Is deinstitutionalization working in our community?

Int J Ment Health Nurs. 2011 Aug;20(4):274-83. doi: 10.1111/j.1447-0349.2010.00726.x. Epub 2011 Mar 31.

Abstract

This exploratory study examined the impact of deinstitutionalization on consumers admitted to a regional community care unit (CCU) between 1996 and 2007, and looked at lengths of stay and re-admissions to acute psychiatric care units and the impact this might have on quality of life. The results showed that the original and current residents of CCU have improved quality of life through friendships, a home-like environment, and reduced re-admissions to acute psychiatric care units; however, further improvements can be made with more emphasis on employment/vocational services and social inclusion. More concerning is those who are unable to access a CCU bed due to chronic CCU bed shortages. This group, referred to as the 'new chronic patients', tend to become victims of 'the revolving door phenomenon', homelessness, and substance abuse. The assertive community treatment model of care and community packages are recommended for people on waiting lists for CCU, or those who do not fit the CCU criteria, to try and reduce the level of disability that is likely to occur from frequent relapses.

MeSH terms

  • Adult
  • Aged
  • Australia
  • Community Mental Health Services
  • Deinstitutionalization / methods*
  • Deinstitutionalization / statistics & numerical data
  • Female
  • Humans
  • Ill-Housed Persons
  • Interpersonal Relations
  • Length of Stay / statistics & numerical data*
  • Male
  • Mental Disorders / rehabilitation*
  • Mental Disorders / therapy
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Readmission / statistics & numerical data*
  • Quality of Life*
  • Residence Characteristics
  • Residential Treatment
  • Social Environment
  • Substance-Related Disorders
  • Vocational Guidance