Community psychiatric nurse teams: intensive support versus generic care.
BACKGROUND
This study evaluated whether a community psychiatric nurse (CPN) team providing a comprehensive aftercare service, using a case management approach, improves psychopathology and social functioning of the long-term mentally ill, and reduces hospital use compared with a generic CPN team.


METHODS
Patients suffering from severe and persistent mental health problems were randomised to intensive aftercare or generic care after referral to the CPN manager. Each group contained 41 patients who were assessed at baseline and at 6, 12 and 18 months by an independent research psychologist. Outcome measures included the GAS, PSE, SAS, patient and relatives' satisfaction, number of admissions, and length of stay.


RESULTS
No difference between the groups was found on any of the outcome measures, despite the much higher number of contacts of the intensive (n = 52) versus generic CPNs (n = 13) and the much greater range of interventions.


CONCLUSIONS
Intensive aftercare for people with persistent mental health problems was not found to be of greater benefit than generic CPN care. Many factors need to be considered for aftercare to be effective, including community resources, process of care, and staff training.
Sainsbury Centre for Mental Health, London.
M
M
Muijen
M
M
Cooney
G
G
Strathdee
R
R
Bell
A
A
Hudson
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000359:Aftercare; D003152:Community Health Nursing; D003191:Comprehensive Health Care; D005260:Female; D006801:Humans; D007902:Length of Stay; D008131:London; D008134:Long-Term Care; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D009746:Nursing, Team; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission; D011568:Psychiatric Nursing; D011618:Psychotic Disorders / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation; D012917:Social Adjustment; D012944:Social Support; D016896:Treatment Outcome