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North Staffordshire Community Beds Study: Longitudinal evaluation of psychiatric in-patient units attached to community mental health centres

I: Methods, outcome and patient satisfaction

Published online by Cambridge University Press:  03 January 2018

Anthony P. Boardman*
Affiliation:
Academic Department of Psychiatry, The Guy's, Kings College and St Thomas' Hospitals' Medical and Dental School, London
Richard E. Hodgson
Affiliation:
Academic Department of Psychiatry, School of Postgraduate Medicine, Keele University, Staffordshire
Martyn Lewis
Affiliation:
Academic Department of Psychiatry, School of Postgraduate Medicine, Keele University, Staffordshire
Keith Allen
Affiliation:
Academic Department of Psychiatry, School of Postgraduate Medicine, Keele University, Staffordshire
*
Dr A. P. Boardman, Academic Department of Psychiatry. 5th Floor, Thomas Guy House, Guy's Hospital, London SEI 9RT

Abstract

Background

This study evaluates two in-patient units attached to community mental health centres (CMHCs) that were designed to supplement acute in-patient care and to integrate with community-based after-care services.

Aim

To examine the comparative outcome of patients with severe mental illness (SMI) admitted to the two units.

Method

All patients with SMI admitted to the acute psychiatric wards serving the two CMHCs, those transferred to the community in-patient units and those admitted directly to these units (n=110) were compared with patients (n=67) admitted to acute wards serving two similar catchment areas without associated community beds. Baseline clinical and social measures were made and repeated at six and 12 months. Satisfaction with services was assessed at 12 months.

Results

The experimental group showed significantly better outcomes, significant reduction in unmet need and better satisfaction with services.

Conclusions

The use of the community beds appears to have significant benefits for patients with SMI.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

See Part II, pp. 79–86 this issue.

Declaration of interest

Support received from the North Staffordshire Health Authority and the North Staffordshire Combined Health Care NHS Trust.

References

Audini, B., Marks, I. M., Lawrence, R. E., et al (1994) Home-based versus out-patient/in-patient care for people with serious mental illness. Phase II of a controlled study. British Journal of Psychiatry, 165, 204210.Google Scholar
Beck, A., Croudace, T. J., Singh, S., et al (1997) The Nottingham Acute Bed study: alternatives to acute psychiatric care. British Journal of Psychiatry, 170, 247252.Google Scholar
Boardman, J., Hodgson, R. & Lewis, M. (1997) Psychiatric beds attached to a community mental health centre. Psychiatric Bulletin, 21, 202204.Google Scholar
Davies, S., Presilla, B., Strathdee, G., et al (1994) Community beds: the future for mental health care? Social Psychiatry and Psychiatric Epidemiology, 29, 241243.CrossRefGoogle ScholarPubMed
Dean, C., Phillips, J., Gadd, E. M., et al (1993) Comparison of community based service with hospital based service for people with acute, severe mental illness. British Medical Journal, 307, 473476.Google Scholar
Department of Health (1996) The Spectrum of Care. Local Services for People with Mental Health Problems. Wetherby: Department of Health.Google Scholar
Flannigan, C. B., Glover, G. R., Wing, J. K., et al (1994) Inner London Collaborative Audit of Admission in Two Health Districts. III: reasons for acute admission to psychiatric wards. British Journal of Psychiatry, 165, 750759.CrossRefGoogle ScholarPubMed
Goldberg, D. & Hillier, V. (1979) A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139145.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.Google Scholar
Haycox, A., Unsworth, L., Allen, K., et al (1999) North Staffordshire Community Beds Study: longitudinal evaluation of psychiatric in-patient units attached to community mental health centres. II: Impact upon costs and resource use. British Journal of Psychiatry, 175, 7986.Google Scholar
Holloway, F. (1997) 24-hour nursed care for people with severe and enduring mental illness. Psychiatric Bulletin, 21, 195196.CrossRefGoogle Scholar
Jones, S. H., Thomkroft, G., Coffey, M., et al (1995) A brief mental health outcome scale. Reliability and validity of the Global Assessment of Functioning (GAF). British Journal of Psychiatry, 166, 654659.CrossRefGoogle ScholarPubMed
MILMIS Project Group (1995) Monitoring inner London mental illness services. Psychiatric Bulletin, 19, 276280.Google Scholar
NHS Executive (1996) 24-hour Nursed Care for People with Severe and Enduring Mental Illness. Leeds: NHS Executive.Google Scholar
Oliver, J. P. J., Huxley, S. & Priebe, W. K. (1997) Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 7683.Google Scholar
Phelan, M., Strathdee, G. & Thornicroft, G. (1995) Emergency Mental Health Services in the Community. Cambridge: Cambridge University Press.Google Scholar
Powell, R. & Hollander, D. (1994) Heading for a breakdown: crisis in admission beds. Journal of Mental Health, 3, 430432.CrossRefGoogle Scholar
Ruggeri, M., Dall'Agnola, R., Agostini, C., et al (1994) Acceptability, sensitivity and content validity of the VECS and VSSS in measuring expectations and satisfaction in psychiatric patients and their relatives. Social Psychiatry and Psychiatric Epidemiology, 29, 265276.CrossRefGoogle ScholarPubMed
Schene, A. H. & van Wijngaarden, B. (1993) Involvement Evaluation Questionnaire (IEQ). Amsterdam: University of Amsterdam.Google Scholar
Sensky, T. & Scott, J. (1995) Acute inpatient wards. In Emergency Mental Health Services in the Community (eds M. Phelan, G. Strathdee & G. Thornicroft), pp 320339. Cambridge: Cambridge University Press.Google Scholar
Shepherd, G., Beadsmoore, A., Moore, C., et al (1997) Relation between bed use, social deprivation, and overall bed availability in acute adult psychiatric units, and alternative residential options: a cross-sectional survey, one day census data, and staff interviews. British Medical Journal, 314, 262266.Google Scholar
Slade, M., Phelan, M., Thornicroft, G., et al (1996) The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Social Psychiatry and Psychiatric Epidemiology, 31, 109113.Google Scholar
SPSS (1996) Statistical Package for the Social Sciences, v. 7.0. Chicago. IL: SPSS Inc.Google Scholar
Thomas, P., Greenwood, M., Kearney, G., et al (1996) The first twelve months of a community support bed unit. Psychiatric Bulletin, 20, 455458.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms: An Instrument Manual for the Present State Examination and CATEGO Programme. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., Curtis, R. H. & Beevor, A. S. (1996) HoNOS: Health of the Nation Outcome Scale. Report on Research and Development. London: Royal College of Psychiatrists.Google Scholar
Wykes, T. & Sturt, E. (1986) The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry, 148, 111.Google Scholar
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