Outcome of case management based on the strengths model compared to standard care. A randomised controlled trial.
BACKGROUND
The outcome of less intensive case management services, such as the strengths model, is still inconclusive, which suggests a need for more controlled studies. The aim of the present study was to investigate the outcome of a strengths model of case management service (SCM) compared to standard care.


METHODS
Seventy-seven clients with a mental illness and a serious impairment in functioning in social contacts, housing or work situation were randomly allocated to SCM or standard care. Outcome was assessed with regard to use of psychiatric services, changes in symptomatology, psychosocial functioning, social network, needs for care, quality of life and client satisfaction with care. The follow-up period was 36 months.


RESULTS
The results showed a greater reduction in needs for care in clients receiving SCM. No differences in clinical or social outcome were shown. Clients receiving SCM also used significantly less days in psychiatric inpatient services and were generally more satisfied with the psychiatric services offered.


CONCLUSIONS
SCM failed to improve clinical and social outcome compared to standard care, but was more successful in reducing days spent in hospital, and the clients were also more satisfied with the service compared to standard care.
Björkman
Tommy
T
Department of Clinical Neuroscience, University Hospital, Lund, Sweden. tommy.bjorkman@psykiatr.lu.se
Hansson
Lars
L
Sandlund
Mikael
M
D000328:Adult; D000704:Analysis of Variance; D019090:Case Management / Q000458:organization & administration*; D003156:Community Mental Health Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D012917:Social Adjustment; D018709:Statistics, Nonparametric; D013548:Sweden