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The Long-term Outcomes and Unmet Needs of a Cohort of Former Long-Stay Patients in Melbourne, Australia

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Abstract

Former long-stay patients with psychotic disorders have significant unmet needs. This study assessed the long-term outcomes for the original cohort of 18 residents of the Footbridge Community Care Unit (CCU), a residential psychiatric rehabilitation unit at St Vincent’s Mental Health Melbourne. A review of case records and interviews were conducted for each member of the cohort 8 years after admission to the CCU. Members of the cohort were living in a variety of settings after discharge from the CCU. Despite significant gains during the period of residential rehabilitation in the CCU after hospital discharge, by the time of follow-up individuals were in general leading restricted lives characterised by a lack of stable residential and social supports. Most reported positively on the support provided in the CCU although later experiences of moving repeatedly from one setting to another were adverse. Five key unmet needs were identified: promotion of independence; stability in accommodation; stability in social networks; consistency of care; and addressing the theme of loss. A longitudinal perspective in management that focuses on stability in residential care is required for long-stay patients.

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References

  • Abrahamson, D. (1993). Institutionalisation and the long-term course of schizophrenia. British Journal of Psychiatry, 162, 533–538.

    Article  PubMed  CAS  Google Scholar 

  • Anthony, W. (2000). A recovery-oriented service system: Setting some system level standards. Psychiatric Rehabilitation Journal, 24(2), 159–168.

    Google Scholar 

  • Anthony, W. A., & Liberman, R. P. (1986). The practice of psychiatric rehabilitation: Conceptual and research base. Schizophrenia Bulletin, 12, 542–559.

    PubMed  CAS  Google Scholar 

  • Australian Health Ministers. (1998). Second National mental health plan. Canberra: Commonwealth Department of Health and Community Services.

    Google Scholar 

  • Australian Mental Health Outcomes and Classification Network. (2005). Adult National Outcomes & Casemix. Collection standard reports version 1.1 (1st ed.). Brisbane, QLD.

  • Bennett, D. H. (1980). The chronic psychiatric patient today. Journal of the Royal Society of Medicine, 73, 301–303.

    PubMed  CAS  Google Scholar 

  • Eagar, K., Trauer, T., & Mellsop, G. (2005). Performance of routine outcome measures in adult mental health care. Australian and New Zealand Journal of Psychiatry, 39, 713–718.

    Article  PubMed  Google Scholar 

  • Fossey, E., Epstein, M., Findlay, R., & Harvey, C. (2002a). Creating a positive experience of research for people with psychiatric disabilities by sharing feedback. Psychiatric Rehabilitation Journal, 25, 369–378.

    PubMed  Google Scholar 

  • Fossey, E., Harvey, C., McDermott, F., & Davidson, L. (2002b). Understanding and evaluating qualitative research. Australian and New Zealand Journal of Psychiatry, 36, 717–732.

    Article  PubMed  Google Scholar 

  • Harding, C. M. (1988). Course types in schizophrenia: An analysis of European and American studies. Schizophrenia Bulletin, 14, 633–643.

    PubMed  CAS  Google Scholar 

  • Harrison, G., Hopper, K., Craig, T., Laska, E., Siegel, C., Wanderling, J., et al. (2001). Recovery from psychotic illness: A 15- and 25-year international follow-up study. British Journal of Psychiatry, 178, 506–517.

    Article  PubMed  CAS  Google Scholar 

  • Harvey, C. A. (1996). The camden surveys I: The psychiatric, behavioural and social characteristics of the severelyl mentally ill in an inner London health district. British Journal of Psychiatry, 168, 410–417.

    Article  PubMed  CAS  Google Scholar 

  • Hobbs, C., Newton, L., Tennant, C., Rosen, A., & Tribe, K. (2002). Deinstitutionalization for long-term mental illness: A 6-year evaluation. Australian and New Zealand Journal of Psychiatry, 36, 60–66.

    Article  PubMed  Google Scholar 

  • Janca, A., & Lee, A. (2002). Continuity of life interview manual. Perth: The University of Western Australia.

    Google Scholar 

  • Johnstone, E. C. (1991). Disabilities and circumstances of schizophrenic patients—a follow-up study. British Journal of Psychiatry, 159(Suppl 13), 5–46.

    Google Scholar 

  • Kuehner, C., & J. E. Cooper. (1999). Quality of life assessment in mental health research: A pilot study of the continuity of life interview. In: WPA section on epidemiology and public health symposium “from epidemiology to clinical practice”. Turku, Finland.

  • Leff, J., & Trieman, N. (2000). Long-stay patients discharged from psychiatric hospitals—social and clinical outcomes after five years in the community. The TAPS Project 46. British Journal of Psychiatry, 176, 217–223.

    Article  PubMed  CAS  Google 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(10), 1318–1324.

    PubMed  CAS  Google Scholar 

  • Love, A. (1998). St Vincent’s community care unit—service goals and objectives. Melbourne: St Vincent’s Mental Health Service Melbourne (unpublished document).

    Google Scholar 

  • Minichello, V., Sullivan, G., Greenwood, K., & Axford, R. (1999). Handbook for research methods in health sciences. Sydney: Addison Wesley Longman Australia Pty Ltd.

