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Results for “Deinstitutionalization”

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PubMed1985

The impact of deinstitutionalization on activities and skills of severely/profoundly mentally retarded multiply-handicapped adults.

This study evaluated the change in activity patterns and skills of severely/profoundly mentally retarded, multiply-handicapped residents as they moved from large total care institutions to community living. Twenty-seven individuals were evaluated just before leaving the institution, 3 months post-exit, and 9 months post-exit. In comparison to a nondisabled reference group, residents were less active, mobile, social, and independent both in the institution and community. Residents did show, however, significant changes toward the nondisabled pattern of daily living after moving to the community. Clients improved in 4 of 16 skill areas within 3 months after entering the community: expressive communication, eating, serving meals and washing dishes, and meal preparation.

Activities of Daily Living↗
PubMedDate not supplied

Pfropfschizophrenia in the age of deinstitutionalization: whose problem?

BACKGROUND: The Kraepelinian concept of pfropfschizophrenia refers to the intertwined coexistence of mental retardation and schizophrenia. Patients with this syndrome are relatively treatment resistant and are often harmed by diverging policies and cost cuts within the framework of mental health care services. Thus, a better understanding of this syndrome has important practical implications. The multiple problems that these patients encounter in various educational and health care agencies and what questions need to be asked to better elucidate these patients' needs are assessed. DATA: Three case reports of adult long-term inpatients fulfilling the criteria for pfropfschizophrenia are presented. Their current mental status and illness histories are discussed in relation to hypothesized pathophysiological processes and current needs. LIMITATIONS: Small cohort, naturalistic study. CONCLUSIONS: Pfropfschizophrenia is a phenotypically heterogeneous syndrome. The chronology of the appearance of cognitive deficits and psychotic symptoms during the course of this disorder should be carefully assessed because it may reflect diverse pathophysiological processes, necessitating differentiated, specific treatment interventions.

Adult↗
PubMedDate not supplied

The impact of deinstitutionalization on family contact.

Indices of family contact were reviewed across four cohorts of persons with mental retardation who were transferred from a large public institution to small supported living arrangements. In this longitudinal study, it was found that family contact increased subsequent to community placement, and that these increased levels of contact were maintained for as long as 4 years.

Adult↗
PubMedDate not supplied

Social impairment in the "Care in the Community" cohort: the effect of deinstitutionalization and changes over time in the community.

This paper presents data from a longitudinal collaborative study of The Care in the Community Sample (Cambrdige, Hayes, Knapp, Gould, & Fenyo, 1994; Cambridge et al., 2001; Knapp et al., 1992). The aim of the study was to investigate how social impairment changes are related to the move from institutional to community care using some preliminary analysis of the above data. A measure of social impairment using the Skills and Behavior Interview from the most recent follow-up of this cohort was found to be consistent with Wing's definition of social impairment, when applied to the cohort 12 years after deinsitutionalization. This measure was then used to retrospectively identify social impairment in the same sample (of approximately 250 people) at baseline (in the institution), at 1 year and at 5 years in the community. Prevalence data pointed to high levels of social impairment in the sample (50.1%) in institutions but the decrease to 39.8% after 1 year in the community was not significant (although conversation and social mixing and initiation of conversation and social interaction did improve over time). Once in the community, social impairment in general did not change over time, although there was a significant decrease in conversation and social mixing, non-verbal communication and initiation of conversation and social interaction. These results are compared to other research findings and the implications and limitations of the study discussed.

Activities of Daily Living↗
PubMedDate not supplied

A reliability study of measures assessing the impact of deinstitutionalization.

This study examined the reliability of several scales and indices used to measure outcome variables (independence, integration, productivity, and satisfaction) among people with developmental disabilities. A stratified random sample of 112 people was interviewed twice in a two-week period and included equal numbers of verbal and nonverbal consumers, of parent versus other caregivers, and consumers with diagnosed level of retardation being dichotomized into high and low. In addition, half of the interviews were test-retest and half were interrater. After stratifying on these four variables, the sample was chosen randomly within subgroups from the total database of 3,700 individuals who receive services through the Developmental Disabilities Services Division of the Oklahoma Department of Human Services. Correlation and proportion agreement analyses were performed on the pre- and post-tests and comparisons made on each scale for each stratification to examine variations in reliability. Acceptable correlations and matched agreements of at least 0.70 for all measures were found, with the Adaptive Development Scale having particularly strong correlations. In addition, responses from people with developmental disabilities on items of the Consumer Satisfaction scale were acceptably reliable.

Activities of Daily Living↗
PubMed1996

The deinstitutionalization movement in Italy. Ideological thrust to cultural error.

The Basaglia movement in Italian psychiatry is described and analyzed in several contexts: the historical, the cultural, and the "practical" in terms of outcomes. Those who began the movement of democratic psychiatry grasped interesting elements of "critical theory": the definitions of madness, power structures, and medical discourse itself. A backward look at the sea change, however, reveals states and rates of dysfunction that disappoint and indicate that political ideology divorced from cultural awareness can often harden the opposition.

Communism↗