Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation.

A conceptual model for the development of community-based treatment programs for the chronically disabled psychiatric patient was developed, and the results of a controlled study and follow-up are reported. A community-treatment program that was based on the conceptual model was compared with conventional treatment (ie, progressive short-term hospitalization plus aftercare). The results have shown that use of the community program for 14 months greatly reduced the need to hospitalize patients and enhanced the community tenure and adjustment of the experimental patients. When the special programming was discontinued, many of the gains that were attained deteriorated, and use of the hospital rose sharply. The results suggest that community programming should be comprehensive and ongoing.