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Introduction Case management (CM) as a model of community intervention in people with severe mental illness and with pharmacological and psychosocial integrated care have been suggested as a way to improve treatment adherence and to prevent hospital admissions among people with severe schizophrenia compared with standard treatment.The objectives of this study were to know the treatment adherence and the psychiatric hospitalizations of patients with severe schizophrenia before (standard treatment in mental health units) and during treatment in an integrated, community based, intensive case managed program.The program for people with severe mental illness in Gijón (Spain) is based on the principles of community care with intensive case management and with a multidiscipli-nary team intervention. Nurses as case managers and integrated psychological and pharmacological treatment, social skills training, psychoeducation, vocational interven-tion and home support are provided.MethodsObservational study, mirror image, of ten years of follow-up and ten retrospectives (pretreatment), of patients with severe schizophrenia in a community based program, with integrated pharmacological and psychosocial treatment and intensive case management (N=344). Reasons for the Program discharge and psychiatric hospital admissions were recorded ten years before and during treatment.Results After 10 years only 12.2% of the patients were voluntary discharges (In previous standard treatment: 84.3%). CGI-S at baseline was 5.9(0.7). After ten years 51.7% of patients continued under treatment (CGI-S= 3.9(0.9); p |
