A comparison of patient clinical and social outcomes before and after the introduction of an extended-hours community mental health team

Objective: The aim of this study was to assess the effectiveness of the addition of standard community treatment to a hospital-based service in a regional district of Australia. Method: The study was a naturalistic investigation of a routine clinical service and utilized a longitudinal panel design. Two matched groups of seriously mentally ill patients were recruited, one before the addition of the community mental health team (CMHT) and one after. Each sample was followed up for one year using a semistructured questionnaire and instruments including the Brief Psychiatric Rating Scale, the Global Assessment Scale, the Life Skills Profile and the Rosenberg Self-Esteem Scale as well as hospital records. Results: Patients in both groups showed similar patterns of improvements. Although the aims of the new service included reducing in-patient utilization and improving social functioning, there were few significant differences between the two groups. While the number of admissions and length of stay were lower in the post-CMHT sample most were admitted rather than treated in their homes by the CMHT. Conclusion: The study concludes that better outcomes might have been achieved if the aims of the CMHT had been limited to either crisis or rehabilitation interventions, but not both. More attention needs to be paid to the service context in which model programmes are introduced so that new developments can be more closely tailored to the realities of what is likely to be achievable.