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A Comparison of Community-Based Care for Schizophrenia in South Verona and South Manchester

Published online by Cambridge University Press:  02 January 2018

Richard Gater ,
Francesco Amaddeo ,
Michele Tansella ,
Gayle Jackson  and
David Goldberg
Richard Gater*
Affiliation:
Mental Illness Research Unit, University of Manchester, Withington Hospital, Manchester
Francesco Amaddeo
Affiliation:
Servizio di Psicologia Medica, Istituto di Psichiatria, Università di Verona, Verona, Italy
Michele Tansella
Affiliation:
Servizio di Psicologia Medica, Istituto di Psichiatria, Università di Verona, Verona, Italy
Gayle Jackson
Affiliation:
Mental Illness Research Unit, University of Manchester, Withington Hospital
David Goldberg
Affiliation:
Institute of Psychiatry, London
*
Dr R. Gater, Mental Illness Research Unit, University of Manchester, Withington Hospital, West Didsbury, Manchester M20 8LR
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Abstract

Background

The community-oriented mental illness services providing care to defined populations in south Verona, Italy (17 628 adults) and south Manchester, England (12 021 adults) have been compared to explore relationships between service organisation and patterns of service use.

Method

The composition and function of the two services and the sociodemographic characteristics of the two centres are described and related to epidemiological data on service use in the community, out-patient clinic, day hospital and in-patient care.

Results

Treated incidence of all psychiatric diagnoses and of schizophrenia were significantly higher in south Manchester than south Verona, indicating that the referral filter between primary and secondary care is more permeable in Manchester. Patients known to the service were more likely to be admitted and to have shorter in-patient stays in south Verona, indicating that the filter between in-patient care and the community is more permeable in Verona than Manchester.

Conclusions

The organisation of services in Verona results in a smaller load on the mental health service; the shorter hospital stays can be related to better integration between hospital and community resources. The organisation of services in Manchester provides care for a greater proportion of the population, but would be likely to require increased resources for the mental health services over time.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 3 , March 1995 , pp. 344 - 352
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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Footnotes

1.

The south Manchester service described in this paper was only available to residents of the Wythenshawe district of south Manchester who were registered with the 11 family doctors linked with the team. This service is not representative of the service available to patients elsewhere in south Manchester.

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