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Community care

What is community care?

Community care refers to community-based interventions that involve medication, psychosocial treatments, monitoring of clinical progress, and housing and supportive services. These programs encourage patients to establish meaningful relationships, occupations and activities, while also establishing routines at home. Community treatment may also involve involuntary outpatient commitment (compulsory community treatment) to ensure patients receive their necessary treatment.

What is the evidence for community care?

Moderate to high quality evidence suggests no differences between compulsory and voluntary community care in the number of hospital readmissions. Lower quality evidence also suggests no differences in the number of bed days, symptom severity or functioning. However, community care may  provide some benefit over standard care for improving treatment adherence, and may provide benefit in low and middle income countries for improving symptoms and disability, and for reducing relapse rates.

Barriers to feasibility of community care in low and middle  income countries include low education, lack of caregivers, resource constraints, and other logistical issues. Barriers to acceptability include fear of stigma and  lack of appreciation of intervention benefits. Facilitators of acceptability include satisfaction with, and appropriateness of, interventions, increased participation rates, and health worker characteristics (e.g. knowledge, trustworthiness, fluency in local  dialects, listening skills).

 

May 2016

Page last updated: 2:36  30 August 2017

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