Training community psychiatric nurses in schizophrenia family work: A study of clinical and economic outcomes for patients and relatives

The purpose of the study was to evaluate whether community psychiatric nurses trained in family work skills could effectively alter the emotional environment in families caring for a person with schizophrenia, and what the cost implications were. Thirty families entered the trial and were randomised to the complete package of family work (16 subjects) or to a control group (14 subjects) receiving education alone. All relatives scored highly on Expressed Emotion (EE) initially. Of the 12 experimental relatives followed up, seven changed to low EE, compared with only two of the 11 control relatives (Fishers exact p =0.053). The relapse rates for the patients over one year were 25% in the experimental group and 36% in the control group, a non-significant difference. However, two other control patients spent the whole year in hospital. The cost of the training and of working with one family was more than covered by the savings in hospital costs.