Smyth, Marcellino Gerard
(1998).
Exclusive home treatment and hospital treatment for acute psychiatric disorder: a controlled evaluation.
University of Birmingham.
M.D.
Abstract
Home Treatment for acute psychiatric illness was compared to conventional hospitalisation in a design which focused on completed episodes of either exclusive alternative. The evaluation was conducted with the West Birmingham Home Treatment Team and All Saints Hospital, Birmingham. Forty cases in each group were examined with closely equivalent sociodemographic features and previous psychiatric history. The length of treatment, clinical outcome, identification and targeting of needs, readmission profile and client satisfaction were compared. The study focused on presentations involving mainly a diagnosis of severe mental illness. Home Treatment was significantly shorter and involved wider targeting of identified needs. There was no significant difference in terms of clinical outcome. Home Treatment and avoidance of admission were preferred by patients. The determinants of satisfaction with acute care in both settings was explored qualitatively. Significant design and sampling problems limit the generalisability of results. The case for and against Home Treatment is examined. The lessons learnt during the course of the study regarding the appropriate focused evaluation of Home Treatment and the place of Home Treatment as a particular model of intensive care are critically discussed.
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