The effectiveness of community care for people with severe mental disorders
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Arch Psych Psych 2009;11(4):43-49
Background. A constant effort is observed all over the world to displace treatment from mental hospitals and other long stay institutions to a community form of care. Community care is poorly developed in Poland. This induces surveys estimating the effectiveness of community care recently formed. Aim. The aim was to estimate the efficacy of a new community model of treatment of patients with schizophrenia. It was expected that community care decreases hospitalizations and enables better functioning in the environment, which in turn improves their quality of life. Method. The study was carried out on 37 patients and 25 caregivers assessed at the referral to the community care and after one year in care. The study uses PANSS, Birchwood Scale and the Quality of Life Scale. Polish questionnaires: Family Burden Questionnaire and Questionnaire of Burdensome Behaviour were used to measure family burden in the patients' and their relatives' views. The focus group was used to evaluate treatment satisfaction. Cost assessment was made using the data form Administrative Departure of the institution. Results. Improvement in psychic state, contacts with family and satisfaction from life were achieved. Reduction in destructive behaviours was noted. Improvement occurred in withdrawal and undertaking social roles. Reduction in costs occurred due to a major decrease in the length of hospitalisations. Conclusions. Community care enables social inclusion through improving social functioning and subjective quality of life and sense of freedom. The community model is cost effective as a result of reduction of hospitalisations.
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