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