September 1979

A Comparative Trial of Home and Hospital Psychiatric CareOne-Year Follow-up

Author Affiliations

From the Department of Psychiatry, Montreal General Hospital (Dr Fenton and Ms Tessier), and The Department of Epidemiology and Health, McGill University (Dr Fenton and Ms Tessier), Montreal, and the Epidemiology of Mental Disorders Research Unit, Psychiatric Institute, New York State Office of Mental Health and Columbia University (Dr Struening), New York.

Arch Gen Psychiatry. 1979;36(10):1073-1079. doi:10.1001/archpsyc.1979.01780100043003

• The effectiveness of community-based treatment stressing home care was compared with hospital-based psychiatric care. One hundred and fifty-five patients destined for inpatient psychiatric care were randomly assigned to Home Care (76 patients) and to Hospital Care (79 patients). Symptoms, role functioning, and psychosocial burden on the family were similar at admission, one month, three months, six months, and one year. The mean in-hospital stay of Hospital Care patients was 41.7 days compared with a mean stay of 14.5 days for Home Care patients. The difference in the amount of ambulatory care received by patients in the two groups was not significant. The evidence is consistent: community-based psychiatric care is an effective alternative to hospital-based care for many but not all severely disabled patients. The active ingredients of successful community treatment are known, yet the lag in implementing these programs persists.