The longer term outcomes of community care: a 12 year follow-up of the Camberwell High Contact Survey

Abstract

Background: There is as yet little evidence available regarding the long-term outcomes of people with severe and enduring mental illness who have been cared for primarily in the community.

Methods: A 12-year follow-up was carried out of the clinical and social problems and needs for care of a group of long-term mentally ill patients (N = 81) who were heavy users of psychiatric services when originally assessed in the Camberwell High Contact Survey between 1983 and 1985. The MRC Needs for Care Assessment Schedule used in the original baseline study was repeated at follow-up.

Results: The clinical and social functioning of the group had remained relatively stable, with high levels of problems and needs at both time points and little evidence of significant improvement or deterioration. The majority had remained in contact with services. There was some increase in levels of unmet as well as met needs, and a decrease in ratings of unmeetable needs, which may have been due to changes in clinical practice.

Conclusion: The challenge for current service providers is not only to keep clients stable, but also to help improve the clinical and social functioning of people who may no longer be the highest priority of current community mental health services. This could be approached by identifying the continuing needs of this group, and persistently delivering active treatments.