The role of mental health service research in promoting effective treatment for adults with schizophrenia†
✍ Scribed by Anthony F. Lehman
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 43 KB
- Volume
- 1
- Category
- Article
- ISSN
- 1091-4358
No coin nor oath required. For personal study only.
✦ Synopsis
Background: Significant gaps exist between scientific knowledge about the efficacy of treatments for mental disorders and the availability of efficacious treatments in routine practice. Mental health service research can help bridge this gap between basic clinical research and the usual care afforded adults with mental disorders.
Aims: To illustrate this potential, data on the efficacy of treatment for schizophrenia are reviewed.
Methods:
The treatments reviewed include pharmacotherapies, psychological interventions, family interventions, vocational rehabilitation and assertive community treatment and case management. Using treatment recommendations based upon outcome data about these treatments and the results of a large survey of usual care for schizophrenia from the Schizophrenia Patient Outcomes Research Team (PORT) project, examples of current deficiencies in the usual treatment of adult mental disorders and relevant questions that need to be addressed by mental health services research are identified.
Results:
Major deficiencies in treatment that were identified include inappropriate dosing with antipsychotic agents, underutilization of adjunctive antidepressant therapy, very low rates of prescription of psychosocial interventions and lack of continuity between inpatient and outpatient settings.
Discussion: These findings raise serious concerns about access to care and the appropriateness and quality of care that is offered.
Implications:
This knowledge about what treatments work for schizophrenia and the patterns of current care suggest the following major questions be addressed by mental health services research: What is the nature of care currently being offered adults with mental disorders? To what degree does this care measure up to scientifically derived quality of care and treatment standards? What is the effectiveness of new technologies under usual practice conditions? For which patients are they cost-effective and under what conditions? How should financial incentives be structured within systems of care to promote the most cost-effective use of new technologies? How should service systems themselves be