Community-based care helpful for schizophrenia in low-income countries

A combination of community- and facility-based treatment for schizophrenia is modestly more effective than facility-based care alone, according to new research published in The Lancet.

The study reports the results of the first randomized trial to test community-based care for people with schizophrenia in a low-income country - in this case, India.

In low- and middle-income countries, there is an absence of the clinical and social services for schizophrenia patients that - in high-income countries - are coordinated by specialist community-based multidisciplinary teams.

Severe financial and human resource constraints in lower-income countries make developing new methods for accessible schizophrenia services very difficult.

"In many low-income countries, fewer than 10% of people with mental health problems receive any treatment," says Graham Thornicroft, a professor of community psychiatry from the Centre for Global Mental Health, King's College London, Institute of Psychiatry, who led the research.

"There may be just a handful of psychiatrists, and in some countries, there are no mental health specialist doctors at all," he adds.

But observational evidence has shown that community-based rehabilitation services in low- and middle-income countries could improve the clinical and social outcomes of people with schizophrenia.

Standard facility-based care versus community-based care