title: Clinical and human resource planning for the downsizing of psychiatric hospitals: the British Columbia experience.
abstract: Riverview Hospital, B.C.'s only and Canada's largest remaining provincial psychiatric hospital began a formal planned "downsizing" process in 1992. This initiative was an important element in the Province's strategic plan to shift to a more community-focused mental health system and to bring tertiary psychiatric services "closer to home" by redeveloping Riverview Hospital on three sites. The paper summarizes the literature pertaining to the "downsizing" of psychiatric hospital services in relation both to clinical and human resource planning. It describes the mental health system in B.C. and the service system context in which this exercise is occurring. It is based on the first three years of experience in identifying the major challenges and the strategies developed to meet these challenges. It draws some conclusions about the effectiveness of these strategies and it speculates about the likely future challenges as the "downsizing" process continues.
authors.affiliation: Riverview Hospital, Port Coquitlam, British Columbia, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Macfarlane
authors.forename: P
authors.initials: P
authors.lastname: Fortin
authors.forename: J
authors.initials: J
authors.lastname: Fox
authors.forename: S
authors.initials: S
authors.lastname: Gundry
authors.forename: J
authors.initials: J
authors.lastname: Oshry
authors.forename: E
authors.initials: E
authors.lastname: Warren
mesh_terms: D001955:British Columbia; D003156:Community Mental Health Services / Q000639:trends; D003688:Deinstitutionalization / Q000639:trends; D005544:Forecasting; D006276:Health Facility Size / Q000639:trends*; D006295:Health Resources / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends; D006752:Hospital Planning / Q000639:trends*; D006754:Hospital Restructuring / Q000639:trends*; D006778:Hospitals, Psychiatric / Q000639:trends*; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation; D010348:Patient Care Team / Q000639:trends