title: Psychiatric aftercare in a metropolitan setting.
abstract: In the face of the trend toward brief hospitalization, rising re-admission rates and other indices of poor community adjustment, concern has developed about the adequacy of psychiatric aftercare services. The authors report on a comprehensive study of psychiatric aftercare in a large metropolitan area (population 2.5 million). The study followed prospectively a group of 747 patients, representative of a significant proportion of patients in the care system. The findings document inadequacies in hospital-based discharge planning, unbalanced use of aftercare services and poor patient outcomes six months and two years post-discharge. The study found heavy reliance on medical/therapeutic aftercare services with a relative neglect of housing, vocational/educational, financial and social/recreational services. Despite the large volume of medical/therapeutic service use, the patient group had a high readmission rate, high levels of symptomatology and poor social adjustment on follow-up. The authors suggest that community-based practitioners with specialized training in psychiatric rehabilitation would improve the system of aftercare.
authors.forename: D
authors.initials: D
authors.lastname: Wasylenki
authors.forename: P
authors.initials: P
authors.lastname: Goering
authors.forename: W
authors.initials: W
authors.lastname: Lancee
authors.forename: L
authors.initials: L
authors.lastname: Fischer
authors.forename: S J
authors.initials: SJ
authors.lastname: Freeman
mesh_terms: D000328:Adult; D000359:Aftercare; D003695:Delivery of Health Care; D005260:Female; D006760:Hospitalization; D006798:Housing; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D009864:Ontario; D010351:Patient Discharge; D010359:Patient Readmission; D011446:Prospective Studies; D012017:Referral and Consultation; D012050:Rehabilitation, Vocational; D014504:Urban Health