The community competence scale in the placement of the deinstitutionalized mentally ill

Abstract

Little systematic research has been directed towards the determination of appropriate residential placements for deinstitutionalized psychiatric patients. A previous study suggested that the Community Competence Scale (CCS), a 124-item multiscale instrument, had potential utility for community placement decisions. In the present study, the CCS was administered to 52 deinstitutionalized patients placed in an urban boarding home, a rural boarding home, and urban apartments. No significant differences on the CCS occurred attributable to urban vs. rural setting; accordingly, the urban and rural boarding home groups were combined. The CCS discriminated between patients placed in boarding home and apartment settings after variability between the groups associated with age and diagnosis had been removed. The CCS discriminated more effectively between the groups than did prior hospitalization, subsequent rehospitalization, or the Social Competence Scale (SCS). The CCS was significantly positively correlated with the SCS and significantly negatively correlated with previous hospitalization and age.

The community placement scale: An adaptation of the community competence scale for placement of the deinstitutionalized mentally ill

“…Interscorer reliability has been found to be .98 ; internal consistency reliability has been measured as .97 (Searight et al, 1986); test-retest reliability over a period of 1 week has been demonstrated to be .94, p < .001 .…”

“…Finally, no significant differences in scores associated with urban vs. rural placement or with gender have been found (Searight et al, 1986).…”

“…The CCS recently has been applied to the assessment of community placement in the deinstitutionalized mentally ill, first by Searight and his colleagues (Searight, Oliver, & Grisso, 1983; Searight, Oliver, & Grisso, 1986) and subsequently by Caul (1984). In these early applications, the CCS has shown considerable potential as a suitable preplacement screening device.…”

“…Prior to its administration by Searight (1983) and Caul (1984), mental health personnel charged with review of rights of human subjects in two states (Missouri and California, respectively) denied permission for 3 of its 16 scales to be administered on the grounds that these subscales would be unduly disturbing for chronic Community Placement Scale 377 psychiatric patients to complete. Their refusal raised the issue of whether portions of the measure would be acceptable to the mental health personnel charged with its application.…”

“…Abbreviation of the scale already has been undertaken in one published and one unpublished study in an attempt to address the issue of reduction of administration time (Searight, 1983;Searight et al, 1983), but results of this effort have been mixed. On the one hand, it has been possible to retain as great classificatory power with a shortened instrument as with the original scale.…”