A controlled study of psychiatric hospital versus community treatment - the effect on relatives

One hundred and twenty patients presenting at Macquarie Hospital for admission were randomly allocated into two groups. The control group patients received standard hospital care and follow-up. The project group patients were not admitted if this could be avoided; instead they were taken back to the community by the project team who provided them and their relatives with comprehensive, assertive and prolonged follow-up treatment backed by a 24-hour crisis service. The majority (63%) of the project group had no admission during the 10 month study period. Initially, the burden on the relatives of the project group was higher, but by one month it was somewhat lower and by four months it was significantly lower than the burden on the control group relatives. Relatives of the project group patients were significantly more satisfied with the treatment than control group relatives. It is clearly feasible to treat most psychiatric patients in the community without increasing the burden on their relatives.