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Clinical Trial
. 2001 Nov 10;323(7321):1093-6.
doi: 10.1136/bmj.323.7321.1093.

Reducing violence in severe mental illness: randomised controlled trial of intensive case management compared with standard care

E Walsh  1 , C Gilvarry, C Samele, K Harvey, C Manley, P Tyrer, F Creed, R Murray, T Fahy
Affiliations
Clinical Trial

Reducing violence in severe mental illness: randomised controlled trial of intensive case management compared with standard care

E Walsh et al. BMJ. .

Abstract

Objectives: To establish whether intensive case management reduces violence in patients with psychosis in comparison with standard case management.

Design: Randomised controlled trial with two year follow up.

Setting: Four inner city community mental health services.

Participants: 708 patients with established psychotic illness allocated at random to intervention (353) or control (355) group.

Intervention: Intensive case management (caseload 10-15 per case manager) for two years compared with standard case management (30-35 per case manager).

Main outcome measure: Physical assault over two years measured by interviews with patients and case managers and examination of case notes.

Results: No significant reduction in violence was found in the intensive case management group compared with the control group (22.7% v 21.9%, P=0.86).

Conclusions: Intensive case management does not reduce the prevalence of violence in psychotic patients in comparison with standard care.

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Flowchart of trial
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References

    1. Monahan J. Mental disorder and violent behaviour: perceptions and evidence. Am Psychol. 1992;47:511–521. - PubMed
    1. Swartz MS, Swanson JW, Hiday VA, Borum R, Wagner HR, Burns BJ. Violence and severe mental illness. The effects of substance abuse and nonadherence to medication. Am J Psychiatry. 1998;155:226–231. - PubMed
    1. Silver E, Mulvey EP, Monahan J. Assessing violence risk among discharged psychiatric patients: toward an ecological approach. Law Hum Behav. 1999;23:237–255. - PubMed
    1. Department of Health. The care programme approach for people with a mental illness referred to the specialist psychiatric services. London: Department of Health; 1990.
    1. UK700 Group. Intensive versus standard case management for severe psychotic illness: a randomised trial. Lancet. 1999;353:2185–2189. - PubMed

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