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

• 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

• 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

To maintain the benefits of treatment whilst preventing relapse

It is case managed, allowing it to be tailored to the individual client's needs

• The client is allocated to a named key worker 
• These are usually community psychiatric nurses 
• These CPNs assess and co-ordinate appropriate care

• Social services 
• Housing authorities 
• Psychiatrists
• Occupational therapists

• 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

To compare the effectiveness of community care and hospitalisation for schizophrenics

• 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

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

Relapse into more serious symptoms

• 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

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

• 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

• Dangerous schizophrenics are kept from the general public 
• Professional staff are on hand to deal with major symptoms or drug side effects

Michael Folkes was receiving community care when he stabbed his girlfriend 70 times