BMJ 2000;320:305-309 ( 29 January )

Education and debate

    The home treatment enigma
    Home treatment---enigmas and fantasies

The home treatment enigma

M G Smyth, honorary senior lecturer,  J Hoult, consultant. 

Department of Psychiatry, Northern Birmingham Mental Health (NHS) Trust, Birmingham B23 6AL

Correspondence to: M G Smyth

The first 150 words of the full text of this article appear below.

Why is home treatment for acute psychiatric illness generally ignored as an alternative to conventional admission to hospital in the United Kingdom? Despite evidence showing that home treatment is feasible, effective, and generally preferred by patients and relatives, its widespread implementation is still awaited. Furthermore, no study has shown that hospital treatment is better than home treatment for any measure of improvement. In general, patients are denied the option of home treatment as a realistic, less restrictive alternative to formal admission under the Mental Health Act 1983, although the recent white paper Modernising Mental Health Services recommends that it should be provided.1

In any economic analysis, hospital admission remains the most expensive element of psychiatric care. Although the pressure on acute beds in inner city psychiatric hospitals in the United Kingdom is increasing---and it has reached breaking point in some areas 2 3 ---it is claimed that managing these patients outside . . . [Full text of this article]
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