Locally-based residential services for mentally handicapped adults: a comparative study.

Area of Science:

• Intellectual and Developmental Disabilities
• Social Psychiatry
• Healthcare Management

Background:

• Large mental handicap hospitals were being downsized during the study period.
• Deinstitutionalization trends prompted the relocation of residents to community-based units.
• Understanding the impact of environmental changes on individuals with mental handicaps is crucial for improving care.

Purpose of the Study:

• To assess the impact of relocation from a large hospital to community units on mentally handicapped adults.
• To compare the outcomes for less severely and more severely handicapped individuals.
• To examine the interaction between environmental factors and individual characteristics on quality of care and life-style.

Main Methods:

• Comparative assessment of two groups of mentally handicapped adults before and after relocation.
• Inclusion of individually matched control subjects who remained in the large hospital.
• Evaluation of daily living patterns, occupation, leisure, skills, behavior, and living unit structure.

Main Results:

• Less severely handicapped, sociable residents showed significant improvements in community NHS hostels.
• More severely handicapped, aloof residents in small converted hospital wards experienced limited changes in daily life.
• Control subjects remaining in the large hospital showed minimal lifestyle changes.
• Environmental factors in the new units influenced outcomes, particularly for less severely handicapped individuals.

Conclusions:

• Relocation to community settings can positively impact the quality of life for some individuals with mental handicaps.
• The effectiveness of deinstitutionalization is influenced by the nature of the new environment and the individual's level of handicap and social interaction.
• Care quality and life-style are outcomes of the complex interplay between environmental provisions and individual needs.