The RANZCP guidelines for Schizophrenia: Why is our practice so far short of our recommendations, and what can we do about it?

The Australian and New Zealand Journal of Psychiatry
Olav NielssenCherrie Galletly

Abstract

The new RANZCP guidelines for the treatment of schizophrenia and related disorders highlights what we know works. In this paper, we examine why patients so often fail to benefit from this knowledge and why clinical practice falls so far short of the recommended standard. Instead of the continuous improvement that we expect of health care in general, in psychiatry we face an accelerating decline in systems of care. There has been a sustained underinvestment in public mental health care and a shared failure by State and Federal governments to construct and commit to a governance and funding model that can deliver the standard of care that is available in other major non-communicable diseases, and which we know is equally possible for severe mental illness. This paper sets out some of the reasons for the poor quality of care received by many people with schizophrenia and related disorders in Australia, and describes ways that care could be improved. In particular, we recommend an explicit statement of what constitutes an adequate standard of care, for people at all stages of these illnesses. This would help provide transparency about whether the care provided by mental health services achieves these benchmarks, and enable publicat...Continue Reading

References

Jun 10, 2005·The Australian and New Zealand Journal of Psychiatry·Olav Nielssen, Shavtay Misrachi
Oct 24, 2006·The Australian and New Zealand Journal of Psychiatry·Eoin J KillackeyPatrick D McGorry
Aug 14, 2008·The British Journal of Psychiatry : the Journal of Mental Science·Nick CraddockStan Zammit
Mar 13, 2012·The American Journal of Psychiatry·Wenche Ten Velden HegelstadThomas McGlashan
Jun 16, 2012·The Journal of Clinical Psychiatry·Olav B NielssenMatthew M Large
Jun 22, 2012·The Australian and New Zealand Journal of Psychiatry·Geoffrey WaghornJohn J McGrath
Aug 1, 2013·The Australian and New Zealand Journal of Psychiatry·Richard J Porter
Oct 22, 2013·The Australian and New Zealand Journal of Psychiatry·Heather HayesOlav B Nielssen
Mar 26, 2014·Current Opinion in Psychiatry·Merete NordentoftAnne A E Thorup
Dec 20, 2014·The Australian and New Zealand Journal of Psychiatry·Scott HendersonGin S Malhi
Feb 27, 2017·The Lancet. Psychiatry·Carsten HjorthøjMerete Nordentoft

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Citations

Feb 8, 2019·Integrative Psychological & Behavioral Science·Jennifer M CleggKathleen H Corriveau
Apr 25, 2019·Perspectives on Psychological Science : a Journal of the Association for Psychological Science·Deborah Kelemen
Aug 9, 2019·Psychological Science·Benjamin D Jee, Florencia K Anggoro
Jul 11, 2019·Psychological Science·Sami R YousifFrank C Keil
Feb 9, 2019·Asia-Pacific Psychiatry : Official Journal of the Pacific Rim College of Psychiatrists·Harry HillCarol Harvey
Jan 22, 2020·Early Intervention in Psychiatry·Cristina MeiPatrick D McGorry
Aug 19, 2021·The Australian and New Zealand Journal of Psychiatry·Olav NielssenMatthew Large

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