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Does community care for the mentally ill make a difference? A tale of two cities.

Matched groups of schizophrenic patients in Portland, Ore., and Vancouver, B.C., were compared approximately 1 year following discharge from an index hospitalization. Whereas Vancouver boasts a rich network of accessible private services and a public mental health system that provides a model of care for the chronically mentally ill, Portland's aftercare facilities at the time of the study were limited. One year after discharge the Vancouver cohort experienced fewer readmissions, was more apt to be employed, and reported a higher level of well-being, all of which suggest that community aftercare positively affects the negative symptoms of schizophrenia.