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The linear continuum of transitional residences: debunking the myth

J L Geller1, W H Fisher

  • 1Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655.

The American Journal of Psychiatry
|July 1, 1993
PubMed
Summary

The transitional residence continuum for psychiatric patients often fails to move individuals to less restrictive settings. Most patients remain in restrictive environments, indicating a need for diverse community residential options.

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Area of Science:

  • Psychiatry
  • Health Services Research
  • Social Work

Background:

  • The continuum of care for psychiatric services includes transitional residences.
  • The effectiveness of this continuum in facilitating a move to less restrictive settings is questioned.

Purpose of the Study:

  • To evaluate if the designed function of the transitional residence continuum is met.
  • To determine if individuals with serious and persistent mental illness transition to less restrictive settings.

Main Methods:

  • A survey of residential placements in western Massachusetts in 1987 and 1991.
  • Data collection on entry and prior settings for mentally ill individuals.
  • Tracking the 1987 study subjects' residential status in 1991.

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Main Results:

  • 70%-75% of beds were occupied by individuals directly from state hospitals in both 1987 and 1991.
  • Only 5%-6% of beds were occupied by individuals moving to less restrictive settings.
  • In 1991, 49.1% of 1987 subjects remained in equally restrictive programs, 7.9% moved to less restrictive programs, and 31.8% moved to independent living.

Conclusions:

  • The transitional residence continuum does not function as intended for most patients.
  • It is recommended that transitional residences become one of several community residential alternatives, not the sole option.