Need for community care among psychotic outpatients

Psychiatric teams examined a representative sample of 177 psychotic patients in community care. The patients' need for care was assessed using a standardized method. The need for alternative, noninstitutional forms of care (i.e. day and residential services) was greater than the actual use of these services. The same was true of the need for support in social activities, for occupational therapy, training in domestic skills, counselling for relatives and psychotherapy. Unmet needs for care were commonest among patients who were young, who drank heavily, and who suffered from many psychotic symptoms and drug side effects. Outpatient care based primarily on visits to the community mental health centres did not provide adequate services for the most disabled patients. It is concluded that decrease of hospital care has brought a growing need for psychiatric day and residential services among outpatients suffering from psychotic disorders.