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Home-oriented management programme for people with early psychosis

Published online by Cambridge University Press:  06 August 2018

Paul Fitzgerald*
Affiliation:
Dandenong Hospital, Victoria, Australia
Jayashri Kulkarni
Affiliation:
Dandenong Hospital, Victoria, Australia
*
Correspondence: Dr Paul Fitzgerald, Dandenong Hospital Department of Psychiatry, 134 Cleeland Street, Dandenong, Victoria, 3175, Australia. Fax: 03 9706 8636

Abstract

Background The HOMES (Home-Oriented Management of Early Psychosis) programme is a new home-based management programme for people presenting for the firsttime with psychotic illnesses. The present paper aims to present preliminary data as to the efficacy of this programme and factors identified as being associated with successful prevention of hospital admission.

Method The programme applied to all the people presenting to the Dandenong Hospital Department of Psychiatry with first-episode psychosis who are considered suitable at first assessment for home-based management. A programme description is included in the paper. Prospective evaluation data on the first 31 people managed within the programme is presented.

Results Twenty-two out of 31 people were managed without the necessity for hospital admission. Illness severity was not related to the ability to manage this group of people outside of hospital. The level of social support and duration of untreated psychosis prior to treatment, may be most closely related to home-based treatment success.

Conclusions Home-based management of people with first-episode psychosis is feasible and offers a viable alternative to admission for this group. Home-based treatment is dependent on the degree of social support but is independent of the degree of illness severity.

Type
Research Article
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Andreasen, N. C. & Olsen, S. (1982) Negative v. positive schizophrenia: definition and validation. Archives of General Psychiatry, 39, 789794.Google ScholarPubMed
Bond, G. R., Miller, L. D. & Krumweid, R. D. (1988) Assertive case management in three CMHCs: A controlled study. Hospital and Community Psychiatry, 39, 411441.Google Scholar
Hambridge, J. A. & Rosen, A. (1994) Assertive community treatment for the seriously mentally ill in suburban Sydney: a program description and evaluation. Australian and New Zealand Journal of Psychiatry, 28, 438445.Google Scholar
Heinrichs, D. W., E., Hanlon. T. & Carpenter, W. T. (1984) The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bulletin, 10, 388398.CrossRefGoogle ScholarPubMed
Hoult, J. (1984) Schizophrenia. A comparative trial of community oriented and hospital oriented psychiatric care. Acta Psychiatrica Scandinavica, 69, 359372.Google Scholar
Hoult, J., Reynolds, I. & Charbonneau-Powis, M. (1983) Psychiatric hospital versus community treatment: The results of a randomised trial. Australian and New Zealand Journal of Psychiatry, 17, 160167.CrossRefGoogle ScholarPubMed
Marks, I. M., Connolly, J., Muijen, M., et al (1994) Home-based versus hospital-based care for people with serious mental illness. British Journal of Psychiatry, 165, 179194.Google Scholar
McGorry, P. D. (1992) The concept of recovery and secondary prevention in psychotic disorders. Australian and New Zealand Journal of Psychiatry, 26, 317.Google Scholar
McGorry, P. D., Chanen, A. & McCarthy, E., et al (1991) Post-traumatic stress disorder following recent-onset psychosis; an unrecognised post-psychotic syndrome. Journal of Nervous and Mental Disease, 179, 253258.Google Scholar
Mulder, R. (1985) Evaluation of the Harbinger Program, 1982–1985. Lansig, MI: Michigan Department of Health.Google Scholar
Olfson, M. (1990) Assertive community treatment: an evaluation of the experimental evidence. Hospital and Community Psychiatry, 41, 634641.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) Brief Psychiatric Rating Scale. Psychological Reports, 10, 799812.Google Scholar
Stein, L. I. & Test, M. A. (1980) An alternative to mental hospital treatment. I: Conceptual model, treatment model, and clinical evaluation. Archives of General Psychiatry, 37, 392397.CrossRefGoogle ScholarPubMed
Taube, C. A., Morlock, L., Burns, B. J., et al (1990) New directions in research on assertive community treatment. Hospital and Community Psychiatry, 41, 642649.Google Scholar
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