A study of client-focused case management and consumer advocacy: the Community and Consumer Service Project.
OBJECTIVE
The study investigated the provision of client-focused services to community-based clients with schizophrenia and bipolar disorder. It hypothesised that the delivery of more client-focused services would improve client outcome in terms of functioning, disability and satisfaction with services. Client-focused services were developed using an empowerment model of case management and by the addition of consumer advocates.


METHODS
Clients referred for case management were randomly allocated to one of three groups: standard case management (n = 35), client-focused case management (n = 39), or client-focused case management plus consumer advocacy (n = 45). Measures of functioning, disability, quality of life, burden of care and service satisfaction were measured at baseline and 12 months. Outcome data were collected concerning number and duration of hospital readmission, crisis intervention and compliance with treatment and services.


RESULTS
While there were no differences between the groups on quantitative measures of functioning, disability, quality of life, service satisfaction and burden of care, there were significant between-group differences on qualitative measures of satisfaction with services.


CONCLUSIONS
Several methodological difficulties hampered interpretation of the findings. Although clients did not differ on outcome measures of functioning and disability, the group receiving client-focused case management reported greater satisfaction with service delivery.
O'Donnell
M
M
Psychiatry Unit, Prince of Wales Hospital, Randwick, New South Wales, Australia. o'donnellmc@sesahs.nsw.gov.au
Parker
G
G
Proberts
M
M
Matthews
R
R
Fisher
D
D
Johnson
B
B
Hadzi-Pavlovic
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D019090:Case Management; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000592:standards*; D003254:Consumer Advocacy; D003258:Consumer Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D011897:Random Allocation; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology