Schizophrenics and Home Care

Home treatment for schizophrenics overseen by local health workers is more effective than institutionalization, a recent large study in India has found.

The study — a clinical trial involving 282 patients at three sites in India — found that supervised home treatment, with limited hospitalization available, was somewhat better at reducing patients’ disability and much better at getting them to stay on their medications.

In poor countries with doctors overwhelmed by the struggle against physical diseases, mental disease is often ignored. In extreme cases, those with mental illness are simply kept in chains.

Many effective anti-psychotic drugs are too old to patent, so if they were available, even the poorest countries could offer some treatment, the study suggested. The health workers needed only six weeks of training.

Still, in the India study, home care was about $150 per patient more expensive than hospitalization or psychiatric care. Travel costs for the workers was a major factor.

by Donald G. McNEIL Jr., The New York Times

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