BMJ 2000;321:177 ( 15 July )

Letters

Psychiatric home treatment

    Vigorous, well designed trials are needed
    Home treatment works
    Treatment at home is nationwide and successful

Vigorous, well designed trials are needed

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

EDITOR---Smyth and Hoult ask why the implementation of home treatment has been "delayed" in the United Kingdom and call for more "sophisticated evaluations" while continuing the same tired (and tiresome) polemic masquerading as science that holds up such progress.1 They present a categorical view of home treatment versus "the rest," where only one of "the 12 features of an effective home treatment team" (several visits daily) is not available in some form in routine British mental health practice. How do Smyth and Hoult know that each of these 12 features is necessary or makes a difference? They do not. The series of studies they quote are all "black box" trials of complex and often poorly defined experimental services against even more poorly defined control services (often simply called standard care). To prove effectiveness, carefully controlled trials that vary only one component are needed. Smyth and Hoult did not quote our . . . [Full text of this article]
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Relevant Article

The home treatment enigma • Home treatment---enigmas and fantasies
M G Smyth, J Hoult, Anthony J Pelosi, and Graham A Jackson
BMJ 2000 320: 305-309. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Cassell, J, Young, A (2002). Why we should not seek individual informed consent for participation in health services research. J. Med. Ethics 28: 313-317 [Abstract] [Full text]  
  • Burns, T., Catty, J. (2002). Mental health policy and evidence: Potentials and pitfalls. Psychiatr. Bull. 26: 324-327 [Full text]  
  • Sandor, A. (2001). Home treatment service. Psychiatr. Bull. 25: 486-487 [Full text]  

Rapid Responses:

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Ciaran S Clarke, et al.
bmj.com, 17 Oct 2000 [Full text]
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Beverly K. Walton, et al.
bmj.com, 16 Apr 2003 [Full text]
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