BMJ 1999;319:13-16 ( 3 July )

Papers

Outcome of long stay psychiatric patients resettled in the community: prospective cohort study

Noam Trieman, senior lecturer, ^a Julian Leff, professor of social and cultural psychiatry, ^a Gyles Glover, senior lecturer. ^b

^a Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London NW3 2PF, ^b Section of Community Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF

Correspondence to: Dr Trieman n.trieman{at}fleet69.demon.co.uk

Objective: To examine the outcome of a population of long stay psychiatric patients resettled in the community.
Design: Prospective study with 5 year follow up.
Setting: Over 140 residential settings in north London.
Subjects: 670 long stay patients from two London hospitals (Friern and Claybury) discharged to the community from 1985 to 1993.
Main outcome measures: Continuity and quality of residential care, readmission to hospital, mortality, crime, and vagrancy.
Results: Of the 523 patients who survived the 5 year follow up period, 469 (89.6%) were living in the community by the end of follow up, 310 (59.2%) in their original community placement. A third (210) of all patients were readmitted at least once. Crime and homelessness presented few problems. Standardised mortality ratios for the group were comparable with those reported for similar populations.
Conclusions: When carefully planned and adequately resourced, community care for long stay psychiatric patients is beneficial to most individuals and has minimal detrimental effects on society.

Key messages Replacing a psychiatric hospital with full residential facilities in the community has worked well for most long stay psychiatric patients Recurrent and sporadic readmissions to hospital are inevitable for high risk patients regardless of their living conditions Fears are unfounded that former hospital inmates are destined to neglect, high mortality, and homelessness, or that they pose a threat to the public

---

© BMJ 1999
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Getting things wrong
BMJ 1999 319: 0. [Full Text] [PDF]

Getting things wrong
BMJ 1999 319: 0. [Full Text] [PDF]

Community care of long stay psychiatric patients presents few problems
BMJ 1999 319: 0. [Full Text]

This article has been cited by other articles:

• PRIEBE, S., McCABE, R., BULLENKAMP, J., HANSSON, L., LAUBER, C., MARTINEZ-LEAL, R., ROSSLER, W., SALIZE, H., SVENSSON, B., TORRES-GONZALES, F., VAN DEN BRINK, R., WIERSMA, D., WRIGHT, D. J. (2007). Structured patient clinician communication and 1-year outcome in community mental healthcare: Cluster randomised controlled trial. Br. J. Psychiatry 191: 420-426 [Abstract] [Full text]  
• Lima, L. A., Goncalves, S., Pereira, B. B., Lovisi, G. M. (2006). The Measurement of Social Disablement and Assessment of Psychometric Properties of the Social Behaviour Schedule (SBS-BR) in 881 Brazilian Long-Stay Psychiatric Patients. Int J Soc Psychiatry 52: 101-109 [Abstract]  
• Thornicroft, G., Bebbington, P., Leff, J. (2005). Outcomes for Long-Term Patients One Year After Discharge From a Psychiatric Hospital. Psychiatr. Serv. 56: 1416-1422 [Abstract] [Full text]  
• Depla, M. F. I. A., de Graaf, R., van Busschbach, J. T., Heeren, T. J. (2003). Community Integration of Elderly Mentally Ill Persons in Psychiatric Hospitals and Two Types of Residences. Psychiatr. Serv. 54: 730-735 [Abstract] [Full text]  
• D'Avanzo, B., Barbato, A., Barbui, C., Battino, R. N., Civenti, G., Frattura, L. (2003). Discharges of Patients from Public Psychiatric Hospitals in Italy between 1994 and 2000. Int J Soc Psychiatry 49: 27-34 [Abstract]  
• McNULTY, S. V., DUNCAN, L., SEMPLE, M., JACKSON, G. A., PELOSI, A. J. (2003). Care needs of elderly people with schizophrenia: Assessment of an epidemiologically defined cohort in Scotland. Br. J. Psychiatry 182: 241-247 [Abstract] [Full text]  
• Dratcu, L. (2002). Acute hospital care: the beauty and the beast of psychiatry. Psychiatr. Bull. 26: 81-82 [Full text]  
• LEFF, J., TRIEMAN, N. (2000). Long-stay patients discharged from psychiatric hospitals: Social and clinical outcomes after five years in the community. The TAPS Project 46. Br. J. Psychiatry 176: 217-223 [Abstract] [Full text]  
• Palmstierna, T. (1999). Only about 1 in 30 predictions of assault by discharged psychiatric patients will be correct. BMJ 319: 1270-1270 [Full text]  

Rapid Responses:

Read all Rapid Responses

Dangerous Inference

Phillip Brewer
bmj.com, 5 Jul 1999 [Full text]

Care in the community

Sudip Sikdar
bmj.com, 8 Jul 1999 [Full text]

Re: Care in the community

D B Double
bmj.com, 30 May 2000 [Full text]

Online poll

Find out more >>