Quality Standard Details
Schizophrenia: Care in the Community for Adults
- Publication Date
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2023-March-01
- Status
- Published
- Topic Area
- Mental Health and Addictions
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Schizophrenia is a severe, chronic mental health condition that usually begins in late adolescence or early adulthood. In Canada, about one in 100 people have schizophrenia. A 2012 report identified schizophrenia as one of the five mental health and addictions–related conditions with the greatest impact on the life and health of people in Ontario.
People with schizophrenia die at a rate that is three times higher than that of the general population and die up to 15 years earlier. In addition, people with schizophrenia are at increased risk for having other psychiatric conditions, including substance use disorders, depression, and anxiety. They are also more likely to experience trauma, homelessness, and unemployment.
People with schizophrenia face important gaps in the quality of care they receive in Ontario; for example, only 26.8% of those who are hospitalized for schizophrenia receive a follow-up visit with a physician within seven days.
This quality standard addresses care for adults aged 18 years and older with a primary diagnosis of schizophrenia (including related disorders such as schizoaffective disorder). It also provides guidance on early psychosis intervention for people who experience a first episode of schizophrenia. The quality standard focuses on care provided in the community, including primary care, hospital outpatient care, rehabilitation, and community supports and services.
The quality standard also applies to care in correctional facilities. People with schizophrenia and other mental health conditions are disproportionately represented in the correctional system. For some people with schizophrenia, their first point of contact for mental health care occurs after they have become involved with the correctional system. For these individuals, it is particularly important that screening processes at intake be sufficiently well developed so that they can be diagnosed with schizophrenia.
Although this quality standard addresses care for people who have already been diagnosed with schizophrenia, the importance of having responsive services that ensure all Ontarians with schizophrenia can receive a diagnosis cannot be understated.
For a quality standard that addresses care for adults with schizophrenia who are seen in an emergency department or admitted to a hospital inpatient setting, please refer to Schizophrenia: Care for Adults in Hospitals.
Quality Standard in Brief
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Quality Statement 1: Care Plan and Comprehensive Assessment
Adults with schizophrenia have a care plan that is regularly reviewed and updated, and that is informed by a comprehensive assessment.
Quality Statement 2: Physical Health Assessment
Adults with schizophrenia receive a physical health assessment on a regular basis.
Quality Statement 3: Self-Management
Adults with schizophrenia have access to information and education that supports the development of self-management skills.
Quality Statement 4: Family Education, Support, and Intervention
Families of adults with schizophrenia are given ongoing education, support, and family intervention that is tailored to their needs and preferences.
Quality Statement 5: Access to Community-Based Intensive Treatment Services
Adults with schizophrenia have timely access to community-based intensive treatment services based on their needs and preferences.
Quality Statement 6: Housing
Adults with schizophrenia have a safe, affordable, stable living environment that reflects their needs and preferences.
Quality Statement 7: Antipsychotic Monotherapy
Adults with schizophrenia are prescribed a single antipsychotic medication, whenever possible.
Quality Statement 8: Treatment With Long-Acting Injectable Antipsychotic Medication
Adults with schizophrenia are offered the option of a long-acting injectable antipsychotic medication.
Quality Statement 9: Treatment With Clozapine
Adults with schizophrenia whose symptoms have not responded to previous adequate trials of treatment with two different antipsychotic medications are offered clozapine.
Quality Statement 10: Continuation of Antipsychotic Medication
Adults with schizophrenia whose symptoms have improved with antipsychotic medication are advised to continue their antipsychotic medication for the long term.
Quality Statement 11: Cognitive Behavioural Therapy for Psychosis and Other Psychosocial Interventions
Adults with schizophrenia are offered cognitive behavioural therapy for psychosis and other evidence-based psychosocial interventions, based on their needs.
Quality Statement 12: Promoting Physical Activity and Healthy Eating
Adults with schizophrenia are offered readily accessible interventions that promote physical activity and healthy eating.
Quality Statement 13: Promoting Smoking Cessation
Adults with schizophrenia who smoke tobacco are offered pharmacological and nonpharmacological interventions to help them reduce or stop smoking tobacco.
Quality Statement 14: Assessing and Treating Substance Use Disorder
Adults with schizophrenia are asked about their substance use and, if appropriate, they are assessed for substance use disorder and offered treatment.
Quality Statement 15: Employment and Occupational Support
Adults with schizophrenia who wish to find work or return to work are offered supported employment programs. Adults with schizophrenia who are not seeking paid work are supported in other occupational or educational activities, in accordance with their needs and preferences
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Spotlight report
Know what successful quality standard implementation looks like, based on examples from the field - Tools to support patient care
- Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
