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Related Experiment Videos

Deinstitutionalization for long-term mental illness: a 6-year evaluation.

Coletta Hobbs1, Lesley Newton, Christopher Tennant

  • 1Department of Psychological Medicine, The University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales 2065, Australia. chob9793@mail.usyd.edu.au

The Australian and New Zealand Journal of Psychiatry
|April 4, 2002
PubMed
Summary

Long-term mental illness patients successfully transitioned to community living, showing stable clinical status and improved quality of life over six years. This deinstitutionalization highlights the need for ongoing support and age-specific services.

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Area of Science:

  • Psychiatry
  • Mental Health Services Research
  • Social Psychiatry

Background:

  • Closure of a Sydney psychiatric hospital necessitated community transition for 47 long-term mental illness patients.
  • This study extends a 2-year evaluation to a 6-year follow-up of community integration.

Purpose of the Study:

  • To evaluate the long-term clinical, social, and quality of life outcomes for patients after psychiatric hospital deinstitutionalization.
  • To assess the sustainability of community living and identify ongoing support needs.

Main Methods:

  • Quantitative assessments included Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale, and Quality of Life measures at baseline, 2, and 6 years.
  • Qualitative semistructured interviews explored residents' perceptions of community living.

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  • Documentation of accommodation, care levels, readmissions, incidents, and medication use.

    • Main Results:

    • Of 47 patients, 36 remained in the community at 6 years, no longer requiring 24-hour supervision.
    • Community residents demonstrated clinical stability with reduced medication levels and improved quality of life.
    • Most residents lived semi-independently in shared accommodation with case manager support.

    Conclusions:

    • Long-term community tenure is achievable with adequate mental health resources, leading to improved quality of life and reduced medication.
    • Ongoing rehabilitation, social integration, and age-specific services are crucial for successful deinstitutionalization.
    • Initial 24-hour supervision may be necessary for some individuals during and after transition.