From March 1997, the acute day hospital in Central Manchester was extended to 24 hours, seven days a week, with patients treated entirely at home if preferred. The development and organisation of the new service are described. Preliminary evaluation data include service activity for the first 12 months and comparison with a consecutive series of in-patients during the first three months.
There was an increase in the number of patients treated in the first year (n=214). Sixty-two per cent of patients suffered from schizophrenia, psychotic depression or bipolar disorder. Patients treated by the new service in the first three months (n=43) were more likely than in-patients (n=37) to have problems eating or drinking and to present with suicide risk, whereas the inpatients were more likely to have had adverse past experiences of services and to show behavioural disturbances.
The findings support the continued development of 24–hour alternatives to inpatient care, while emphasising that those requiring inpatient care have different presentations and needs.
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