The Daily Living Programme

1992 ◽  
Vol 160 (3) ◽  
pp. 379-384 ◽  
Author(s):  
M. Muijen ◽  
I. M. Marks ◽  
J. Connolly ◽  
B. Audini ◽  
G. McNamee
Keyword(s):  
Mental Illness ◽  
Home Care ◽  
Serious Mental Illness ◽  
Daily Living ◽  
Hospital Care ◽  
Treatment Costs ◽  
Standard Group ◽  
Direct Treatment ◽  
Individualised Treatment ◽  
Hospital Use

Patients with a serious mental illness requiring admission were randomised to home care or standard hospital care. Over the initial 18 months, 60 patients entered each group and were studied for a mean of 10 months. Home care reduced hospital use by 80%, with patients being admitted for a mean of 14 days, compared with 72 days for the standard group, but this bed-saving made no difference in direct treatment costs. Home care offers individualised treatment, and many patients require continuing support with the emphasis on areas such as finances and housing.

Home-Based Care and Standard Hospital Care for Patients with Severe Mental Illness: A Randomised Controlled Trial

1993 ◽  
Vol 162 (2) ◽  
pp. 239-243 ◽  
Author(s):  
C. J. Simpson ◽  
C. P. Seager ◽  
J. A. Robertson
Keyword(s):  
Mental Illness ◽  
Randomised Controlled Trial ◽  
Home Care ◽  
Daily Living ◽  
Hospital Care ◽  
Controlled Trial ◽  
Home Based ◽  
Randomised Controlled ◽  
Home Based Care ◽  
Hospital Group

ObjectiveTo compare the efficacy of home based care with standard hospital care in treating serious mental illness.DesignRandomised controlled trial.SettingSouth Southwark, London.Patients189 patients aged 18–64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated.Main outcome measuresUse of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff.ResultsHome care reduced hospital stay by 80% (median stay 6 days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non–significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme.ConclusionsHome based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.

scholarly journals Impact of family practice continuity of care on unplanned hospital use for people with serious mental illness

2019 ◽  
Vol 54 (6) ◽  
pp. 1316-1325 ◽  
Author(s):  
Jemimah Ride ◽  
Panagiotis Kasteridis ◽  
Nils Gutacker ◽  
Tim Doran ◽  
Nigel Rice ◽  
...  
Keyword(s):  
Mental Illness ◽  
Family Practice ◽  
Continuity Of Care ◽  
Serious Mental Illness ◽  
Hospital Use

scholarly journals Influence of Criminal Justice Involvement and Psychiatric Diagnoses on Treatment Costs Among Adults With Serious Mental Illness

2015 ◽  
Vol 66 (9) ◽  
pp. 907-909 ◽  
Author(s):  
Allison G. Robertson ◽  
Jeffrey W. Swanson ◽  
Hsiuju Lin ◽  
Michele M. Easter ◽  
Linda K. Frisman ◽  
...  
Keyword(s):  
Mental Illness ◽  
Criminal Justice ◽  
Serious Mental Illness ◽  
Treatment Costs ◽  
Psychiatric Diagnoses ◽  
Criminal Justice Involvement

Home-Based Versus Hospital-Based Care for People with Serious Mental Illness

1994 ◽  
Vol 165 (2) ◽  
pp. 179-194 ◽  
Author(s):  
I. M. Marks ◽  
J. Connolly ◽  
M. Muijen ◽  
B. Audini ◽  
G. McNamee ◽  
...  
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Social Adjustment ◽  
Daily Living ◽  
Emergency Admission ◽  
Controlled Study ◽  
Patient Admissions ◽  
Home Based ◽  
Home Based Care

Background.A controlled study tested whether the superior outcome of community care for serious mental illness (SMI) in Madison and in Sydney would also be found in inner London.Method.Patients from an inner London catchment area who faced emergency admission for SMI (many were violent or suicidal) were randomised to 20 months or more of either home-based care (Daily Living Programme, DLP; n = 92), or standard in-patient and later out-patient care (controls, n = 97). Most DLP patients had brief in-patient stays at some time. Measures included number and duration of in-patient admissions, independent ratings of clinical and social function, and patients' and relatives' satisfaction.Results.Outcome was superior with home-based care. Until month 20, DLP care improved symptoms and social adjustment slightly more, and enhanced patients' and relatives' satisfaction. From 3 to 18 months DLP care greatly reduced the number of in-patient bed days as long as the DLP team was responsible for any in-patient phase its patients had. Cost was less. DLP care did not reduce the number of admissions, nor of deaths from self-harm (3 DLP, 2 control). One DLP patient killed a child. Even at 20 months many DLP and control patients still had severe symptoms, poor social adjustment, no job, and need for assertive follow-up and heavy staff input. (Beyond 20 months most gains were lost apart from satisfaction.)Conclusions.It is unclear how much the gain until 20 months from home-based care was due to its site of care, its being problem-centred, its teaching of daily living skills, its assertive follow-up, the home care team's keeping responsibility for any in-patient phase, its coordination of total care (case management), or to other care components. Home-based care is hard to organise and vulnerable to many factors, and needs careful training and clinical audit if gains are to be sustained.

