Abstract
The purpose of this study was to compare satisfaction with care in patients with schizophrenia in two CMHT models: traditional and pilot program group with concurrent assessment of symptom severity and social functioning. Ninety patients with schizophrenia treated in Community Mental Health Teams were included in the study, 60 in the traditional model and 30 in the pilot-program model.A demographic data questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Verona Service Satisfaction Scale (VSSS-54), the Disability Assessment Schedule (WHODAS), the Social Network Index (SNI),and a scale measuring loneliness (UCLA Loneliness Scale) were used. The pilot-program group was characterized by significantly lower age of subjects (p=0.048), less psychiatric medication use (p=0.027), higher total(p<0.001) and positive (p<0.001) symptom severity in PANSS, smaller social network (p=0.003), less role activity in social network (p<0.001), higher level of loneliness (p=0.001) and higher level of disability (p<0.001). The pilot-program group had significantly higher satisfaction with involvement of families in the therapeutic process(p = 0.024). In the pilot-program group, younger, more severely ill patients with higher severity of symptoms and worse social functioning were included in the treatment with no differences in the number of hospitalizations between the groups. It can be concluded that CMHT in the pilot-program Mental Health Centers (MHCs) protects this group of patients from hospitalization. There was also higher satisfaction with family involvement in the therapeutic process in the pilot-program group. A valuable continuation of the study would be to evaluate the treatment outcomes in all CMHTs operating under the pilot-program MHCs.
Highlights
In Poland, as early as the 1970s, measures were taken to prepare for the introduction of a reform of psychiatric care
In the pilot program group, younger, more severely ill patients with higher severity of symptoms and worse social functioning were included in the treatment with no differences in the number of hospitalizations between the groups
It can be initially concluded that Community Mental Health Team (CMHT) in the pilot program Mental Health Centers (MHCs) protects this group of patients from hospitalization
Summary
In Poland, as early as the 1970s, measures were taken to prepare for the introduction of a reform of psychiatric care. It was proposed to create a rational system of location of psychiatric hospitals and the role of outpatient treatment units, including community mental health teams, was emphasized. In 1979, a report was created on the state of psychiatric care and directions of postulated systemic changes, which, were not accompanied by appropriate legislative processes [1]. Its first edition was adopted by the government in December 2010 and was valid until 2015. It aimed to improve the quality of life and treatment of people with mental disorders in Poland and emphasized the need to modernize psychiatric care, as well as to raise public awareness about mental disorders. In 2009, only 3.4 percent of all health care expenditures were allocated to psychiatric care, with outpatient care accounting for about 20 percent of all funds allocated to psychiatric care and community care accounting for only 0.5 percent
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