Therapeutic communities have had some success in reducing socially aberrant behaviour associated with conditions defined as personality disorders. What evidence exists for their efficacy in patients presenting with acute psychosis, including paranoid delusions and explosive anger?
There is some rather "older" literature on this subject, e.g.,
Kennard D. The therapeutic community as an adaptable treatment modality across
different settings. Psychiatr Q. 2004 Fall;75(3):295-307.
Nieminen P, Isohanni M, Winblad I. Length of hospitalization in an acute
patients' therapeutic community ward. Acta Psychiatr Scand. 1994
Dec;90(6):466-72.
Steiner H, Haldipur CV, Stack LC. The acute administration ward as a
therapeutic community. Am J Psychiatry. 1982 Jul;139(7):897-901.
McGlashan TH, Levy ST. Sealing-over in a therapeutic community. Psychiatry.
1977 Feb;40(1):55-65.
Communities would be better to have promotion and prevention programs, although it is needed for them to have follow-up programs for people with psychosis disorders to prevent chronic trends in such patients
A plain no. TCs do not largely work with a full time Psychiatry MD. Having said that, people with a Mental Disorder, including most psychotic, anxious and bipolar cases, who are able to understand what is going on, stabilized on medication and followed up by a Psychiatrist or trained clinician, can easily find a place in a TC to receive appropriate care in several other domains of their lives. Here in Brazil, TCs are specially meant to alcohol, crack and other drugs dependents and the group is considered a quite important therapeutic aspect of them. I recommend reading George De Leon' books and papers.
There have been some therapeutic communities to work with offenders with mixed mental health and addictions difficulties.
An overall (dated) review:
Lees, J., Manning, N. & Rawlings, B. (1999) Therapeutic Community Effectiveness. A Systematic International Review of Therapeutic Community Treatment for People with Personality Disorders and Mentally Disordered Offenders . York: NHS Centre for Reviews and Dissemination. Briefing paper at www.pettarchiv.org.uk/atc-briefingpaper.htm .
The Sacks studies below refer to TCs based on the Hierarchical US tradition (mainly developed from an Addictions background)
The Pullen chapter refers to the UK tradition of 'democratic' TCs developed form a background in war hospitals from Tom Main etc. which is explained in the Kennard article cited in an answer above.
Sacks, S., Banks, S., McKendrick, K., & Sacks, J. Y. (2008). Modified therapeutic community for co-occurring disorders: A summary of four studies. Journal of Substance Abuse Treatment, 34(1), 112-122.
Sullivan, C. J., Sacks, S., Mckendrick, K., Banks, S., Sacks, J. Y., & Stommel, J. (2007). Modified therapeutic community treatment for offenders with co-occurring disorders: Mental health outcomes. Journal of Offender Rehabilitation, 45(1-2), 227-247.
Pullen, G. P. (1999) Schizophrenia: hospital communities for the severely disturbed. In Therapeutic Communities: Past, Present and Future (eds P. Campling & R. Haigh), pp. 140–150. London: Jessica Kingsley.
Check Guided Functional Peer Support in Finland and Open Dialogue. Not therapeutic communities per se, but promising modalities.
Seikkula, Jaakko et al. "Five-year experience of first-episode nonaffective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies." Psychotherapy Research, 16(2): 214-228. March 2006.
Couple more alternatives:
Mosher, Loren R. "Soteria and Other Alternatives to Acute Hospitalization." The Journal of Nervous and Mental Disease, 187: 142-149. 1999.
Iancu, Sorana C. et al. "Mental health recovery on care farms and day centres: a qualitative comparative study of users' perspectives." Disability and Rehabilitation, 36(7): 573-583. 2014.
I think R.D. Lang started his TC work with chaotic and psychotic clients.
San Padriagno (near San Marino republic in Italy) may be worth asking as they have facility to treat severely ill people as well as working with addicts.
For my (very old) experience with therapeutic communities, please see https://www.cmaj.ca/content/171/12/1477.full
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