Community mental health team management in severe mental illness: a systematic review

Background Community mental health teams are now generally recommended for the management of severe mental illness but a comparative evaluation of the ir effectiveness is lacking. Aims To assess the benefits of community mental health team management in s evere mental illness. Method Asystematic review was conducted of community mental health team man agement compared with other standard approaches. Results Community mental health team management is associated with fewer de aths by suicide and in suspicious circumstances (odds ratio=0.32, 95% Cl 0. 09-1.12), less dissatisfaction with care (odds ratio=0.34, 95% Cl 0.2-0.59) and fewer drop-outs (odds ratio=0.61, 95% Cl 0.45-0.83). Duration of in-pa tient psychiatric treatment is shorter with community team management and c osts of care are less, but there are no gains in clinical symptomatology or social functioning. Conclusions Community mental health team management is superior to standard care in promoting greater acceptance of treatment, acid may also reduce ho spital admission and avoid deaths by suicide. This model of care is effecti ve and deserves encouragement. Declaration of interest None.