Shern D L, Tsemberis S, Anthony W, Lovell A M, Richmond L, Felton C J, Winarski J, Cohen M
New York State Office of Mental Health, Albany, USA.
Am J Public Health. 2000 Dec;90(12):1873-8. doi: 10.2105/ajph.90.12.1873.
This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness.
Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study participants at baseline and at 6-month intervals over 24 months, using measures of service use, quality of life, health, mental health, and social psychological status. The average deviation from baseline summary statistic was employed to assess change.
Compared with persons in standard treatment (n = 77), members of the experimental group (n = 91) were more likely to attend a day program (53% vs 27%), had less difficulty in meeting their basic needs, spent less time on the streets (55% vs 28% reduction), and spent more time in community housing (21% vs 9% increase). They showed greater improvement in life satisfaction and experienced a greater reduction in psychiatric symptoms.
With an appropriate service model, it is possible to engage disaffiliated populations, expand their use of human services, and improve their housing conditions, quality of life, and mental health status.
本研究测试了一种精神康复方法，用于为街头流浪的重度精神疾病患者组织和提供服务。
将街头流浪的重度精神疾病患者随机分配到实验项目（称为“选择”）或纽约市的标准治疗组。我们在基线时以及在24个月内每隔6个月对研究参与者进行评估，使用服务利用、生活质量、健康、心理健康和社会心理状态等指标。采用与基线汇总统计量的平均偏差来评估变化。
与接受标准治疗的患者（n = 77）相比，实验组的成员（n = 91）更有可能参加日间项目（53%对27%），满足基本需求的困难更小，在街上花费的时间更少（减少55%对28%），在社区住房中花费的时间更多（增加21%对9%）。他们在生活满意度方面有更大改善，精神症状减少得更多。
采用适当的服务模式，有可能让脱离社会的人群参与进来，扩大他们对人类服务的利用，并改善他们的住房条件、生活质量和心理健康状况。
