A Randomised Controlled Trial of service level agreements between GPs and secondary services for the care of the long term mentally ill.

INTERVENTION: 1. Locally negotiated service level agreements 2. Standard care CONDITION: Mental and behavioural disorders: Schizophrenia and other psychoses ; Mental and Behavioural Disorders ; Schizophrenia PRIMARY OUTCOME: The principal outcome measures will include levels of disability, mental ill health, self care and quality of life. Global Assessment of Functioning (GAF), Health of the Nation Outcome Scale (HoNOS), Verona Satisfaction Scales (VECS and VSSS), GHQ for patient carers, Client Service Receipt Interview (CSRI) to assess cost, questionnaires to evaluate staff views on the clarity of roles and attitudes to the primary/secondary care interface. SECONDARY OUTCOME: Not provided at time of registration INCLUSION CRITERIA: Practices: General practices with a majority of their patients within the Mental Health Trust boundaries, with a computerised repeat prescribing system. Patients: Patients with long term mental illness based on the criteria of duration, diagnosis and disability. Patients with diagnoses of schizophrenia and related disorders and bipolar affective disorder will be included, in addition to those with chronic relapsing depression or on prophylactic antidepressants for more than six months. Those disabled by chronic neurotic disorders will also be included.