A COMPARISON OF COMMUNITY-BASED CARE FOR SCHIZOPHRENIA IN SOUTH VERONA AND SOUTH MANCHESTER

Background. The community-oriented mental illness services providing c are to defined populations in south Verona, Italy (17 628 adults) and south Manchester, England (12 021 adults) have been compared to explor e relationships between service organisation and patterns of service u se. Method. The composition and function of the two services and the s ociodemographic characteristics of the two centres are described and r elated to epidemiological data on service use in the community, out-pa tient clinic, day hospital and in-patient care. Results. Treated incid ence of all psychiatric diagnoses and of schizophrenia were significan tly higher in south Manchester than south Verona, indicating that the referral filter between primary and secondary care is more permeable i n Manchester. Patients known to the service were more likely to be adm itted and to have shorter in-patient stays in south Verona, indicating that the filter between in-patient care and the community is more per meable in Verona than Manchester. Conclusions. The organisation of ser vices in Verona results in a smaller load on the mental health service ; the shorter hospital stays can be related to better integration betw een hospital and community resources. The organisation of services in Manchester provides care for a greater proportion of the population, b ut would be likely to require increased resources for the mental healt h services over time.