ABSTRACT
Those with clinical experience of MCHT, who have seen admission to hospital averted many times, even for very sick individuals, and have witnessed the relief on the faces of the patients and their families, will share Dean and Gadd’s enthusiasm and puzzlement. However, donning one’s mental health services researcher hat, or one’s mental health systems planner’s hat, one has to agree with Kluiter; caution is required in adopting this model of care. All of the comparative studies are flawed to some degree; for example, questions have been raised about the degree to which their findings can be generalized to the general clinical population we deal with today, and we are often left in the dark regarding the conventional hospital-oriented treatment to which MCHT is compared. The irony is that while we mull over these studies, and wrestle with whether MCHT can be an alternative to admission, we lose sight of the fact that what MCHT purports to replace-hospital treatment-has, itself, been poorly evaluated (Kluiter, 1997).
