Home treatment for mental health problems: a systematic review

Area of Science:

• Community mental health research
• Health services research

Background:

• Concerns exist regarding the scope and generalizability of community mental health research.
• Experimental and control services in mental health research are often poorly characterized.

Purpose of the Study:

• To systematically review the effectiveness of home treatment for mental health problems regarding hospitalization rates.
• To address concerns about the generalizability of randomized controlled trials (RCTs) by including non-randomized studies.

Main Methods:

• Systematic review using Cochrane methodology with an expanded scope.
• Inclusion of non-randomized studies alongside RCTs.
• Follow-up with authors for data on service components and analysis of associations with hospitalization days.

Main Results:

• 91 studies were identified, with 18 comparing home treatment to inpatient care.
• Services often included a 'home treatment function' with regular patient visits.
• Regular home visiting and combined health/social care responsibility showed potential for reduced hospitalization, though heterogeneity complicated meta-analysis.

Conclusions:

• Evidence on the effectiveness of home treatment for mental health remains inconclusive.
• A coordinated research strategy focusing on study design and prospective recording of service components is recommended.
• Improved reporting of experimental and control service components is crucial for meaningful analysis.