Two-year outcomes of psychosocial rehabilitation of black patients with chronic mental illness

Abstract

Objective: Outcome as measured by psychosocial functioning was examined in a two-year follow-up study of 46 patients with chronic mental illness, 44 of whom were African American, who participated in an intensive psychosocial rehabilitation program based in a community mental health center.

Methods: Patients attended a program that operated seven days a week in a predominantly urban, black section of Baltimore. Level of functioning was determined at baseline and at six and 12 months using a scale based on data from the 1972 International Pilot Study of Schizophrenia. Parameters assessed included the length of time patients stayed out of the hospital, the frequency and depth of social relationships, dysfunction in work, the presence of symptoms, the ability to maintain personal hygiene, and the ability to participate in leisure activities.

Results: The sample was divided into three diagnostic groups: patients with schizophrenia alone (N=27), patients with a mood disorder (N= 12), and patients with a dual diagnosis of schizophrenia and a substance use disorder (N=7). Scores on the level-of-functioning measure were significantly correlated between baseline and six months, between six months and 24 months, and between baseline and 24 months. Statistical tests indicated a substantial and significant increase in level of functioning from baseline to 24 months for all groups.

Conclusions: The results provide evidence for the effectiveness of an intensive psychosocial rehabilitation program for urban, black patients with chronic psychiatric illness, including those with a dual diagnosis.