In Nigeria, Ibadan, India, some achieve 85% recovery rates ... on the best test of recovery - that is, combining social and clinical recovery.

Wholelife countries have communities where people with schizophrenia are among people they know, and who know them - they have grown up together.

Such communities in the third world have plenty of space in an equable climate so that out of doors is available all the time for 'distancing yet staying in touch' through sight and sound - wandering about is acceptable , and the pace of change around is easy; what is there does not change much. The work that is done is what has always been done within a local schedule, and grown up with. Separation with illness and return when well enough is to rejoin something that has a routine well known, and some social process which has not changed much. An extended family with residual obligations of mutuality, stay together as available support.

Such attributes have been put forward as explaining the difference between the relatively better result for schixophrenia in less developed countries

A bigger proportion stay well after a first attack. If the illness continues, twice as many relapse in 'western countries' as in the third world.

Studies in India , rather suggest the differences are rural living versus urban living. The explanation is that the rural settings have less High Expressed Emotion, Yes, but how is that ? .

Or is it that life in rural living has a relatively unchanging domestic and a more leaiurely and simple work schedule, an external collectiveseasonal routine into which people with schizophrenia can fit , without receiving high EE from fellow work mates
More space, more time.
A simple internal 'Library' of experience to access, with a simple outside 'template'

{ The studies seem to be weighted for hot countries where outside living is easier ??]

Successful countries run 'whole system' attitudes - worthwhile occupations and income , lasting and supportive social relationships, effective treatment and decent housing, recognition of the individual in their interests, involvement of family and friends , and the neighbourhood, volunteers , agencies, charities: identification of person based needs and respect; development through learning and reflection; on the job.
Community partnerships that can provide work opportunities, occupational and educational activities, social networks.

The point is how to have these readily accessible and with secure backing in a suficiently sheltered menu with which to engage.

Cornwall Partnership ( mental health ) Trust [ leader ; Amailia Burt ] has signed up.

It's a three year programme - so that means there is no hurry in it , I'm afraid.

It identifies
... a defined group of service users

? what definition ? ... based on information form a Cues patient questionnaire, describing local needs

..committed to working with'outside agencies' [ e.g Pentreath Industries - not any more ? the Cornwall Primary Care Trust changed the priority - no longer a rehabilitation contract - now , getting people back into competitive woprk]

feed back from users. [ and carers ??!! ]

learning from others [ e.g. Dave King ]

Identification of the lead individual ? Andy Jago ?

linked with the local Implementation Team

The collection of information will be by using a patient questionnaire 'CUES' tick list. Staff will have to be trained to be familiar with it in use.

It furnishes an add-on data set

regular briefing

sharing the progress with others.

Not a mention of getting carer experience!!!

CUES for Carers