[The impact of social welfare policies on the deinstitutionalisation of the mentally ill in Germany].
OBJECTIVE
In Germany the competent institution for supported housing for mentally ill and handicapped persons is traditionally the regional welfare authority, while welfare authorities on state (Lander) level hold the competencies for accommodation in hostels and homes: Assessment of the impact of policies that try to overcome this separation of competencies.


METHODS
1. Analysis of the practise of distributing the competencies for accommodation for mental ill and handicapped persons in the 16 German Lander. 2. Assessment of the supply with accommodation for mental ill and handicapped persons in the Lander. 3. Investigation of a possible relationship between distribution of competencies for accommodation and number of accommodation in supported housing and hostels/homes.


RESULTS
Data about available accommodation in supported housing and hostels are inconsistently limited and available. As far as this data can be interpreted, Lander that have the administrative and particularly financial competency for accommodation uniquely organised, generally offer more supported housing. At the same time they provide relatively less accommodation in hostels and homes. Despite having the competencies for accommodation uniquely organised, some Lander continue to provide accommodation for mentally ill persons predominantly in hostels and homes.


CONCLUSIONS
A comprehensive and between the Lander comparable system of documentation of accommodation for mentally ill and handicapped persons is highly needed. Unique organisation of competencies for accommodation of mental ill and handicapped persons is a necessary - however not commensurate precondition for the increase of the supply in supported housing. Beyond that, other factors seem to be influential, such as political will, attitudes towards the mentally ill, interests of hostel providers, pre-existing hostel infrastructure. In respect of these factors more research is needed.
Bramesfeld
Anke
A
Abteilung Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover. bramesfeld.anke@mh-hannover.de
Holler
Gerhard
G
D003688:Deinstitutionalization / Q000191:economics / Q000331:legislation & jurisprudence*; D005380:Financing, Government / Q000331:legislation & jurisprudence; D005858:Germany; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence; D012112:Residential Facilities / Q000191:economics / Q000331:legislation & jurisprudence* / Q000600:supply & distribution; D012946:Social Welfare / Q000191:economics / Q000331:legislation & jurisprudence*; D012949:Social Work, Psychiatric / Q000191:economics / Q000331:legislation & jurisprudence