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The British Journal of Psychiatry 173: 385-390 (1998)
© 1998 The Royal College of Psychiatrists
T Wykes, M Leese, R Taylor and M Phelan
Department of Psychology, Institute of Psychiatry, London.
BACKGROUND: Community care for people with psychosis can be provided via several different service models. The study compared two models: standard community treatment with high patient: staff ratios, and intensive community treatment in which there was more of an emphasis on community involvement and lower patient:staff ratios. METHOD: All people fulfilling diagnostic criteria for psychosis and living in two defined geographical areas in south London were identified. These people were provided with either an intensive or standard service depending on their address. Their social behaviour and symptoms were measured at the beginning of the study and after two years. RESULTS: There is little evidence of any effects of the two service models on levels of symptoms. However, the standard service did seem to be advantageous in reducing social disability for those with medium or low levels of disability. CONCLUSIONS: The effect of intensive community services was the opposite to that predicted. Despite improvements in outcomes (e.g. hospital admission), there were no advantages for this type of service in the measures of disability or symptoms. In fact, the standard service was effective in reducing disability, whereas in the intensive service there was no change.
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