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The treatment of common mental disorders by a community team based in primary care: a cost-effectiveness study

Published online by Cambridge University Press:  09 July 2009

D. Goldberg*
Affiliation:
Mental Illness Research Unit, University of Manchester
G. Jackson
Affiliation:
Mental Illness Research Unit, University of Manchester
R. Gater
Affiliation:
Mental Illness Research Unit, University of Manchester
M. Campbell
Affiliation:
Mental Illness Research Unit, University of Manchester
N. Jennett
Affiliation:
Mental Illness Research Unit, University of Manchester
*
1Address for correspondence: Professor David Goldberg, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.

Synopsis

Thirty patients suffering from new episodes of depression or anxiety disorders seen by a hospital-based psychiatric service were matched for severity of illness with 30 patients seen by a community mental health team based upon primary care. These patients were drawn from a total of 108 such patients seen in the community and 57 seen by the hospital service. Clinical and social outcomes were similar in both groups, and neither was clearly superior in terms of quality of clinical information recorded. However, patients treated in the community were seen more quickly, had more continuity of care and were more satisfied with the service. Health services costs were less for those patients treated in the community, because patients were less likely to be admitted. With one a typical patient excluded, treatment by the community team is more cost effective. The greater number of patients seen by the primary-care-based service means that there is no overall cost saving to the NHS.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Boardman, A., Bouras, N. & Cundy, J. (1978). The Mental Health Advice Centre in Lewisham. Service Usage: Trends for 1978 to 1984. National Unit for Psychiatric Research and Development, Research Report No. 3: London.Google Scholar
Cooper, P., Osborn, M., Gath, D. & Feggeter, G. (1982). Evaluation of a modified self-report measure of social adjustment. British Journal of Psychiatry 141, 6875.CrossRefGoogle ScholarPubMed
Corney, R. & Clare, A. (1985). Construction, development and testing of a self-report questionnaire to identify social problems. Psychological Medicine 15, 637642.CrossRefGoogle ScholarPubMed
Ferguson, B., Cooper, S. & Brothwell, J. (1992). The clinical evaluation of a new community psychiatric service based upon general practice psychiatric clinics. British Journal of Psychiatry 160, 493497.CrossRefGoogle ScholarPubMed
Goldberg, D. & Huxley, P. (1992). Common Mental Disorders: A Bio-social Model. Tavistock/Routledge London.Google Scholar
Goldberg, D., Tantam, D., Gater, R., Jackson, G., Jennett, N. & Lowson, K. (1992). The interface between primary care and specialist mental health services in the community. Mental Illness Research Unit, Occasional Paper No. 2. University of Manchester: Manchester.Google Scholar
Jackson, G., Gater, R., Goldberg, D., Tantam, D., Loftus, L. & Taylor, H. (1993). A new community health team based in primary care. British Journal of Psychiatry 162, 375384.CrossRefGoogle ScholarPubMed
Kisely, S., Faragher, B., Gask, L. & Goldberg, D. (1992). Measuring psychiatric disorder in the recent past: the use of the Psychiatric Assessment Schedule retrospectively. Psychological Medicine 22, 457486.CrossRefGoogle ScholarPubMed
Larsen, D., Atkinson, C., Hargreaves, W. & Nguyen, T. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and Program Planning 2, 197207.CrossRefGoogle ScholarPubMed
Tyrer, P. (1984). Psychiatric clinic in general practice: an extension of community care. British Journal of Psychiatry 145, 914.CrossRefGoogle ScholarPubMed
Tyrer, P., Sievewright, N. & Wollerton, S. (1984). General practice psychiatric clinics, impact on psychiatric services. British Journal of Psychiatry 145, 1519.CrossRefGoogle ScholarPubMed
Warner, R., Gater, R., Jackson, G. & Goldberg, D. (1993). Effects of a community mental health service on the practice and attitudes of general practitioners. British Journal of General Practice 43, 507511.Google ScholarPubMed
Williams, P. & Clare, A. (1981). Changing patterns of psychiatric care. British Medical Journal 282, 375377.CrossRefGoogle ScholarPubMed
Wing, J., Cooper, J. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar