Long-term outcome of state hospital patients discharged into structured community residential settings.
OBJECTIVE
This longitudinal study examined various dimensions of the lives of patients with chronic mental illness immediately before and again several years after their discharge from a state hospital into well-staffed structured community residential settings.


METHODS
Fifty-three patients with chronic mental illness and long histories of hospitalization were evaluated shortly before their state hospital discharge using a comprehensive structured assessment of nine dimensions of functioning and symptomatology. A follow-up assessment was undertaken a mean of 7.5 years after discharge into four structured group home settings.


RESULTS
At follow-up, 57 percent of the patients continued to live in structured community residential settings, 28 percent had moved on to independent living, and 16 percent had returned to an institutional setting. Fifty-five percent needed hospital readmission, but the total sample spent only 11 percent of the time after discharge in the hospital. At follow-up, patients showed significant improvements in cognitive and social functioning, and 94 percent expressed a preference for life in the community.


CONCLUSIONS
Many patients discharged to structured community residential settings seem to prefer them to the state hospital, are able to graduate to independent settings, and show improvement in important dimensions of functioning after several years in the community. Other dimensions seem resistant to change despite the structure and support afforded by residential settings.
Okin
R L
RL
Department of Psychiatry, University of California, San Francisco.
Borus
J F
JF
Baer
L
L
Jones
A L
AL
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D002140:California; D002908:Chronic Disease; D003688:Deinstitutionalization; D005260:Female; D005500:Follow-Up Studies; D016352:Group Homes; D006783:Hospitals, State; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D017060:Patient Satisfaction; D012559:Schizophrenia / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D012931:Social Environment