BMJ  2005;331:586-587 (17 September), doi:10.1136/bmj.331.7517.586

Editorial

Evidence based reform of mental health care

Early, intensive, and home based treatments are the answer

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

Two big ideas have dominated reform in mental health care in recent years and underpin the widespread enhancement of services that is being attempted in England. These are that people with mental disorders should have treatment in the community, and that young people with early psychosis should receive timely and comprehensive intervention during the critical years following onset. Two large, high quality studies in this issue report much needed evidence on the impact and feasibility of these drivers for reform.^{1 2} Both studies are large and well designed and report positive results in support of the present reforms.

Johnson and colleagues (p 599) show elegantly that providing, in a disadvantaged inner city community, intensive treatment at home for acutely ill people with severe mental disorder substantially reduces the use of inpatient care.¹ The number needed to treat attests to the potency of this effect, which seems to be sustained . . . [Full text of this article]

ORYGEN Research Centre, University of Melbourne, Parkville, Victoria 3052, Australia (mcgorry@ariel.unimelb.edu.au)

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• McGorry, P. D (2008). Is early intervention in the major psychiatric disorders justified? Yes. BMJ 337: a695-a695 [Full text]  

Rapid Responses:

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Early intervention in psychosis

Alasdair J Macdonald
bmj.com, 19 Sep 2005 [Full text]

What evidence is needed for service reforms in mental health?

Tom Burns
bmj.com, 23 Sep 2005 [Full text]

Unrealistic standards for reform

PATRICK MCGORRY
bmj.com, 25 Sep 2005 [Full text]

Re: Unrealistic standards for reform

tom burns
bmj.com, 14 Oct 2005 [Full text]

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