title: Deinstitutionalised patients, homelessness and imprisonment: systematic review.
abstract: Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely.
  
  
  
  To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation.
  
  
  
  A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail.
  
  
  
  Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported.
  
  
  
  Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison.
authors.affiliation: Petr Winkler, PhD, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic, and Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Barbara Barrett, PhD, Paul McCrone, PhD, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Ladislav Csémy, PhD, Miroslava Janous̆ková, PhD, Cyril Höschl, DSc, FRCPsych, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic petr.winkler@nudz.cz.
authors.forename: Petr
authors.initials: P
authors.lastname: Winkler
authors.affiliation: Petr Winkler, PhD, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic, and Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Barbara Barrett, PhD, Paul McCrone, PhD, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Ladislav Csémy, PhD, Miroslava Janous̆ková, PhD, Cyril Höschl, DSc, FRCPsych, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Barbara
authors.initials: B
authors.lastname: Barrett
authors.affiliation: Petr Winkler, PhD, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic, and Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Barbara Barrett, PhD, Paul McCrone, PhD, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Ladislav Csémy, PhD, Miroslava Janous̆ková, PhD, Cyril Höschl, DSc, FRCPsych, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.affiliation: Petr Winkler, PhD, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic, and Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Barbara Barrett, PhD, Paul McCrone, PhD, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Ladislav Csémy, PhD, Miroslava Janous̆ková, PhD, Cyril Höschl, DSc, FRCPsych, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Csémy
authors.affiliation: Petr Winkler, PhD, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic, and Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Barbara Barrett, PhD, Paul McCrone, PhD, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Ladislav Csémy, PhD, Miroslava Janous̆ková, PhD, Cyril Höschl, DSc, FRCPsych, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Miroslava
authors.initials: M
authors.lastname: Janous̆ková
authors.affiliation: Petr Winkler, PhD, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic, and Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Barbara Barrett, PhD, Paul McCrone, PhD, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK; Ladislav Csémy, PhD, Miroslava Janous̆ková, PhD, Cyril Höschl, DSc, FRCPsych, Department of Social Psychiatry, National Institute of Mental Health, Klecany, Czech Republic.
authors.forename: Cyril
authors.initials: C
authors.lastname: Höschl
mesh_terms: D003688:Deinstitutionalization / Q000706:statistics & numerical data*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D011329:Prisoners / Q000706:statistics & numerical data*