The Role of Comprehensive Community-Based Rehabilitation Service Model in the Holistic Management of Patients with Severe Mental Disorders: A Randomized Controlled Trial Study

Ying Chen, Yanqiu Zhang, Yuan Li, Mingbing Su, Min Gao

Show Less

¹ Kunming Psychiatric Hospital, Kunming 650101, Yunnan, China,

JCNR 2026 , 10(4), 300–307; https://doi.org/10.26689/jcnr.v10i4.14517

© 2026 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Objective: To investigate the clinical efficacy, improvement in social functioning, prevention of relapse, and health economic value of a comprehensive community-based rehabilitation service model in the holistic management of patients with severe mental disorders, providing empirical evidence for the standardized promotion of community rehabilitation. Methods: A parallel-group randomized controlled trial (RCT) was conducted, involving 200 patients with severe mental disorders in a stable phase. They were randomly assigned at a 1:1 ratio to an intervention group (comprehensive community rehabilitation, n = 100) and a control group (routine community management, n = 100), with continuous intervention for 12 months. The Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance Scale (PSP) were used as primary outcome measures to compare differences in symptom improvement, social functioning, relapse rate, medication adherence, hospitalization status, and medical expenses between the two groups. Results: After 12 months of intervention, the PANSS total score in the intervention group (43.0 ± 6.8) was significantly lower than that in the control group (47.9 ± 7.5), while the PSP score (66.0 ± 8.0) was significantly higher than that in the control group (60.8 ± 7.3), with statistically significant differences (p < 0.001). The relapse rate in the intervention group (10.0%) was significantly lower than that in the control group (22.0%), while the medication adherence rate (83.0%) was significantly higher than that in the control group (68.0%). The hospitalization rate, number of hospitalization days, and annual total medical expenses were all significantly lower in the intervention group than in the control group (p < 0.05). Conclusion: The comprehensive community-based rehabilitation service model can effectively improve psychiatric symptoms and social functioning in patients with severe mental disorders, reduce the risk of relapse and hospitalization, and save medical costs. It represents an efficient and promotable core intervention strategy for the holistic management of severe mental disorders.

References

Ma H, Wu X, Chen R, et al., 2021, Current Status and Prospects of Community Management of Severe Mental Disorders in China. Chinese Journal of Psychiatry, 54(1): 1–6.

National Health Commission, 2018, Work Specifications for the Management and Treatment of Severe Mental Disorders (2018 Edition).

Ministry of Civil Affairs, Ministry of Finance, National Health Commission, et al., 2022, Notice on Launching the “Integrated Action for Mental Health Rehabilitation”.

Xie B, 2023, Bottlenecks and Breakthrough Paths in the Development of China’s Community Rehabilitation System for Mental Disorders. Chinese Mental Health Journal, 37(5): 357–361.

Moher D, Hopewell S, Schulz K, et al., 2010, Consort 2010 Explanation and Elaboration: Updated Guidelines for Reporting Parallel Group Randomised Trials. BMJ, 340: c869.

American Psychiatric Association, 2013, Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington DC: APA.

Ye X, Zeng F, Wang Y, et al., 2023, Meta-Analysis of the Effects of Community Rehabilitation on Symptoms and Social Function in Schizophrenia. Chinese Journal of Behavioral Medicine and Brain Science, 32(3): 241–247.

Fu W, Zhang M, Qin H, et al., 2022, Efficacy and Health Economic Evaluation of Comprehensive Community Rehabilitation for Chronic Schizophrenia. Chinese Journal of Rehabilitation Theory and Practice, 28(6): 721–726.

Chen J, Zhang M, 2020, Research Progress in Psychosocial Rehabilitation for Mental Disorders. Chinese Journal of Psychiatry, 53(2): 89–94.

Si T, Yu X, 2022, Whole-Course Management and Rehabilitation Strategies for Schizophrenia. Chinese Journal of Psychiatry, 55(1): 1–5.

Kay S, Fiszbein A, Opfer L, 1987, The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Schizophr Bull, 13(2): 261–276.

Si T, Yang F, Wang C, et al., 2010, Reliability and Validity Study of the Chinese Version of the Personal and Social Performance Scale (PSP). Chinese Journal of Psychiatry, 43(3): 142–145.

Morisky D, Green L, Levine D, 1986, Concurrent and Predictive Validity of a Self-Reported Measure of Medication Adherence. Med Care, 24(1): 67–74.

Fang J, Hao Y, 1999, Reliability and Validity of the Chinese Version of the World Health Organization Quality of Life Scale. Chinese Mental Health Journal, 13(4): 203–205.

Wang Y, Chen C, Li J, 2012, Reliability and Validity Evaluation of the Chinese Version of the Caregiver Burden Inventory (CBI). Chinese Journal of Public Health, 28(6): 827–828.

Zhang W, Kuang J, 2013, Advanced Tutorial on SPSS Statistical Analysis. Beijing: Higher Education Press.

Marshall M, Lockwood A, Adams C, et al., 2020, Assertive Community Treatment for People with Severe Mental Illness. Cochrane Database Syst Rev, 2020(8): CD000942.

Wang X, Lu Z, Li H, 2022, Expert Consensus on Relapse Warning and Early Intervention for Schizophrenia. Chinese Journal of Psychiatry, 55(4): 221–227.

Yu X, 2023, From “Hospital-Centered” to “Community-Based”: Transformation of Mental Health Services in China. Chinese Mental Health Journal, 37(1): 1–4.

Wu X, Ma H, Guan W, et al., 2021, Study on Hospitalization Service Utilization and Economic Burden of Patients with Severe Mental Disorders. Chinese Journal of Public Health, 37(5): 667–670.

Chen Z, Feng J, Shi Y, et al., 2024, Research Progress in Health Economic Evaluation of Community Rehabilitation for Mental Disorders. Journal of Sichuan University (Medical Science Edition), 55(2): 211–216.

Li K, Yang Y, Zhang Y, 2023, Suggestions and Prospects for the Development of Community Rehabilitation Services for Mental Disorders in China. Chinese Journal of Health Management, 17(6): 401–405.

Previous article in this issue

Next article in this issue