Home based and hospital care for severe mental illness.

OBJECTIVE: to analyze the scientific literature on home-based family care of people with severe mental illness. METHOD: integrative review of 14 databases (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI COnNECT, LILACS, PsycINFO, PubMed, SciELO, and Scopus) searched with the key words "family caregivers", "severe mental illness", and "home" between 2003 and 2013. RESULTS: of 787 articles retrieved, only 85 met the inclusion criteria. The articles appeared in 61 journals from different areas and disciplines, mainly from nursing (36%). The countries producing the most scientific literature on nursing were Brazil, the UK, and the US, and authorship predominantly belonged to university centers. A total of 54.12% of the studies presented quantitative designs, with descriptive ones standing out. Work overload, subjective perspectives, and resources were the main topics of these papers. CONCLUSIONS: the international scientific literature on home-based, informal family care of people with severe mental disorder is limited. Nursing research stands out in this field. The prevalent topics coincide with the evolution of the mental health system. The expansion of the scientific approach to family care is promoted to create evidence-based guidelines for family caregivers and for the clinical practice of professional caregivers.

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Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial

The British Journal of Psychiatry ◽

10.1192/bjp.162.2.239 ◽

1993 ◽

Vol 162 (2) ◽

pp. 239-243 ◽

Cited By ~ 17

Author(s):

C. J. Simpson ◽

C. P. Seager ◽

J. A. Robertson

Keyword(s):

Mental Illness ◽

Randomised Controlled Trial ◽

Home Care ◽

Daily Living ◽

Hospital Care ◽

Controlled Trial ◽

Home Based ◽

Randomised Controlled ◽

Home Based Care ◽

Hospital Group

ObjectiveTo compare the efficacy of home based care with standard hospital care in treating serious mental illness.DesignRandomised controlled trial.SettingSouth Southwark, London.Patients189 patients aged 18–64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated.Main outcome measuresUse of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff.ResultsHome care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non–significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme.ConclusionsHome based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.

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The outcome of treatment in hostels

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700008296 ◽

2004 ◽

Vol 21 (2) ◽

pp. 53-56 ◽

Cited By ~ 1

Author(s):

Rob Macpherson ◽

Kelwyn Williams ◽

Helen Elliot ◽

Anne-Marie Brewer ◽

Tom McGee

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Hospital Care ◽

Time Frame ◽

Potential Value

AbstractObjectives: This paper aimed to examine the outcome of hostel treatment including the effect on hospitalisation rates.Methods: The work of the four medium/long term Gloucester hostels developed between 1983 and 1993, to provide 24-hour nursed care to ‘new long stay’ patients in Gloucester is described.Results: Fifty-eight patients with predominately severe mental illness were admitted to the hostels up to 1999, and demographic/illness data is presented. Mean duration of hostel stay was 4.8 years, and one third of patients were readmitted to hospital (most briefly) during their hostel admission, one patient 11 times. Thirty-four patients were discharged from hostels, 29 to less dependent settings, but four referred to hospital care. There was a significant reduction in the number of admissions and duration of hospitalisation in the time between discharge from the hostel to the present or death, as compared with the same time frame for each individual prior to entering the hostel system.Conclusions: The data adds further support to the potential value of 24 hour nursed care for patients with severe mental illness.

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