THE CAMDEN SCHIZOPHRENIA SURVEYS .1. THE PSYCHIATRIC, BEHAVIORAL AND SOCIAL CHARACTERISTICS OF THE SEVERELY MENTALLY ILL IN AN INNER LONDONHEALTH DISTRICT

Background. The development of appropriate community care requires kno wledge of the characteristics of the severely mentally ill. Method. Al l patients with a broad diagnosis of schizophrenia (n=528) were identi fied via key informants within an inner London health district; Feighn er and DSM-III-R criteria for schizophrenia were applied. Clinical and social status, psychopathology (Manchester Scale) and problem behavio urs (Social Behaviour Schedule) were assessed in a 4:5 representative sample. Results. Fifty-seven per cent had experienced at least one com pulsory admission. Forty-five per cent (excluding long-stay in-patient s) had marked positive psychotic symptoms; social isolation and lack o f daytime activity was more common than among comparable populations e lsewhere. One hundred and eleven (25%) of the non-hospitalised patient s were not in contact with specialist services. Conclusions. Difficult ies in establishing and maintaining a therapeutic alliance between pat ients and professionals present a challenge to services in inner Londo n. Many social and occupational needs were not being met by existing c ommunity provision.