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Integrated care for people with long-term mental and physical health conditions in low-income and middle-income countries
- Authors:
- THORNICROFT Graham, et al
- Journal article citation:
- Lancet Psychiatry, 6(2), 2019, pp.174-186.
- Publisher:
- Elsevier
Integrated care is defined as health services that are managed and delivered such that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector and, according to their needs, throughout the life course. In this Review, we describe the most relevant concepts and models of integrated care for people with chronic (or recurring) mental illness and comorbid physical health conditions, provide a conceptual overview and a narrative review of the strength of the evidence base for these models in high-income countries and in low-income and middle-income countries, and identify opportunities to test the feasibility and effects of such integrated care models. We discuss the rationale for integrating care for people with mental disorders into chronic care; the models of integrated care; the evidence of the effects of integrating care in high-income countries and in low-income and middle-income countries; the key organisational challenges to implementing integrated chronic care in low-income and middle-income countries; and the practical steps to realising a vision of integrated care in the future. (Edited publisher abstract)
From efficacy to effectiveness in community mental health services. PRiSM Psychosis Study 10
- Authors:
- THORNICROFT Graham, et al
- Journal article citation:
- British Journal of Psychiatry, 173, November 1998, pp.423-427.
- Publisher:
- Cambridge University Press
The PRiSM Psychosis Study investigated the outcomes of community mental health services for epidemiological representative cases of psychosis in London. The results presented in the other studies are interpreted. Concludes that the evidence supports a community-orientated rather than a hospital-orientated approach and there is little difference between the community mental health team models.
Social inclusion, social quality and mental illness
- Authors:
- HUXLEY Peter, THORNICROFT Graham
- Journal article citation:
- British Journal of Psychiatry, 182(4), April 2003, pp.289-290.
- Publisher:
- Cambridge University Press
This article argues that it is possible to derive two quite different meanings for social exclusion, with different evidential bases, and with different implications for social and clinical action. The first concept of social exclusion, Demos, has implications for citizens' rights; the other, Ethnos, has more-significant implications for the practising clinician. Demos refers to the range of access rights which are offered by citizenship of a given nation state. By contrast, Ethnos refers to a shared cultural community rather than a national community, and to the shared values, identification and sense of cohesion that are engendered by membership of particular social groups and communities. Interventions designed to have an impact upon social inclusion through Demos channels would include enhancing structures that promise and deliver greater access to services. Actions by psychiatrists to achieve service improvement through Ethnos-related measures would, for example, relate to greater emphasis within the psychiatric training curriculum on understanding the interrelationships between ethnic minority culture and the experience of mental illness. There is in turn an interplay between these two domains: Ethnos-related measures are unlikely to be effective without concurrent Demos-related changes.