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Evidence summaries

Community Mental Health Teams (Cmht) for People with Severe Mental Illnesses and Disordered Personality

Community mental health teams (CMHT) management may be more acceptable to those with mental illness than a non-team standard care approach. CMTH also seems to be associated with fever deaths, but the evidence is insufficient. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 3 studies with a total of 587 subjects. CMHT management did not reveal any statistically significant difference in death by suicide and in suspicious circumstances (n=587, 3 RCTs, RR 0.49 CI 0.1 to 2.2) or from any cause (n=587, 3 RCTs, RR 0.47 CI 0.2 to 1.3) during medium term evaluation (3 - 12 months) although overall fewer deaths occurred in the CMHT group (5 vs. 12). Significantly more people in the CMHT group were satisfied with services compared with those receiving standard care (n=87, RR 0.37 CI 0.2 to 0.8, NNT 4 CI 3 to 11). Fewer people were admitted to hospital in the CMHT groups (n=587, 3 RCTs, RR 0.81 CI 0.7 to 1.0, NNT 17 CI 10 to 104). Admittance to accident and emergency services, contact with primary care, and contact with social services did not reveal any statistical difference between comparison groups.

Comment: The quality of evidence is downgraded by sparse data and inconsistency of results.

    References

    • Malone D, Newron-Howes G, Simmonds S, Marriot S, Tyrer P. Community mental health teams (CMHTs) for people with severe mental illnesses and disordered personality. Cochrane Database Syst Rev 2007 Jul 18;(3):CD000270. [PubMed]

Primary/Secondary Keywords