Quality of life outcomes for intensive versus standard community mental health services

Abstract

BackgroundWe report the impact on the quality of life (QOL) of people with psychosis of an intensive compared with a standard model of community care.MethodPeople with psychosis, in two sectors in south London, were interviewed with a variety of measures at baseline, and at two-year follow-up (n=138). After baseline, services within one sector were reorganised, and a more intensive model of community care was introduced. QOL was measured using the Lancashire Quality of Life Profile.ResultsThe two overall QOL measures, global QOL and the average of the domain-specific scores, were remarkably stable over time. There was weak evidence for an improvement in living situation domain in the intensive sector; this may be accounted for by a large drop in in-patient admissions. In both sectors objective QOL was poor, and there was little change in any of the objective indicators except in-patient admissions, and a suggestion of increased social activity in the intensive sector.ConclusionsWe failed to find an effect of intensive community care on QOL in people with psychosis. This may indicate an insensitivity to change in QOL measures, or that the intervention failed to produce the kind of changes in mental health and functioning which would be reflected in improved QOL.