Determining suitability of placement for long-stay psychiatric inpatients

Fifty-three long-stay patients on the back wards of a large psychiatric hospital in London were assessed to determine their suitability for other placements after the hospital was closed. The general and deviant behavior subscales of the REHAB Scale were used in the assessment. A wide range of scores indicated that these patients varied greatly in basic living skills. Associations were investigated between patients' scores and somatic problems, fluctuations in mental state, and adverse reactions to change, which affect patients' ability to live in the community. Of 14 patients whose scores indicated a potential for discharge, two had significant deviant behaviors, seven had fluctuating mental states, and two were known to react adversely to change. Although the REHAB Scale is useful, results show that placement decisions should not be based on scores alone. Flexible services that take into account fluctuations in patients' functioning are required.