While research has shown community-based psychiatric care to be as good as, or better than, hospital-based care, generalisation to clinical practice has been difficult. This prospective, randomised controlled study examined a community-based approach feasible within National Health Service (UK) conditions. 94 patients were randomly allocated to experimental & 78 to control treatments & followed for 1 year. No differences in clinical or social functioning outcome were found. Both groups improved substantially on clinical measures in the first six weeks, with some slow consolidation thereafter. There were 3 suicides in the control group & 1 in the experimental group. Access to care was better in the experimental group than in the control group.