Reducing violence in severe mental illness: randomised controlled trial of intensive case management compared with standard care.
OBJECTIVE
To establish whether intensive case management reduces violence in patients with psychosis in comparison with standard case management.


METHODS
Randomised controlled trial with two year follow up.


METHODS
Four inner city community mental health services.


METHODS
708 patients with established psychotic illness allocated at random to intervention (353) or control (355) group.


METHODS
Intensive case management (caseload 10-15 per case manager) for two years compared with standard case management (30-35 per case manager).


METHODS
Physical assault over two years measured by interviews with patients and case managers and examination of case notes.


RESULTS
No significant reduction in violence was found in the intensive case management group compared with the control group (22.7% v 21.9%, P=0.86).


CONCLUSIONS
Intensive case management does not reduce the prevalence of violence in psychotic patients in comparison with standard care.
Walsh
E
E
Section of Forensic Mental Health, Guy's King's and St. Thomas's School of Medicine, Institute of Psychiatry, London, UK.
Gilvarry
C
C
Samele
C
C
Harvey
K
K
Manley
C
C
Tyrer
P
P
Creed
F
F
Murray
R
R
Fahy
T
T
D000328:Adult; D019090:Case Management; D003156:Community Mental Health Services / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008131:London; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D019037:Urban Health Services; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data