Description
Rapid changes are taking place in the practice of psychiatry and nowhere is this more pronounced than in its community aspects. Although much that has changed sometimes appears to have done so without adequate forethought or research there is already a considerable body of knowledge that underscores recent developments. In this book, first published in 1995, prominent researchers in this expanding subject debate the implications of knowledge derived from a variety of sources, and look ahead to impending developments that will need further research enquiry. The chapters are wide in scope and topical in content and the discussions after each are frank and informative. This book will be of help to all those involved in the organisation of psychiatric care.
Chapter
2
Evaluation of community treatments foracute psychiatric illness
Possibility of a meta-analysis
Patients included in each study
Demographic and diagnostic variables
Outcome of experimental and control treatments
Can such treatments be sustained?
3
Synopsis of the Daily Living Programme forthe seriously mentally ill: a controlledcomparison of home and hospital based care
Funding and staffing of the study
Outcome of the first phase (months 0—20)
Preliminary results of the second (partial withdrawal) phase
What DLP care did not achieve
Training in home based care
4
Evaluation of a complete community service
5
Early intervention study ofpsychiatric emergencies
History of the Early Intervention Service
Implications of the findings in conjunction with those of other studies
6
Evaluation of psychiatric services:the merits of regular review
Evaluation of psychiatric services
Other methods of service assessment
7
A home based assessment study
Team structure and resources
The most provocative findings
Is the service sustainable and generalisable?
8
Home treatment as an alternative to acutepsychiatric inpatient admission: a discussion
Why the interest in home based treatment?
Possible advantages of home based care
Assessing studies of alternatives to admission
UK studies of community alternatives to inpatient care
Observations on the home care literature
9
The toxicity of community care
What makes up a community mental health service?
What should a community psychiatric service do for patients?
Measuring the toxicity of services
10 Community mental health services: towardsan understanding of cost-effectiveness
Principles of cost evaluation
Like with like comparisons
Merging costs and outcomes
Towards an understanding of cost-effectiveness
11
Future research strategies
The randomised controlled trial
Alternatives to randomised controlled trials
Identification of subgroups for study
Training of staff for community care