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What are the features of community care?
Acts as an alternative to hospitalisation, involving support in the community so sufferers can live as normal life as possible and perhaps gain paid employment
On what is community care partially based?
- Research in the 60s and 70s that suggested that psychiatric hospitals may be dehumanising and led to an increase in symptoms
- This could be due to social learning theory or self fulfilling prophecy due to labelling
How might advances in drug treatment mean community care is a more viable option?
- Care can be given by families allowing patients to live a normal life
- Patients have the major symptoms minimised so are no longer a threat to society
What is the goal of community care?
To maintain the benefits of treatment whilst preventing relapse
How is community care managed?
It is case managed, allowing it to be tailored to the individual client's needs
To whom is the client referred during community care?
- The client is allocated to a named key worker
- These are usually community psychiatric nurses
- These CPNs assess and co-ordinate appropriate care
From whom is input required in order for community care to succeed?
- Social services
- Housing authorities
- Occupational therapists
Give examples of treatment offered in community care
- Sheltered and supported living arrangements
- Ongoing psychotherapy matched to individual needs and circumstances
- An environment allowing social skill enhancement and the fostering of friendships that prevents isolation
- Monitored medication
What was the aim of the Stein and Test study of 1980?
To compare the effectiveness of community care and hospitalisation for schizophrenics
What was the methodology of the Stein and Test study of 1980?
- 2 groups of 65 schizophrenics were compared over a 12 month period
- 1 group received hospital treatment with medication then were discharged without support
- The other group were given community care to support them living in the community
- This consisted of food, shelter, training in social and community skills, educational support and help developing a social network of friends
What did Shepard state in 1980?
Community care can be successful if specialists have small case loads of 10-15 patients and help is available day and night with care offered continually
What becomes more likely is support is withdrawn from clients?
Relapse into more serious symptoms
How does community care improve the skills of clients?
- Independence is fostered and social and living skills are improved
- Living in the community gives clients the opportunity to model 'normal behaviour' and to have support with finding employment
How can community care be seen as preferable to hospital treatment?
Hospitals are seen as places that increase some of the symptoms associated with schizophrenia such as apathy and withdrawal and stigmatise those with mental illness
What are the drawbacks of community care?
- Good community care is expensive
- Critics argue that services are often patchy and the burden on families increases
- There are differences in the quality of provision across the country, depending on available funding in local areas
- Some patients slip through the net and do not receive the attention they need leading to negative consequences for them and others
What are the benefits of institutionalisation over community care?
- Dangerous schizophrenics are kept from the general public
- Professional staff are on hand to deal with major symptoms or drug side effects
Name a high profile failing of community care
Michael Folkes was receiving community care when he stabbed his girlfriend 70 times