title: Organizational analysis of deinstitutionalization in a psychiatric hospital.
abstract: BACKGROUND
  Few studies have been conducted of the organizational aspects that impact on the course of psychiatric deinstitutionalization.
  
  
  METHODS
  A case study was undertaken of 10 years of deinstitutionalization in a Montreal psychiatric hospital.
  
  
  RESULTS
  Deinstitutionalization has forged ahead in the hospital over the past few years, although the course it has taken is not the one initially plotted by its promoters. Care management of deinstitutionalized patients remains under the control of the psychiatric hospital and its physicians. However, the patients' well-being has remained a focus of concern and does not seem to have been detrimentally affected by this development.
  
  
  CONCLUSIONS
  Deinstitutionalization is both a solution to the criticisms levelled at the hospital-psychiatric approach of managing persons with severe and persistent mental disorders and an extremely useful tool in the power struggle among the various stakeholders in mental health services reform. Deinstitutionalization has become unavoidable.
authors.affiliation: Centre de recherche, Centre Hospitalier Universitaire de Québec.
authors.forename: D
authors.initials: D
authors.lastname: Reinharz
authors.forename: A P
authors.initials: AP
authors.lastname: Contandriopoulos
authors.forename: A D
authors.initials: AD
authors.lastname: Lesage
mesh_terms: D019090:Case Management / Q000458:organization & administration; D002908:Chronic Disease; D003688:Deinstitutionalization / Q000458:organization & administration*; D006778:Hospitals, Psychiatric; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011618:Psychotic Disorders / Q000534:rehabilitation*; D011785:Quality Assurance, Health Care / Q000191:economics; D011792:Quebec