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Two Year Follow-up of Behavioural Functioning in Long-Stay Chronically Mentally Ill Clients Transferred to the Community

Published online by Cambridge University Press:  27 August 2015

Robyn Vertongen ,
Frank P. Deane  and
Graeme Beaumont
Robyn Vertongen
Affiliation:
Massey University, New Zealand
Frank P. Deane*
Affiliation:
University of Wollongong, Australia
Graeme Beaumont
Affiliation:
Norlhcote Community Mental Health Center, New Zealand
*
lllawarra Institute for Mental Health and Department of Psychology, University of Wollongong NSW 2522, Australia. E-mail: [email protected].
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Abstract

The effects of transferring 28 long-stay chronically mentally ill patients from a psychiatric hospital to community placements was evaluated. The Rehabilitation Evaluation Hall and Baker (REHAB; Baker & Hall, 1983) scale was used to assess clients' adaptive and maladaptive behavioural functioning at 12, 18 and 24 month intervals following the hospital baseline. Social contacts and inpatient readmissions were also assessed. The results showed that clients' general adaptive functioning and maladaptive behaviour, on average, remained stable across the hospital baseline and two year follow-up period. Clients with frequent social contacts were found to have significantly better adjustment on a number of the REHAB subscales and those who exhibited more maladaptive behaviour were more likely to be readmitted to a psychiatric inpatient unit. Overall the results were encouraging with relatively low readmission rates, however, approximately 10% of clients showed significant difficulty adjusting in the community. The implications of the findings for chronically mentally ill people and suggestions for community programmes are discussed.

Type
Articles
Information
The Australian Journal of Rehabilitation Counselling , Volume 4 , Issue 2 , 1998 , pp. 59 - 70
Copyright
Copyright © Cambridge University Press 1998

