Evolving service interventions in Nunhead and Norwood

Abstract

Background: Service evaluation requires a detailed understanding of the services studied.Method: Community mental health services evaluated in the PRiSM Psychosis Study in south London are described. The intensive sector and standard sector services are contrasted.Results: The intensive sector had two teams with extended opening hours: a psychiatric acute care and emergency (PACE) team, and a psychiatric assertive continuing care (PACT) team focusing on care for people with chronic illness. In the standard sector there was a generic community team providing office-hour assessments, case management of the severely mentally ill and close liaison with in-patient services. The team made use of the local psychiatric emergency clinic and of other local resources. The intensive sector was characterised by: more admissions to fewer beds, more non-hospital residential places, extended hours, on-call rota, wider range of interventions, more medical and nursing staff, a lower nursing grade mix and higher staff turnover. The standard sector had a less highly resourced generic community psychiatric service.Conclusions: Change in services has been more marked in the intensive sector.