    Google Scholar 

  • Mueser, K. T., & Bond, G. R. (2000). Psychosocial treatment approaches for schizophrenia. Current Opinion in Psychiatry, 13, 27–35.

    Article  Google Scholar 

  • Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. G. (1998). Models of community care for severe mental illness: a review of research on case management. Schizophrenia Bulletin, 34, 37–74.

    Google Scholar 

  • Nelson, G., Brent Hall, G., & Walsh-Bowers, R. (1999). Predictors of the adaptation of people with psychiatric disabilities in group homes, supportive apartments, and board-and-care homes. Psychiatric Rehabilitation Journal, 22, 381–389.

    Google Scholar 

  • Newton, L., Rosen, A., Tennant, C., Hobbs, C., Lapsley, H., & Tribe, K. (2000). Deinstitutionalization for long-term mental illness: an ethnographic study. Australian and New Zealand Journal of Psychiatry, 34, 484–490.

    Article  PubMed  CAS  Google Scholar 

  • Patton, M. Q. (2002). Qualitative research evaluation methods (3rd ed.). Thousand Oaks, California: Sage Publications.

    Google Scholar 

  • Priebe, S., & Turner, T. (2003). Reinstitutionalisation in mental health care. British Medical Journal, 326, 175–176.

    Article  PubMed  Google Scholar 

  • Rapp, C., & Goscha, R. C. (2006). The strengths model (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Rice, P. L., & Ezzy, D. (1999). Qualitative research methods: A health focus. Melbourne: Oxford University Press.

    Google Scholar 

  • Rosen, A., Hadzi-Pavlovic, D., & Parker, G. (1986). The life skills profile: A measure assessing function and disability in schizophrenia. Schizophrenia Bulletin, 12, 604–630.

    Google Scholar 

  • Salzer, M. S., & Shear, S. L. (2002). Identifying consumer-provided benefits in evaluations of consumer-delivered services. Psychiatric Rehabilitation Journal, 25, 281–288.

    PubMed  Google Scholar 

  • Solomon, P., & Draine, J. (2001). The state of knowledge of the effectiveness of consumer provided services. Psychiatric Rehabilitation Journal, 25, 20–27.

    PubMed  CAS  Google Scholar 

  • Stein, L. I., & Test, M. A. (1980). Alternative mental hospital treatment I: Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry, 37, 392–397.

    PubMed  CAS  Google Scholar 

  • Trauer, T. (2001). Symptom severity and personal functioning among patients with schizophrenia discharged from long-term hospital care into the community. Community Mental Health Journal, 37, 145–155.

    Article  PubMed  CAS  Google Scholar 

  • Trauer, T., Farhall, J., Newton, R., & Cheung, P. (2001). From long-stay psychiatric hospital to community care unit: Evaluation at 1 year. Social Psychiatry and Psychiatric Epidemiology, 36, 416–419.

    Article  PubMed  CAS  Google Scholar 

  • Trieman, N., & Leff, J. (2002). Long-term outcome of long-stay psychiatric in-patients considered unsuitable to live in the community—TAPS project 44. British Journal of Psychiatry, 181, 428–432.

    Article  PubMed  Google Scholar 

  • Turner, T., & Priebe, S. (2002). Forget community care—reinstitutionalisation is here. British Journal of Psychiatry, 181, 253.

    Article  PubMed  CAS  Google Scholar 

  • Victorian Government Department of Health and Community Services. (1996). Victoria’s mental health service resources for case managers: Individual service planning. Melbourne: Victorian Government Department of Health and Community Services.

    Google Scholar 

  • Warner, R. (2003). Recovery from schizophrenia: Psychiatry and political economy (3rd ed.). London: Brunner-Routledge.

    Google Scholar 

  • Warner, R., & Mandiberg, J. (2003). Changing the environment of schizophrenia at the community level. Australasian Psychiatry, 11(Suppl), S58–S64.

    Article  Google Scholar 

  • Wing, J., Beevor, A. S., Curits, R. H., Park, S. B. G., Hadden, S., & Burns, A. (1998). Health of the nation outcome scales: Research and development. British Journal of Psychiatry, 172, 11–18.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Centre for International Mental Health, School of Population Health, The University of Melbourne, Parkville, VIC, Australia

    Prem Chopra

  2. Victorian Transcultural Psychiatry Unit, St. Vincent’s Health Melbourne, Level 2, Bolte Wing, St. Vincent’s Hospital, Nicholson Street Fitzroy, Fitzroy, VIC, 3065, Australia

    Prem Chopra

  3. ORYGEN Research Centre, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia

    Helen E. Herrman

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  1. Prem Chopra
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  2. Helen E. Herrman
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Correspondence to Prem Chopra.

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Chopra, P., Herrman, H.E. The Long-term Outcomes and Unmet Needs of a Cohort of Former Long-Stay Patients in Melbourne, Australia. Community Ment Health J 47, 531–541 (2011). https://doi.org/10.1007/s10597-010-9351-z

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  • DOI: https://doi.org/10.1007/s10597-010-9351-z

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