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[Deinstitutionalization and modern history].

The authors trace the history of ideological or socio-economical-political conditions of desinstitutionalisation. They try to analyse the consequence of it about the constitution of a new pathology of homeless and careless chronic mental ill. This pathology was described first in the states and Canada. It begins to be described in France. The authors go on to show it's a new kind of mental pathology, needing to take place in the new classifications of mental illness.

Canada↗
PubMed1994

[From deinstitutionalization to social rejection: the point of view of ex-psychiatric patients].

A series of in-depth interviews conducted with ex-psychiatric patients who use alternative resources in the area of mental health has revealed several manifestations of rejection, stigmatization and discrimination. These are experienced as significant and determining with respect to the social integration of patients, as well as harmful to their quality of life in the community. Data shows that this population suffers from social isolation due to lack of communication with community members and from various forms of rejection and disparating attitudes on the part of entourage. Their fragile socio-economic conditions confine them to live in a sub-culture and at the fringe of society.

Adult↗
PubMed1993

[Deinstitutionalization of chronic psychiatric patients exemplified by a public psychiatric hospital].

Basing on the multifarious phenomena of hospitalism in chronically mentally ill patients the authors report on a survey of known facts and analyses to enable focussing of appropriate on-target measures were taken to arrive at conclusions for caring for these long-term patients: 1. Fixing the deadline of the study; 2. Determining the quality of patient care; 3. Analysing the experiences collected in respect of the integrated training programme to promote cognitive, communicative and social abilities and skills among the patients in resident living quarters within the confines of the hospital. An attempt is made to arrive at an overall evaluation of the measures taken so far in respect of de-hospitalisation and in building up complementary settlements outside the hospital but close to communal institutions.

Adult↗
PubMed1995

Mental health: deinstitutionalization and the problem of citizenship.

This article considers how the issue of citizenship rights for people with serious mental problems and disorders has been constructed in recent Australian mental health policy discourse. In the first section of the paper a form of discourse analysis is employed to analyse the preferred meanings and representations that this discourse assigns to the issue of citizenship and human rights for people with serious mental health problems and disorders. The second section of the paper compares this official discourse on citizenship and mental health to other variants such as those found in medical-psychiatric discourse and in the discourse of the mental health movement(s). The paper concludes with comments regarding current prospects for extending citizenship rights to people who use mental health services.

Australia↗
PubMed1997

[Quality of life, needs and treatment evaluation of long-term hospitalized patients. Part II of the Berlin Deinstitutionalization Study].

OBJECTIVE: Objective living situation, subjective quality of life, need for care, and assessment of treatment of long-term hospitalised patients were investigated. METHODS: 237 patients from 6 hospitals were examined using standardised instruments. RESULTS: Patients' satisfaction was generally relatively high, but varied greatly in subgroups and individuals. Patients were most satisfied with personal safety in the hospital and least satisfied with the expectation to live in the hospital for a long time. Therapists assessed clearly more needs for care in the patients than the patients did themselves. Statistical analysis revealed significant correlations between the subjective quality of life in different domains, the number of needs stated and plausible determining factors. CONCLUSIONS: Findings reflecting patients' living situation in the hospital are very heterogeneous. In respect of subjective evaluation criteria, there is little space for improvement in the future.

Activities of Daily Living↗
PubMed1997

[The statute of deinstitutionalization in Great Britain].

The aim of this article is to explain the current status of deinstitutionalisation and of community care development by studying the extent to which community care can or should take over the functions of the asylum. These functions include those that are manifest, or explicit, and those that are latent, or unintended but implicit (Bachrach 1976). The continuing relevance of both sets of functions is argued to be exerting a powerful influence on the processes of asylum closure and community care development. The results include delayed asylum closures and transinstitutionnalisation, the shift of some patients from asylums to other institutions, which stifle the development of community care by concentrating spending in hospitals.

Community Mental Health Services↗
PubMed1998

[Treatment prognosis and discharge 2 years later. III. Berlin Deinstitutionalization Study].

In a two-year follow-up we report on discharges in a cohort of 422 middle-term and long-term inpatients and prognoses of their psychiatrists and psychologists concerning time of discharge and location, after 50% long-term patients with a present stay of more than two years and 82% of middle-term patients (stay: 6-24 months) had been discharged. More than one-third of the long-term patients could be placed in sheltered accommodation, but 42% are still referred to nursing homes. All together 68% are still in institutional settings--either as inpatients or in nursing homes. Prognoses were not very reliable concerning the time of discharge but substantial with regard to placement in sheltered accommodation. This can be interpreted as a result of successful co-operation between inpatient and community-based services.

Activities of Daily Living↗
PubMed1978

The aftermaths of deinstitutionalization: problmes and solutions.

Thousands of mentally handicapped patients released from mental hospitals are now living in a variety of community settings. Services to help them remain in community are often fragmented, uncoordinated and limited. Research and experience have highlighted the services they need. Numerous demonstrations have shown that patients can be successfully maintained in community setting. Coordinated services and fixed responsibility for each individual placed are essential.

Adult↗