Pathways of care of women in secure hospitals: which women go where and why.

Background: Care pathways for women needing expensive, secure hospital care are poorly understood.

Aims: To characterise women in low and medium security hospitals in England and Wales and to compare populations by security and service provider type.

Method: Census data from all specialist commissioning areas.

Recovery from postnatal depression: a consumer's perspective.

To identify factors that women who have recovered from postnatal depression consider to be important in the recovery process and to measure the consensus among recovered women regarding the importance of those factors. A two-panel, three-round adapted Delphi exercise supplemented by a user-led interpretation work-shop. Panel one consisted of ten women who had been treated by a health visitor for and recovered from postnatal depression.

Using activity data to explore the influence of case-load size on care patterns.

Background: A limited case-load size is considered crucial for some forms of intensive case management and many countries have undertaken extensive reorganisation of mental health services to achieve this. However, there has been limited empirical work to explore this specifically.

Aims: To test whether there is a discrete threshold for changes in intensive case management practice determined by case-load size.

Essential elements of an early intervention service for psychosis: the opinions of expert clinicians.

Background: Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements.

Methods: A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians.

Assertive community treatment across the Atlantic: comparison of model fidelity in the UK and USA.

Background: The significant reductions in hospital admission demonstrated in US assertive community treatment (ACT) studies have not been replicated in the UK. Explanations cite poor UK 'model fidelity' and/or better UK standard care. No international model-fidelity comparisons exist.

The effect of intensive case management on the relatives of patients with severe mental illness.

Objective: Relatives play a vital role in caring for patients with severe mental illness but receive inadequate support from psychiatric services. Evidence suggests that although intensive case management is directed primarily at patients, relatives may benefit as well. This study examined whether relatives of patients who were receiving intensive case management had more contact with mental health professionals than relatives of patients who were receiving standard case management.

Exposure to case management: relationships to patient characteristics and outcome. Report from the UK700 trial.

Background: Trials in community psychiatry must balance rigour with generalisability. The UK700 trial failed to find a significant effect on hospitalisation, but its sample population contained significant heterogeneity of exposure to case management in the two groups.

Aims: To test whether patients successfully exposed to a minimum of 12 months' intensive case management over the 2-year follow-up period achieved reduced hospitalisation.