The Maine and Vermont Three-Decade Studies of Serious Mental Illness

Abstract

BackgroundThis study compared long-term outcome of serious mental illness in two states using a matched design to assess psychiatric rehabilitation programmes; Vermont subjects participated in a model psychiatric rehabilitation programme, while the Maine group received more traditional care.MethodMaine and Vermont subjects (n = 269) were matched by age, sex, diagnosis, and chronicity. Demographic, illness, and life history information were abstracted from hospital records by clinicians blind to outcome. DSM–III criteria were applied retrospectively. Outcome was assessed by clinicians blind to history.ResultsVermont subjects alive at follow-up (n = 180) were more productive (P < 0.0009), had fewer symptoms (P < 0.002), better community adjustment (P < 0.001) and global functioning (P < 0.0001) than Maine subjects (n = 119).ConclusionsOutcome differences may be due to Vermont's model programme and a policy of allowing an earlier opportunity for community life.