[Accumulation of "new" long-stay patients in homes being part of psychiatric hospitals: a challenge for psychiatric care].
OBJECTIVE
In the end of the deinstitutionalization of "old-long-term" hospitalised patients, restrictive psychiatric homes were created on the grounds of psychiatric hospitals exclusively to take in the remaining "difficult-to-place" patients. However, new chronic mentally ill persons have been accumulating in these institutions since then. This study analyses the characteristics of the "new long-stay" population.


METHODS
Interviews with all patients and their caring staff in eight hospital-hostels in one German federal state.


RESULTS
Characteristics and reasons for admission as well as for previous exclusion from the established community care were found in a marked requirement for control and surveillance as well as need for help and high dependence in everyday life, markedly dissocial behaviour and low social functioning.


CONCLUSIONS
Despite there are promising opportunities specific programs that are effective to prevent a subgroup of chronic mentally ill persons from inappropriate re-institutionalisation, exclusion or forensic psychiatry are not yet sufficiently provided by general psychiatric services.
Franz
Michael
M
Klinik für Psychiatrie und Psychotherapie, Vitos Klinikum Kurhessen, Bad Emstal, Germany. michael.franz@vitos-kurhessen.de
Meyer
Thorsten
T
Dubowy
Minja
M
Hanewald
Bernd
B
Gallhofer
Bernd
B
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003688:Deinstitutionalization / Q000639:trends*; D004185:Disability Evaluation; D005260:Female; D016352:Group Homes / Q000639:trends*; D006778:Hospitals, Psychiatric / Q000639:trends*; D006801:Humans; D007406:Interview, Psychological; D008134:Long-Term Care / Q000639:trends*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D020380:Needs Assessment; D010343:Patient Admission / Q000639:trends*; D012917:Social Adjustment