Clinical and social changes in severely mentally ill individuals admitted to an outpatient XXXX team: an 18-month follow-up study.

@entity1 @entity161 @entity716 @entity146
AIM: The study investigated clinical and social changes during an 18-month follow-up period in a group (n = 76) of @entity161 outpatients admitted to a newly implemented outpatient @entity716 team. Changes related to level of contact with the @entity716 team were also examined as well as aspects of the content of the treatment interventions and work situation from a staff perspective. METHODS: Structured face-to-face interviews with the @entity1 were performed at baseline and after 18 months. The Camberwell Assessment of Need instrument, the Lancashire Quality of Life Profile and the Interview Schedule for Social Interaction were used on both interview occasions along with Global Assessment of Functioning Scale and Brief Psychiatric Rating Scale. Thematic open-ended questions were used in staff interviews. RESULTS: Psychiatric symptoms, number of needs and number of met needs decreased, and perceived quality of life improved for the total sample during the follow-up period. @entity1 only in contact with a psychiatrist in the @entity716 team improved more in symptoms and spent fewer days in hospital during follow-up time compared with those who had combined @entity146 and supportive contacts, and were also more satisfied with their medication. @entity1 with a combined contact deteriorated in psychosocial functioning compared with the group only in contact with a psychiatrist. Some of the elements in treatment interventions and work situation as well as hindrances in providing community-based care adapted to the @entity1 ' needs were identified. CONCLUSIONS: Community-based @entity146 services, to a larger extent, need to embrace evidence-based interventions and to perform regular, structured and comprehensive need assessments in order to ensure the effectiveness of interventions. Attention should be paid to staff motivation and education as well as to providing practical guidelines, supervision and support.
