Reducing violence in severe mental illness: randomised controlled trial of intensive case management compared with standard care.

Abstract

To establish whether intensive case management reduces violence in patients with psychosis in comparison with standard case management. Randomised controlled trial with two year follow up. Four inner city community mental health services. 708 patients with established psychotic illness allocated at random to intervention (353) or control (355) group. Intensive case management (caseload 10-15 per case manager) for two years compared with standard case management (30-35 per case manager). Physical assault over two years measured by interviews with patients and case managers and examination of case notes. No significant reduction in violence was found in the intensive case management group compared with the control group (22.7% v 21.9%, P=0.86). Intensive case management does not reduce the prevalence of violence in psychotic patients in comparison with standard care.