Iranian Journal of Medical Sciences

Document Type: Original Article(s)

Authors

1 Mental Health Research Centre, Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran

2 Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

3 Health Research Center, Department of Psychiatry and Social Determinants, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

4 Department of Psychiatry, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Behavioral Science Research Center, Department of Psychiatry, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6 Department of Psychiatry, Razi Hospital, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Abstract

Background: Providing community-based mental health services is crucial and is an agreed plan between the Iranian Mental Health Office and the Regional Committee for the Eastern Mediterranean (affiliated with WHO). The aim of this study was to determine the effectiveness of home-visit clinical case-management services on the hospitalization rate and other clinical outcomes in patients with severe mental illness.Methods: A total of 182 patients were randomly allocated into three groups, namely, home-visit (n=60), telephone follow-up (n=61) and as-usual care (n=61) groups. Trained nurses as clinical case-managers provided home-visit services and the telephone follow-up tasks. Hospitalization rate as a measure of recurrence, as well as burden, knowledge, general health condition of caregivers with positive/negative symptoms, satisfaction, quality of life, and social skills of the consumers were assessed as the main and secondary outcomes, respectively.Results: Most clinical variables were improved in both intervention groups compared with the control group. During the one year follow-up, the rate of rehospitalization for the telephone follow-up and as-usual groups were respectively 1.5 and 2.5 times higher than the home-visit group.Conclusion: Trained clinical case-managers are capable of providing continuous care services to patients with severe mental illness. The telephone follow-up services could also have beneficiary outcome for the consumers, their caregivers, and the health system network.