Continuous treatment teams in the care of the chronic mentally ill

Since deinstitutionalization began, the model of service delivery for the chronic mentally ill has been characterized first by the mere availability of services and then by continuity of care as coordinated through the case manager system. However, there is increasing evidence that the continuity of care model has neglected an element crucial to its success--continuity of caregivers. Continuity of caregivers means that a single, continuous treatment team is responsible for patients in both inpatient and outpatient settings. The author discusses several programs that have successfully used continuous treatment teams, the theoretical considerations supporting use of the teams, and the problems be encountered after trying to implement such teams at a public psychiatric hospital in Washington, D.C.