WITHDRAWN: Case management for people with severe mental disorders

Area of Science:

• Psychiatry
• Health Services Research
• Mental Health Care Delivery

Background:

• Deinstitutionalization since the 1960s led to community-based care for severe mental illness.
• Rising readmission rates indicated potential shortcomings in community care models.
• Case management emerged in the 1970s to coordinate community care for severely mentally ill individuals.

Purpose of the Study:

• To evaluate the effectiveness of case management for severely mentally ill individuals in community settings.
• To compare case management against standard care on service contact, hospital admissions, clinical/social outcomes, and costs.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) identified through extensive electronic database searches.
• Inclusion criteria focused on RCTs comparing case management to standard community care for adults with severe mental disorders.
• Data extraction and analysis involved odds ratios, number needed to treat, and assessment of continuous data quality and heterogeneity.

Main Results:

• Case management increased patient contact with psychiatric services (OR 0.70).
• Case management approximately doubled psychiatric hospital admission rates (OR 1.84).
• No significant advantages were found for psychiatric or social outcomes, except for compliance in one study; cost data was inconclusive.

Conclusions:

• Case management improves service contact but increases hospital admissions and potentially costs.
• Current evidence does not support significant improvements in mental state, social functioning, or quality of life.
• The value of case management as a cornerstone of community mental health care is questioned based on existing evidence.