with severe mental illnesses. Data collection and analysis We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early from a trial had no improvement. Main results Three new studies have been found since the last review in 2006 to add to the five studies already included in this review. None of the previously included studies investigated crisis intervention alone; all used a form of home care for acutely ill people, which included elements of crisis intervention. However, one of the new studies focuses purely on crisis intervention as provided by Crisis Resolution Home Teams within the UK; the two other new studies investigated crisis houses i.e. residential alternatives to hospitalisation providing home-like environments. Crisis intervention appears to reduce repeat admissions to hospital after the initial ‘index’ crises investigated in the included studies, this was particularly so for mobile crisis teams supporting patients in their own homes. Crisis intervention reduces the number of people leaving the study early, reduces family burden, is a more satisfactory form of care for both patients and families and at three months after crisis, mental state is superior to standard care. We found no differences in death outcomes. Some studies found crisis interventions to be more cost effective than hospital care but all numerical data were either skewed or unusable. No data on staff satisfaction, carer input, complications with medication or number of relapses were available. Authors’ conclusions Care based on crisis intervention principles, with or without an ongoing home care package, appears to be a viable and acceptable way of treating people with serious mental illnesses. If this approach is to be widely implemented it would seem that more evaluative studies are still needed.

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“…By the 1980s medical staff had largely lost their authority as managers and were at risk of becoming ‘peripheralised as dispensers of medicine’ (Gittins 1998, p. 97). Furthermore, the gradual shift towards more community‐focused care had led to a reduction in bed numbers, for some a ‘reflection of their own machismo’ (Simpson et al. 1993).…”

Section: The Continuing Power Base Of Psychiatrymentioning

confidence: 99%

The changing relationship between mental health nurses and psychiatrists in the United Kingdom

Brimblecombe¹

2005

Journal of Advanced Nursing

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Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial

Cited by 18 publications

References 5 publications

Effects of Home Visit Intervention on Re-hospitalization Rates in Psychiatric Patients

Effects of Home Visit Intervention on Re-hospitalization Rates in Psychiatric Patients

Crisis intervention for people with severe mental illnesses

The changing relationship between mental health nurses and psychiatrists in the United Kingdom

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