WOW Specialty Home Care Service for Individuals With Serious Mental Illness

2008 ◽  
Vol 21 (1) ◽  
pp. 23-32
Author(s):  
Judith LLoyd Storfjell ◽  
Emily Brigell ◽  
Kathryn Christiansen ◽  
Judith McDevitt ◽  
Arlene Miller ◽  
...  
Keyword(s):  
Mental Illness ◽  
Home Care ◽  
Serious Mental Illness ◽  
Care Service ◽  
Home Care Service

scholarly journals Observations from community care for serious mental illness during a controlled study

1996 ◽  
Vol 20 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Joseph Connolly ◽  
Isaac Marks ◽  
Robin Lawrence ◽  
Gary McNamee ◽  
Matt Muijen
Keyword(s):  
Mental Illness ◽  
Inner City ◽  
Serious Mental Illness ◽  
Daily Living ◽  
Psychiatric Care ◽  
Community Care ◽  
Care Team ◽  
Controlled Study ◽  
Community Psychiatric ◽  
Self Harm

A controlled study of community care in serious mental illness (SMI) was carried out. Patients with SMI were randomised to have hospital care or be looked after by a community psychiatric care team in a Daily Living Programme (DIP). The day-to-day work of a clinical team with the difficulties encountered in delivering community psychiatric care in an inner city is described. There were seven deaths from self-harm during the 45-month study. One DIP patient committed homicide. An ordeal by media following this and the suicides are described. Lessons learnt include the need for the community care team to be responsible for discharge from any in-patient phases and for attention to team morale, especially during adversity, and to time spent working under pressure.

scholarly journals Determining the caregivers’ burden in caregivers of patients with mental illness

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Salma Parveen Siddiqui ◽  
Javeria Khalid
Keyword(s):  
Mental Illness ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Serious Mental Illness ◽  
Daily Living ◽  
Family Members ◽  
Armed Forces ◽  
Physical Capacity ◽  
Care Recipient ◽  
Brief Cope

Objective: To examine the factors associated with caregivers’ burden in individuals providing care to family members suffering from serious mental illness. Methods: This Cross Sectional Study was carried out at Armed Forces Institute of Mental Health, Rawalpindi, from May 2015 to December 2015. A purposive sample of 120 family caregivers (60 males and 60 females, age range= 18-65) who were taking care of patients with serious mental illness (i.e. Major Depressive Disorder, Bipolar Disorder & Schizophrenia) for at least one year were recruited from the hospital and assessed through Zarit Burden Interview (ZBI) and Brief COPE inventory. The decline in functional status, and diminished physical capacity compromising the independent living of the care recipient was assessed through Katz Index of Independence in Activities of daily living (ADL) and Lawton Instrumental activities of daily living (IADL). Results: The results suggest that the longer the duration of illness (F=25.71, p < 0.01), with increased impairments of care-recipients, (decline in functional status, F=21.33, p < 0.001; diminished physical capacity F =32.41, p < 0.001) the more the burden experienced by the caregivers. Moreover, caregivers who were married (t=-2.98, p < 0.01), less educated (t =5.48, p < 0.01), lived in rural area (t = -7.99, p < 0.01), had lower monthly income (t = -4.95, p < 0.01) provide longer hours of caregiving (F=19.12, p < 0.001) and used avoidant coping behavior (F= 56.37, p < 0.001) reported significantly higher caregiver burden than caregivers who were unmarried, more educated, lived in urban area and had better income. Conclusion: The results of study demonstrate that caring for family members with serious mental illness impacts the caregivers’ wellbeing. It, therefore, highlights the need for support and counseling services for the caregivers to reduce the burden of caring. doi: https://doi.org/10.12669/pjms.35.5.720 How to cite this:Siddiqui S, Khalid J. Determining the caregivers’ burden in caregivers of patients with mental illness. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.720 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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