PUBLIC-HEALTH POLICY, COMMUNITY-SERVICES, AND OUTCOMES FOR PATIENTS WITH SCHIZOPHRENIA

Amidst the specter of managed care, individual mental health services are struggling to redefine their niche, consolidate with partners and provide a realistic continuum of care for persons with serious and per sistent mental illness. Because of the chronicity of schizophrenia, it s economic and social ramifications, the disparity in health insurance for these patients and limited resources, the development of communit y services has often proceeded in a fragmentary manner. Several states have well coordinated community programs with integration between pri vate and public services. The Assertive Community Treatment (ACT) mode l has proved successful, although this is costly to maintain. Services that synergize optimum pharmacologic and psychosocial treatments can achieve favorable patient outcome, as evaluated across clinical, rehab ilitative, humanitarian, and public welfare domains.