Restrictiveness of Care Among the Severely Mentally Disabled

Preference Weights for Cost-Outcome Analyses of Schizophrenia Treatments: Comparison of Four Stakeholder Groups

“…Level descriptions were adapted from Strauss and Carpenter (1974) and from the Social Adjustment Scale (Paykel et al 1971). Independent living: Level descriptions were adapted from a restrictiveness scale used in prior studies of the severely mentally ill (Ransohoff et al 1982; Hargreaves et al 1984). Vocational function: Level descriptions reflect the limited range of vocational function experienced by most persons with schizophrenia.…”

“…6. Independent living: Level descriptions were adapted from a restrictiveness scale used in prior studies of the severely mentally ill (Ransohoff et al 1982;Hargreaves et al 1984). 7.…”

Long-Term Care Services for the Chronically Mentally Ill: Reimbursement System Structure, Effects, and Alternatives

“…Studies of psychiatric outpatient clients and their extent of disability, medical illness, and treatment outcomes are increasing in number and becoming more sophisticated and generalizable (Maricle, Hoffman, Bloom, et al 1987;Goldman and Taube 1988;Moltzen, Gurevitz, Rappaport, et al 1986;Horgan 1986). Some of these studies also address the use of services by the chronically or severely mentally disabled Hargreaves, Gaynor, Ransohoff, et al 1984;Taube, Kessler, and Bums 1986). While generalizability is limited due to the methodologies underlying case presentations, these studies provide important information on portions of the CMI population served in a variety of innovative and nontraditional settings.…”

“…However, there is now a growing literature on the effect of deinstitutionalization and the community support movement on the patients involved, particularly those who fell outside the supposed support network that was expected to be established (Waxman 1986;Brunger 1986;Goldman and Morrissey 1985;Bachrach 1984; Hargreaves, Gaynor, Ransohoff, et al 1984;Gudman and Shore 1984;Braun, Kochansky, Shapiro, et al 1981). From the research to date, we are beginning to see that not only are those served by existing facilities and programs heterogeneous, but so too are those not served.…”

Therapeutic effort, treatment outcome, and national health policy.

“…A promising approach to the measurement of restrictiveness has been developed by Hargreaves and his colleagues (Hargreaves, Gaynor, Ransohoff, & Attkisson, 1984; Ransohoff, Zachary, Gaynor, & Hargreaves, 1982). Their measure describes the degree to which the clinical service environment is designed to exert control over (re-strict) the patient's interactions and movements in order to optimize outcomes.…”