The revolving door phenomenon of hospitalization and relapse is very common among psychiatric patients in Iran.

To examine the effectiveness of a home aftercare service for patients with schizophrenia and bipolar disorders.

Patients admitted to Roozbeh hospital (Tehran, Iran) were consecutively enrolled and were randomized into the home aftercare service and the treatment-as-usual groups. In the home aftercare group, multidisciplinary teams made home visits on a monthly basis that provided education and treatment. The treatment-as-usual group received the existing services. All patients were followed one year after discharge in 4-month intervals in which data about rehospitalisations, symptoms, functioning, quality of life, and service satisfaction were obtained.

A total of 130 patients were enrolled (70 with bipolar disorder and 60 with schizophrenia) and were randomized to receive either home aftercare (66) or treatment-as usual (64). Home aftercare led to greater reduction in mean rehospitalization rate in the follow-up (0.4 in home care vs 0.07 in TAU, p = 0.011). Moreover, patients in the home care group had more improvement in psychotic symptoms (p = 0.003), depressive symptoms (p = 0.003), and clinical global impression of illness severity (p = 0.008), as well as greater patient satisfaction with the service (p < 0.001). In multiple regression analysis, home aftercare and bipolar diagnosis were associated with less rehopsitalization.

Home aftercare is an effective service for patients with severe mental disorders after being discharged from the hospital. Its implementation in aftercare services is suggested.