[Possibilities in the management of long-term patients outside the psychiatric hospital; clinical assessment by the treatment staff in The Netherlands].
How many longstay patients could be just as well served by less sheltered facilities, and what are the main reasons for staff-members to consider patients suitable for alternative care? These were the two questions of a Dutch study (1984-1985) in five mental hospitals. Both, the attending psychiatrist and one of the nurses, were asked to give an independent judgement for each of the persons of a random sample of 381 longstay patients. Some results: thirty percent of the longstay patients were judged eligible for alternative care. They were younger, less frequently diagnosed as schizophrenic, better integrated inside and outside of the mental hospital, more likely to be residents of wards with high turnover-rates, were less aggressive, and had better social skills, and shorter periods of inpatient stay. Compared with the rest of the patients no statistically significant differences were found with regard to suicidal behaviour, organic brain syndrome and formal admission status.