The Effectiveness Of Case Management In Violence And Social Function Of The Patients Tith Schizophrenia

Background and Purpose: Mental illness is a group of disease with low cure rate, high recurrence and disability rate, which not only seriously affect people's health, but also bring a heavy burden for the state, society and the family. According to epidemiological survey in 1992, China's overall morbidity rate of mental illness is 13.47‰, there are more than 16 million persons with mental illness. The mental illness has become a serious public health issue and a prominent social problem. The community mental health services developed in 1950s have been proved to be a effective way to reduce the occurrence of mental illness and mental disability and to prevent the relapse of mental illness by most of counties in the world. Case Management is a process full of cooperation in order to meet the needs of patients in health, which includes assessment, planning, implementation, coordination, monitoring and evaluation and tries to achieve high-quality community service through a variety of communication and choice of treatment conditions. Therefore, the case management plays an important role in community mental health service, it makes the community mental health services better than before in continuity, coordination and efficiency. Moreover, the community mental health service is at an early stage in China. Many regions are exploring a effective way which is fit for the community mental health service of our country. First, we established the community case management system through studying the foreign case management models in Xinhui District, Jiangmen City, Guangdong Province. The purpose of the study is to explore the effect of case management for the patients with schizophrenia and to improve the implementation of the case management program.Objects and Methods: 30 schizophrenic patients were selected for case management treatment for one year in Shuangshui town, Xinhui District, Jiangmen City. Using the Clinical Global Impression Scale (CGI), the individual and social performance scale ( PSP), risk behavior assessment form, and Social Disability Screening Schedule (SDSS) to evaluation the patients' situation once a month. Using Positive and Negative Syndrome Scale (PANSS) and Social Support Rating Scales (SSRS) to evaluate the patients' situation once every six months.Results: 1 Through the case management the number and frequency of violence in second,third,fourth,fifth and sixth month decline than the first month (P<0.01).2 Statistically, there is no significant difference between each month in scores of SDSS .3 There is statistical significant difference in the score of each item of PANSS between the sixth month and the joining month through the case management.4 There is statistical significant difference in the score of social support and subjective support than the norm. There is also statistical significant difference in the score of each item of SSRS between the sixth month and the joining month.Conclusion: 1 To establish networks of mental illness and to implement case management programs in the community can effectively reduce the incidence of violence of the schizophrenic patients, improve the patient's condition and prevent the deterioration of the social functions of the schizophrenic patients.2 We should strengthen the family intervention to improve the social support.