Abstract
Little is known about thefirst patients who left hospital before and during the official implementation of the hospital discharge policy in Northern Ireland. This study describes patterns of residential provision for former long-stay patients (approximately two-thirds of whom had an ICD-9 diagnosis of schizophrenia) discharged from the six major psychiatric hospitals in Northern Ireland between 1987 and 1990 (n=321). It also employs several instruments within a retrospective survey design to examine outcomes for a 35% sample of people (112/321) discharged between 1997 and 1990 and followed up in 1993. Almost two-thirds (61%) had been discharged to independent living or low-staffed statutory settings. None of the group was homeless, one person was in prison and three people had committed suicide during the first 2 years after discharge. Almost one-third had to be re-admitted at some stage during the 6-year period and 13% had died. ‘Moderate’ to ‘major problems’ with most daily living skills were reported for less than 25% of people, while 15% or less had problem behaviour. Approximately 90% or more were satisfied with most aspects of their new homes and most also reported feeling happier (77%), healthier (63%) and more independent (78%) since discharge. However, social, recreational and occupational opportunities were limited. Purchasers, providers and practitioners need to review ways in which former long-stay patients might be empowered to live more meaningful and integrated lives in the community, particularly as the current government strategy for health and social well-being (1997–2002) in Northern Ireland points to the closure of existing psychiatric hospitals.
Similar content being viewed by others
References
Anderson J, Dayson D, Wills W, Gooch C, Margolius O, O'Driscoll C, Leff J (1993) The TAPS project 13. Clinical and social outcomes of long-stay psychiatric patients after one year in the community. Br J Psychiatry 162:45–56
Beecham J, Knapp M (1992) Costing psychiatric interventions. In: Thornicroft G, Brewin C, Wing J (eds) Measuring mental health needs. Gaskill, London
Cambridge P, Hayes L, Knapp MRJ, Fenyo A, Gould E (1994) Care in the community five years on. Ashgate, Aldershot
Cantril H (1965) The pattern of human concerns, Rutgers University Press, New Brunswick
Clifford P (1987a) The problems questionnaire. Research and Development for Psychiatry, London
Clifford P (1987b) The social functioning questionnaire. Research and Development for Psychiatry, London
DHSS (NI) (1986) A regional strategy for the Northern Ireland Health and Personal Social Services, 1987–1992. Department of Health and Social Services, Belfast
DHSS (NI) (1996) Health and well-being into the next millenium: regional strategy for health and social well-being 1997–2002. Department of Health and Social Services, Belfast
Donnelly M, McGilloway S, Mays N, Perry S, Knapp M, Kavanagh S, Beecham J, Fenyo A, Astin J (1994) Opening new doors: an evaluation of community care for people discharged from psychiatric and mental handicap hospitals. HMSO, Belfast
Feragne MA (1983) The psychosocial functioning inventory. Eval Health Prof 6:25–48
Francis VM, Vesey P, Lowe G (1994) The closure of a long-stay psychiatric hospital: a longitudinal study of patients' behaviour. Soc Psychiatry Psychiatr Epidemiol 29:184–189
Kingdon D, Turkington D, Malcolm K, Szuleck AK, Larkin E (1991) Replacing the mental hospital. Community provision for a district's chronically disabled in domestic environments Br J Psychiatry 159:113–117
Knapp MRJ, Cambridge P, Thomason C, Beecham JK, Allen C Darton RA (1992) Care in the community: challenge and demonstration. Ashgate/Personal Social Services Research Unit, Aldershot
Leff J, Thornicroft G, Coxhead N, Crawford C (1994) The TAPS project 22. A five-year follow up of long-stay psychiatric patients discharged to the community. Br J Psychiatry 165:13–17
O'Brien J (1992) Closing the asylums: where do all the formerlong stay patients go? Health Trends 24:88–90
Renshaw J, Hampson R, Thomason C, Darton R, Judge K, Knapp M (1988) Care in the community: the first steps. Gower, Aldershot
Seltzer G, Seltzer M (1983) Satisfaction questionnaire. Paper presented at the American Association of Mental Deficiency Annual Meeting on Residential Satisfaction and Community Adjustment Cambridge, MA
Snaith ARP, Ahmed SN, Mehta S, Hamilton M (1971) Assessment of the severity of primary depressive illness. Psychol Med 1:143–149
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Donnelly, M., McGilloway, S., Mays, N. et al. A 3- to 6-year follow-up of former long-stay psychiatric patients in Northern Ireland. Soc Psychiatry Psychiatr Epidemiol 32, 451–458 (1997). https://doi.org/10.1007/BF00789139
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00789139