Community Care for Schizophrenics

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Community Care
Essential and broad approach to treating schizophrenia
Designed to minimise hospital stays and provide support in the community
Allows sufferers to live a more normal life and hold down paid employment
Should provide for a wide range of support and treatments, including:
o Sheltered/supported living arrangements
o On-going psychotherapy matched to needs and circumstances of the
o An environment where social skills can be enhanced and developed to
prevent isolation
o Monitored medication
Proper community care is more beneficial than long-term hospitalisation
Highly effective, but if the support is withdrawn then relapse will occur
Also, the full range of community care is expensive
Aim: Stein and Test (1980) compared the effectiveness of community care and
hospitalisation in people with schizophrenia.
Method: Two groups of 65 people suffering from schizophrenia were compared. One
group received hospital treatment with medication and were then discharged without
support. The other group were given community care to support them living in the
community. Community care consisted of food and shelter; training in social and
community skills, educational support and help with developing a social network of
friends. The study lasted for 12 months.
Results: The unsupported discharged patients showed high levels of relapse ­ 58 out
of the 65 were readmitted to hospital within the 1-year period. By contrast, 53 of the
people given community care remained living in the community over the year.
Conclusion: Community care provides successful support to people with
schizophrenia and helps prevent relapse and future hospitalisation.
Hospitals for schizophrenia were dehumanising and increased negative
Neuroleptic drugs allowed psychiatrists to expand outpatient day care
Evaluation of day care:
o Those who favour community care argue that quality of life can be
improved at no extra cost
o Hospitals are seen as places that increase some of the symptoms of
schizophrenia, such as apathy and withdrawal, and stigmatise those with
mental illness
o Critics of community care argue that services are often patchy and the
burden on families increases

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o Failings in community care have been highlighted in media reports of
tragic cases, such as the murder of Jonathan Zito on an underground
station in London
Evaluation of drug treatment:
o The side effects of Neuroleptic medication are distressing, for example
muscular spasms, Parkinsonism (including tremor and shuffling gait),
and tardive dyskinesia (including involuntary movements of the head
and tongue).
o Clozapine is associated with potentially fatal lowering of the white
blood count and its use requires regular blood monitoring.…read more


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