Table 4 The core components of shared care models for severe and/or persistent mental disorders (contd)
From: Shared care in mental illness: A rapid review to inform implementation
| Â | Harrison-Read 2002 | Lester 2003 | ACCESS Rosenheck 2002 | Rosenheck 2003 | van Orden 2009 | Warner 2000 |
|---|---|---|---|---|---|---|
Process of care | Enhanced Community Management/Assertive Community Treatment | Patient-held record | Integration of service systems with outreach and case management | Housing + Intensive Case Management | Collaborative care involving access to a mental health worker in primary care | Shared care record |
Condition | "Heavy users" of psychiatric services | Schizophrenia | SMI and associated co-morbidities + homelessness | Psychiatric and/or substance abuse disorders | Mental disorder (not described) | Long term mental illness- psychosis, personality disorder or other condition requiring long term supervision |
Length of follow-up | 2 years | 1 year | 5 years | 1 year | 1 year | 1 year |
Screening | no | no | yes | unclear | yes | Patients selected at hospital discharge |
Additional training for staff | unclear | yes - in use of the record | yes - inter-agency | yes - with written materials | Â | no |
Treatment algorithm | unclear | no | unclear | no | Â | no |
Formal stepped care | unclear | no | unclear | no | Â | no |
Enhanced communication between health providers | yes | yes - shared care record and flagging of patient records in both general practice and specialist settings | yes | yes - inter-agency agreement | yes | yes - shared care record linked to other communication processes |
Care management location | community | general practice and community | community | community | general practice/primary care | general practice and community |
Patient education/self management | unclear | no | unclear | no | yes - CBT | no -instruction on use of the booklet only |
Case management | yes | unclear | yes | yes | ? | unclear |
Specialist supervision | yes | unclear | yes | unclear | yes | unclear |
Care coordination | yes | unclear | yes | yes | no - referral only | unclear |
Follow up provided to patient | unclear | unclear | yes | unclear | unclear | unclear |
Crisis support | no | unclear | unclear | yes | unclear | unclear |
Standardised outcome measure | yes | yes | yes | yes | yes | yes |