COMMUNITY-BASED PSYCHIATRIC REHABILITATION IN SHANGHAI - FACILITIES, SERVICES, OUTCOME, AND CULTURE-SPECIFIC CHARACTERISTICS

This paper describes the community mental health services in Shanghai, analyses the effectiveness of these services, and discusses their cul ture-specific characteristics. It reports on a prospective, matched-co ntrol study of the three most important types of service: a community follow-up programme in psychiatric out-patient clinics at primary-leve l general hospitals, 'guardianship networks' operated by non-professio nal volunteers, and work therapy stations. In total 308 pairs of subje cts completed the study. Using Chinese versions of the Disability Asse ssment Schedule to assess impairment in psychosocial functioning and t he Present State Examination to assess the levels of positive and nega tive symptoms, ten blind evaluators who had excellent inter-rater reli ability assessed the functioning of subjects at enrolment and every si x months for the next two years. Over the two years, symptoms and soci al functioning improved in the treatment groups and deteriorated in th e control groups. Thus these community psychiatric services have the d ual benefit of promoting rehabilitation and preventing psychosocial de terioration.