Australia's National Mental Health Strategy and deinstitutionalization: some empirical results.
OBJECTIVE
To determine the role of the National Mental Health Strategy in the deinstitutionalization of patients in psychiatric hospitals in Queensland.


METHODS
Regression analysis (using the maximum likelihood method) has been applied to relevant time-series datasets on public psychiatric institutions in Queensland. In particular, data on both patients and admissions per 10 000 population are analysed in detail from 1953-54 to the present, although data are presented from 1883-84.


RESULTS
These Queensland data indicate that deinstitutionalization was a continuing process from the 1950s to the present. However, it is clear that the experience varied from period to period. For example, the fastest change (in both patients and admissions) took place in the period 1953-54 to 1973-74, followed by the period 1974-75 to 1984-85.


CONCLUSIONS
In large part, the two policies associated with deinstitutionalization, namely a discharge policy ('opening the back door') and an admission policy ('closing the front door') had been implemented before the advent of the National Mental Health Strategy in January 1993. Deinstitutionalization was most rapid in the 30-year period to the early 1980s: the process continued in the 1990s, but at a much slower rate. Deinstitutionalization was, in large part, over before the Strategy was developed and implemented.
Doessel
Darrel P
DP
School of Population Health, The University of Queensland, Brisbane, Australia. darrel_doessel@qcmhr.uq.edu.au
Scheurer
Roman W
RW
Chant
David C
DC
Whiteford
Harvey A
HA
D001315:Australia; D003156:Community Mental Health Services / Q000266:history / Q000600:supply & distribution; D003688:Deinstitutionalization / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000639:trends; D006291:Health Policy / Q000266:history / Q000639:trends*; D049672:History, 19th Century; D049673:History, 20th Century; D006778:Hospitals, Psychiatric / Q000266:history / Q000458:organization & administration / Q000600:supply & distribution*; D006779:Hospitals, Public / Q000266:history / Q000458:organization & administration / Q000600:supply & distribution; D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000534:rehabilitation / Q000628:therapy; D008605:Mental Health Services / Q000600:supply & distribution*; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D012044:Regression Analysis