Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T17:41:58.327Z Has data issue: false hasContentIssue false
  • English
  • Français

Community Psychiatric Nurse Teams: Intensive Support Versus Generic Care

Published online by Cambridge University Press:  02 January 2018

Matt Muijen ,
Margaret Cooney ,
Geraldine Strathdee ,
Ray Bell  and
Annette Hudson
Matt Muijen*
Affiliation:
Sainsbury Centre for Mental Health, London
Margaret Cooney
Affiliation:
Maudsley Hospital, London
Geraldine Strathdee
Affiliation:
Maudsley Hospital, London
Ray Bell
Affiliation:
Community Mental Health, Greenwich Health Authority, London
Annette Hudson
Affiliation:
Community Mental Health, Greenwich Health Authority, London
*
Dr M. Muijen, Director, Sainsbury Centre for Mental Health, 134/138 Borough High Street, London SE1 1LB
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

This study evaluated whether a community psychiatric nurse (CPN) team providing a comprehensive aftercare service, using a case management approach, improves psychopathology and social functioning of the long-term mentally ill, and reduces hospital use compared with a generic CPN team.

Method.

Patients suffering from severe and persistent mental health problems were randomised to intensive aftercare or generic care after referral to the CPN manager. Each group contained 41 patients who were assessed at baseline and at 6, 12 and 18 months by an independent research psychologist. Outcome measures included the GAS, PSE, SAS, patient and relatives' satisfaction, number of admissions, and length of stay.

Results.

No difference between the groups was found on any of the outcome measures, despite the much higher number of contacts of the intensive (n = 52) versus generic CPNs (n = 13) and the much greater range of interventions.

Conclusions.

Intensive aftercare for people with persistent mental health problems was not found to be of greater benefit than generic CPN care. Many factors need to be considered for aftercare to be effective, including community resources, process of care, and staff training.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 2 , August 1994 , pp. 211 - 217
Copyright
Copyright © Royal College of Psychiatrists, 1994 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bachrach, L. L. (1980) Overview: model programs for chronic mental patients. American Journal of Psychiatry, 137, 1023–1031.Google Scholar
Bachrach, L. L. (1981) Continuity of care for chronic mental patients: a conceptual analysis. American Journal of Psychiatry, 138, 1449–1455.Google Scholar
Bond, G. R., Miller, R. D. & Krumwied, R. D. (1988) Assertive case management in 3 CMHC's: a controlled study. Hospital and Community Psychiatry, 39, 411–418.Google Scholar
Borland, A., McRae, J. & Lycan, C. (1989) Outcomes of five years of continuous intensive case management. Hospital and Community Psychiatry, 40, 369–376.Google ScholarPubMed
Braun, P., Kochansky, G., Shapiro, R., et al (1981) Overview: deinstitutionalization of psychiatric patients, a critical review of outcome studies. American Journal of Psychiatry, 136, 736–749.Google Scholar
Buell, G. & Anthony, W. (1975) The relationship between patient demographic characteristics and rehabilitation outcome. Community Mental Health Journal, 12, 208–214.Google Scholar
Department of Health (1990) The Care Programme Approach for People with a Mental Illness Referred to the Special Psychiatric Services (HC(90)23,LASSL(90)11). London: DoH.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. L., et al (1976) The Global Assessment Scale. A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.Google Scholar
Franklin, J., Solowitz, B., Mason, M., et al (1987) An evaluation of case management. American Journal of Public Health, 77, 675–678.Google Scholar
Goering, P., Wasylenski, D., Farkas, M., et al (1988) What difference does case management make? Hospital and Community Psychiatry, 39, 272–276.Google Scholar
Greenwich Health Authority (1991) Health in Greenwich 1990. A Report on the Health of the People for the Greenwich Health Authority. London: Greenwich Health Authority.Google Scholar
Griffiths, R. (1988) Community Care: Agenda for Action. London: HMSO.Google Scholar
Hedlund, J. L. & Vieweg, B. W. (1980) The Brief Psychiatric Rating Scale: a comprehensive review. Journal of Operational Psychiatry, 11, 48–63.Google Scholar
HMSO (1989) Caring for People: Community Care in the Next Decade and Beyond. London: HMSO.Google Scholar
Hoult, J. & Reynolds, I. (1983) Psychiatric Hospital Versus Community Treatment: A Controlled Study. New South Wales: Department of Health.Google Scholar
Larsen, D. H., Attkison, C. C., Hargreaves, W. A., et al (1979) Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning, 2, 197–207.Google Scholar
McRae, J., Higgins, M., Lycan, C., et al (1990) What happens to patients after five years of intensive case management stops? Hospital and Community Psychiatry, 41, 175–179.Google ScholarPubMed
Meltzer, D., Hale, A. S., Malik, S. H., et al (1991) Community care for patients with schizophrenia one year after hospital discharge. British Medical Journal, 303, 1023–1026.Google Scholar
Muijen, M., Marks, I. M., Connolly, J., et al (1992a) The Daily Living Program: preliminary comparison of community versus hospital based treatment for the seriously mentally ill facing emergency admission. British Journal of Psychiatry, 160, 379–384.CrossRefGoogle ScholarPubMed
Muijen, M., Marks, I. M., Connolly, J., et al (1992b) Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749–754.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799–812.Google Scholar
Stein, L. J. & Test, M. A. (1980) Alternative to mental hospital treatment. 1: Conceptual model, treatment program and clinical evaluation. Archives of General Psychiatry, 37, 392–397.Google Scholar
Wasylenki, D., Goering, P., Lancee, W., et al (1985) Psychiatric aftercare in a metropolitan setting. Canadian Journal of Psychiatry, 30, 329–336.Google Scholar
Weissman, M. M., Paykel, E. S., Siegel, R., et al (1971) The social role performance of depressed women: comparisons with a normal group. American Journal of Orthopsychiatry, 41, 390–405.Google Scholar
White, E. (1990) Surveying CPNs. Nursing Times, 86, 62–66.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego System. London: Cambridge University Press.Google Scholar
Wooff, K. & Goldberg, D. P. (1988) Further observations on the practice of community care in Salford. British Journal of Psychiatry, 153, 30–37.Google Scholar
Wooff, K., Goldberg, D. P. & Fryer, T. (1988) The practice of community psychiatric nursing and mental health social work in Salford. British Journal of Psychiatry, 152, 783–792.Google Scholar
Wright, R. G., Heiman, J. R., Shupe, J., et al (1989) Defining and measuring stabilization of patients during 4 years of intensive community support . American Journal of Psychiatry, 146, 1293–1298.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.