Internal vs. external care management in severe mental illness: randomized controlled trial and qualitative study

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. There were no apparent advantages in cost or in clinical outcomes for patients with severe mental illness (SMI) treated by either internal or external care management (ICM and ECM, respectively). However, the findings of the qualitative study suggested that the model of ICM implemented in Paddington was insufficient to overcome the systematic divisions between policies, practices and personnel of health and social care agencies. The authors suggested that social work and health care functions may need to be fully integrated at all levels in order to achieve improved outcomes for patients and greater cost-effectiveness.