EFFECTS OF COMMUNITY-SERVICES ON DISABILITY AND SYMPTOMS - PRISM PSYCHOSIS STUDY 4

Background Community care for people with psychosis can be provided vi a several different service models. The study compared two models: sta ndard community treatment with high patient: staff ratios, and intensi ve community treatment in which there was more of an emphasis on commu nity involvement and lower patient:staff ratios. Method All people ful filling diagnostic criteria for psychosis and living in two defined ge ographical areas in south London were identified. These people were pr ovided with either an intensive or standard service depending on their address. Their social behaviour and symptoms were measured at the beg inning of the study and after two years. Results There is little evide nce of any effects of the two service models on levels of symptoms. Ho wever, the standard service did seem to be advantageous in reducing so cial disability for those with medium or low levels of disability. Con clusions The effect of intensive community services was the opposite t o that predicted. Despite improvements in outcomes (e.g. hospital admi ssion), there were no advantages for this type of service in the measu res of disability or symptoms. In fact, the standard service was effec tive in reducing disability, whereas in the intensive service there wa s no change.