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Effects of community services on disability and symptoms

PRiSM Psychosis Study 4

Published online by Cambridge University Press:  02 January 2018

Til Wykes ,
Morven Leese ,
Ruth Taylor  and
Michael Phelan
Til Wykes*
Affiliation:
Department of Psychology, Institute of Psychiatry, London
Morven Leese
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Ruth Taylor
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Michael Phelan
Affiliation:
Charing Cross Hospital, Fulham Palace Road, London
*
Til Wykes, Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
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Abstract

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.

Type
PRiSM Psychosis Study
Information
The British Journal of Psychiatry , Volume 173 , Issue 5 , November 1998 , pp. 385 - 390
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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