Assessment of outcomes in community support systems: results, problems, and limitations.

Assessment of outcomes in community support systems for chronic mental patients is associated with a number of difficulties, including the lack of an operational definition, the need to study synthesized programs as approximations to organic community support systems, ans severe methodological deficits within existing studies and in cross-study comparability. Although outcome studies indicate that community support programs show some apparent advantages in the treatment of patients, treatment gains are limited and tenuous. Moreover, interpretation of study results must be tentative because of methodological and programmatic limitations. Improved program evaluation and impact evaluation procedures are necessary to assess the efficacy of community support systems both in enhancing patient care and in providing solutions for the problems associated with deinstitutionalization.