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Frequency and predictors of adverse events

PRiSM Psychosis Study 3

Published online by Cambridge University Press:  02 January 2018

Sonia Johnson ,
Morven Leese ,
Liz Brooks ,
Paul Clarkson ,
Hilary Guite ,
Graham Thornicroft ,
Frank Holloway  and
Til Wykes
Sonia Johnson*
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London Medical School, London
Morven Leese
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Liz Brooks
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Paul Clarkson
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Hilary Guite
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Graham Thornicroft
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Frank Holloway
Affiliation:
Maudsley Hospital, London
Til Wykes
Affiliation:
Department of Psychology, Institute of Psychiatry, London
*
Dr Sonia Johnson, Department of Psychiatry and Behavioural Sciences, University College London Medical School, 48 Riding House Street, London W1N 8AA
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Abstract

Background

Community care has been criticised as a hazardous policy associated with high rates of adverse events. There is little research evidence as to the truth of this claim.

Method

Best available evidence from public records, interviews, case notes, key workers and general practitioners was assembled to establish: (a) which of the 514 subjects initially identified as having psychotic illnesses had died during an average follow-up of 4.9 years; (b) care currently received by all 286 subjects originally selected for interview; and (c) rates of major adverse events and of admission for these 286 individuals.

Results

Twenty-eight natural and 11 unnatural deaths had occurred. Among subjects still living at the end of the follow-up, 84% were in contact with specialist mental health services and 11% only with primary care services. Rates of serious violence, imprisonment and homelessness were relatively low. Forty-one per cent had been admitted at least once during a mean follow-up of 3.2 years and 20% at least once under the Mental Health Act. After adjustment, there were no significant differences between standard and intensive care sectors.

Conclusions

Rates of adverse events and slipping through the net’ are relatively low among individuals receiving community-based services, whether intensive or standard care.

Type
PRiSM Psychosis Study
Information
The British Journal of Psychiatry , Volume 173 , Issue 5 , November 1998 , pp. 376 - 384
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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