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References

Avison, W.R., & Speechley, K.N. (1987). The discharged psychiatic patient: A review of social, social-psychological, and psychiatric correlates of outcome. American Journal of Psychiatry, 144 (1), 10–18.Google Scholar
Baker, R., & Hall, J.N. (1983). REHAB: Rehabilitation Evaluation Hall and Baker Users Manual. Aberdeen: Vine Publishing.Google Scholar
Baker, R., & Hall, J.N. (1988). REHAB: A new assessment instrument for chronic psychiatric patients. Schizophrenia Bulletin, 14, 97–111.CrossRefGoogle Scholar
Bellack, A.S., & Mueser, K.T. (1986). A comprehensive treatment program for schizophrenia and chronic mental illness. Community Mental Health Journal, 22, 175–189.CrossRefGoogle ScholarPubMed
Bigelow, D.A., Cutler, D.L., Moore, L.J., McComb, R., & Leung, R. (1988). Characteristics of state hospital patients who are hard to place. Hospital and Community Psychiatry, 39, 181–185.Google ScholarPubMed
Bigelow, D.A., McFarland, B.H., Gareau, M.J., & Young, D.J. (1991). Implementation and effectiveness of a bed reduction project. Community Mental Health Journal, 27, 125–133.CrossRefGoogle Scholar
Bootzin, R.R., Shadish, W.R. Jr., & McSweeny, A.J. (1989). Longitudinal outcomes of nursing home care for severely mentally ill patients. Journal of Social Issues, 45, 31–48.CrossRefGoogle Scholar
Breier, A., Schreiber, J.L., Dyer, J., & Pickar, D. (1991). National Institute of Mental Health longitudinal study of chronic schizophrenia. Archives of General Psychiatry, 48, 239–246.CrossRefGoogle ScholarPubMed
Brugha, T.S., Wing, J.K., Brewin, C.R., MacCarthy, B., Mangen, S., Lesage, A., & Mumford, J. (1988). The problems of people in long-term psychiatric day care: An introduction to the Camberwell High Contact Survey. Psychological Medicine, 18, 443–456.CrossRefGoogle Scholar
Carone, B. J., Harrow, M., & Westermeyer, J.F. (1991). Posthospital course and outcome in schizophrenia. Archives of General Psychiatry, 48, 247–253.CrossRefGoogle ScholarPubMed
Carson, J., Coupar, A., Gill, J., & Titman, P. (1988). The inter-rater reliability of Hall and Baker's REHAB scale: A cross-validation study. British Journal of Clinical Psychology, 27, 277–278.CrossRefGoogle Scholar
Deane, F. P., Huzziff, R. C., Beaumont, G. (1995). Discharge planning: Levels of care and behavioural functioning in long-term psychiatric inpatients transferred to community placements. Community Mental Health in New Zealand, 9, 18–27.Google Scholar
Denker, S.J., & Denker, K. (1994). Does community care reduce the need for psychiatric beds for schizophrenic patients? Acta Psychiatrica Scandinavica, 89 (suppl 382), 74–79.CrossRefGoogle Scholar
Fairley, N. A., Siegert, R., Simpson, A., Wilson, J., & Roach, B. (1993). Psychiatric disorders and disability in New Zealand long-stay psychiatric patients. Australian and New Zealand Journal of Psychiatry, 27, 590–594.CrossRefGoogle ScholarPubMed
Farkas, M. D., Rogers, E. S., & Thurer, S. (1987). Rehabilitation outcome of long-term hospital patients left behind by deinstitutionalisation. Hospital and Community Psychiatry, 38, 864–870.Google Scholar
Foreman, E. I., & Baker, R. (1986). A validity study of a new rating scale for psychiatric patients. Acta Psychiatrica Scandinavica, 73, 101–108.CrossRefGoogle ScholarPubMed
Francis, V. M., Vesey, P., & Lowe, G. (1994). The closure of a long-stay psychiatric hospital: A longitudinal study of patients' behaviour. Social Psychiatry and Psychiatric Epidemiology, 29, 184–189.CrossRefGoogle Scholar
Haines, H., & Abbott, M. (Eds.). (1986). The future of mentol health services in New Zealand: Deinstitutionalisation. Auckland, NZ: Mental Health Foundation of New Zealand.Google Scholar
Hoult, J., & Reynolds, I. (1984). A comparative trial of community orientated and hospital orientated psychiatric care. Acta Psychiatrica Scandinavica, 69, 359–372.CrossRefGoogle ScholarPubMed
Hoult, J., Reynolds, L., Charbonneau-Powis, M., Weekes, P., & Briggs, J. (1983). Psychiatric hospital versus community treatment: The results of a randomised trial. Australian and New Zealand Journal of Psychiatry, 17, 160–167.CrossRefGoogle ScholarPubMed
Jones, E. M. (1991). Interhospital relocation of long-stay psychiatric patients: A prospective study. Acta Psychiatrica Scandinavica, 8, 214–216.CrossRefGoogle Scholar
Lamb, R. (1993). Lessons learned from deinstitutionalisation in the US. British Journal of Psychiatry, 162, 587–592.CrossRefGoogle ScholarPubMed
Leff, J. (1992). Problems of transformation. The International Journal of Social Psychiatry 38, 16–23.CrossRefGoogle ScholarPubMed
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. British Journal of Psychiatry, 165 (Suppl. 25), 13–17.CrossRefGoogle Scholar
Leff, J., Trieman, N., & Gooch, C. (1996). Team for the Assessment of Psychiatric Services (TAPS) project 33: Prospective follow-up study of long-stay patients discharged from two psychiatric hospitals. American Journal of Psychiatry, 153, 1318–1324.Google Scholar
Liberman, R. P., DeRisi, W. J., & Mueser, K. T. (1989). Social skills training for psychiatric patient. New York: Pergamon.Google Scholar
Liberman, R. P., Mueser, K.T., & Wallace, C. J. (1986). Social skills training for schizophrenics at risk for relapse. American Journal of Psychiatry, 143, 523–526.Google ScholarPubMed
Linke, S., & Taylor, D. (1987). Levels of dependency of the long-term mentally disabled in community and hospital settings. Behavioural Psychotherapy, 15, 314–318.CrossRefGoogle Scholar
Kruzich, J. M., & Berg, W. (1985). Predictors of self-sufficiency for the mentally ill in long-term care. Community Mental Health Journal, 21, 198–207.CrossRefGoogle ScholarPubMed
Macmillan, M., Hornblow, A., & Baird, K. (1992). From hospital to community: A follow-up of community placement of the long term mentally ill. New Zealand Medical Journal, 9, 348–350.Google Scholar
Mason, P., Harrison, G., Glazegrook, C., Medley, I., Dalkin, T., & Croudace, T. (1995). Characteristics of outcome in schizophrenia at 13 years. British Journal of Psychiatry, 167, 596–603.CrossRefGoogle Scholar
Mechanic, D., & Rochefort, D.A. (1990). Deinstitutionalisation: An appraisal of reform. Annual Review of Sociology, 16, 301–327.CrossRefGoogle Scholar
O'Driscoll, C. (1993). The TAPS project. 7: Mental hospital closure: A literature review of outcome studies and evaluation techniques. British Journal of Psychiatry, 162 (Suppl. 19), 7–17.CrossRefGoogle Scholar
O'Driscoll, C., & Leff, J. (1993). The TAPS project. 8: Design of the research study on the long-stay patients. British Journal of Psychiatry, 162 (Suppl. 19), 18–24.CrossRefGoogle Scholar
Segal, S. P., & Kotler, P. L. (1993). Sheltered care residence: Ten-year personal outcomes. American Journal of Orthopsychiatry, 63, 80–91.CrossRefGoogle ScholarPubMed
Shadish, W. R. Jr., Lurigio, A. J., & Lewis, D. A. (1989). After deinstitutionalization: The present and future of mental health of long-term care policy. Journal of Social Issues, 45, 1–15.CrossRefGoogle Scholar
Tessler, R. C., & Manderscheid, R. W. (1982). Factors affecting adjustment to community living. Hospital and Community Psychiatry, 33, 203–207.Google ScholarPubMed
Thornicroft, G., & Bebbington, P. (1989). Deinstitutionalisation: From hospital closure to service development. British Journal of Psychiatry, 155, 739–753.CrossRefGoogle ScholarPubMed
Wykes, T. (1992). The assessment of severely disabled psychiatric patients for rehabilitation. In Kavanagh, D.J. (Ed.), Schizophrenia: An overview and practical handbook, (pp. 221–238). Melbourne: Chapman & Hall.CrossRefGoogle Scholar