Treatment Outcome Study of Community-Based Residential Care
Author(s):
William B. Hawthorne, PhD
William Fals-Stewart, PhD
James B. Lohr, MD

This retrospective outcome study of two community-based, residential programs with a psychosocial rehabilitation orientation was published in February 1994 (Hawthorne, W. B., Fals-Stewart W., & Lohr J. B. (1994). A treatment outcome study of community-based residential care. Hospital and Community Psychiatry, 45 (2), 152-155). The study utilized a repeated-measures design to evaluate client outcomes of 104 (49%) of the 212 eligible clients who had completed residential treatment at Casa Pacifica or Chrysalis Center and a one-year post-discharge follow-up period. The study period ended in 1992 when Chrysalis Center was closed due to State mental health funding cuts.

Service utilization data from the public mental health database and self-report employment and living situation data were collected for 24 months before program entry and for 12 months after discharge from the either of the two similar residential programs. The one-year mean number of psychiatric hospital and/or crisis residential admission episodes and days for the 24 month period preceding admission was compared to the one-year mean after discharge from the program. Employment status, living situation, and Global Assessment of Functioning (GAF) scores at program entry and at one-year follow-up were also compared. In addition, 13 socio-cultural and clinical factors including other services received were individually tested for association with outcome. Mean age for study participants was 31.4 years. Sixty (57%) participants were men and 44 (42%) were women. Diagnostic categories of participants included 50% schizophrenia (including schizoafective disorder), 20% major depression, 19% bipolar disorder, and 11% were other diagnoses.

Findings included significantly fewer hospital and/or crisis residential admissions and days during the follow-up year. At the one-year follow-up, a significantly greater proportion of clients were employed and living independently, and fewer were homeless. GAF scores were significantly improved at the one-year follow-up. No associations were found between other variables tested. Comparisons of sociodemographic variables of study participants (49% of eligible clients) and non-participants (51% of eligible clients) found no significant differences between the groups. Despite design limitations, the findings suggest that psychosocial residential treatment models may offer a low cost and effective approach to community-based rehabilitation efforts with seriously mentally ill clients.