Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 8/2018

01-08-2018 | Original Paper

Quality of life and social functioning of former long-stay psychiatric patients transferred into the community: a 10 year follow up study

Authors: S. J. McInerney, S. Finnerty, E. Walsh, L. Spelman, N. E. Edgar, B. Hallahan, C. McDonald

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2018

Login to get access

Abstract

Purpose

Deinstitutionalisation in Ireland began following the impetus of the successful transfer of psychiatric patients into the community in other countries. This study sought to evaluate the quality of life (QoL) and social functioning (SF) of former long-stay institutionalised patients with severe and enduring mental illness who had been relocated into local community settings and followed up 10 years later.

Method

One month prior to hospital closure, 87 former long-stay psychiatric patients, the majority of whom had a diagnosis of schizophrenia, were assessed on a range of QoL and SF measures. Patients were followed-up 10 years later in the community, to evaluate baseline predictors of quality of life and social functioning.

Results

Study completers (n = 35) improved significantly on a range of QoL and SF measures over the 10 year period. Specific improvements were noted in domestic skills (t = − 2.8, p < 0.0008), community skills (t = − 4.9, p < 0.001), as well as the activity and social relations measure (t = − 4.1, p < 0.001). Increased social function (t = − 6.3, p < 0.001) and improvement on the social behaviour scale (t = 7.6, p < 0.001) were noted at follow-up. Linear regression analysis found that less social behaviour problems at baseline predicted QoL 10 years later (t = − 2.6, p < 0.02).

Conclusion

This study demonstrated that transfer into the community from an institutional environment was associated with long-term improvements in quality of life and social functioning, even in those who spent many years in the institution. Those who demonstrated the greatest improvement in QoL had less social behavioural problems at baseline assessment, providing further evidence of the success of community living for former long-stay patients.
Literature
1.
Department of Health. Dublin, Ireland: (1984) Planning for the Future: Report of a Study Group on the Development of Psychiatric Service
2.
Mental Health Commission of Ireland (2007) MHC Annual Report 2007
3.
Thornicroft G, Gooch C, O’Driscoll C, Reda S (1993) The TAPS project. 9: the reliability of the patient attitude Questionnaire. Br J Psychiatry. (1993) 25–29
4.
Leff J, Trieman N (2000) Long-stay patients discharged from psychiatric hospitals: social and clinical outcomes after five years in the community. The TAPS Project 46. Br J Psychiatry 176:217–223CrossRefPubMed
5.
Harding C, Brooks G, Ashikaga T, Strauss J, Breier A (1987) The vermont longitudinal study of persons with severe mental illness, II: long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. Am J Psy 144:727–735CrossRef
6.
Geller JL, Fisher WH (1993) The linear continuum of transitional residences: debunking the myth. Am J Psychiatry 150:1070–1076CrossRefPubMed
7.
Lesage AD, Morissette R, Fortier L, Reinharz D, Contandriopoulos AP (2000) I. Downsizing psychiatric hospitals: needs for care and services of current and discharged long-stay inpatients. Can J Psychiatry 45:526–531CrossRefPubMed
8.
Grinshpoon A, Naisberg Y, Weizman A (2006) A six-month outcome of long-stay inpatients resettled in a hostel. Psychiatr Rehabil J 30:89–95 7CrossRefPubMed
9.
Chan H, Inoue S, Shimodera S, Fujita H, Fukuzawa K, Kii M, Kamimura N, Kato K, Mino Y (2007) Residential program for long-term hospitalized persons with mental illness in Japan: Randomized controlled trial. Psychiatry Clin Neurosci 61:515–521CrossRefPubMed
10.
McInerney SJ, Finnerty S, Avalos G, Walsh E (2010) Better off in the community? A 5-year follow up study of long-term psychiatric patients discharged into the community. Soc Psychiatry Psychiatr Epidemiol 45:469–473CrossRefPubMed
11.
Petersen KL, Nicholls TL, Groden D, Schmitz N, Stip E, Goldner EM, Arnold LM, Lesage A (2013) Redevelopment of tertiary psychiatric services in British Columbia: a prospective study of clinical, social, and residential outcomes of former long-stay inpatients. Schizophr Res 149:96–103CrossRefPubMed
12.
Trieman N, Leff J (2002) Long-term outcome of long-stay psychiatric in-patients considered unsuitable to live in the community: TAPS Project 44. Br J Psychiatry 181:428–432CrossRefPubMed
13.
Kwon JS, Choi J-S (2009) Social functioning and quality of life as measures of effectiveness in the treatment of schizophrenia. World Psychiatry 8:35–36CrossRefPubMedPubMedCentral
14.
Wykes T, Sturt E (1986) The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. Br J Psychiatry 148:1–11CrossRefPubMed
15.
Leff J, Trieman N, Gooch C (1996) Team for the assessment of psychiatric services (TAPS) project 33: prospective follow-up study of long-stay patients discharged from two psychiatric hospitals. Am J Psychiatry 153:1318–1324CrossRefPubMed
16.
Clifford P, Charman A, Webb Y, Best S (1991) Planning for community care. Long-stay populations of hospitals scheduled for rundown or closure. Br J Psychiatry 158:190–196CrossRefPubMed
17.
Farragher B, Carey T, Owens J (1996) Long-term follow-up of rehabilitated patients with chronic psychiatric illness in Ireland. Psychiatr Serv 47:1120–1122CrossRefPubMed
18.
Heinrichs DW, Hanlon TE, Carpenter WT (1984) The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 10:388–398CrossRefPubMed
19.
Mastroeni A, Bellotti C, Pellegrini E, Galleti F, Lai E, Falloon IRH. (2005) Clinical and social outcomes five years after closing a mental hospital: a trial of cognitive behavioural interventions. Clin Pract Epidemiol Ment Heal;1:Arte Number: 25. ate of Pubaton: 23 No 2005
20.
Ryu Y, Mizuno M, Sakuma K, Munakata S, Takebayashi T, Murakami M, Falloon IRH, Kashima H (2006) Deinstitutionalization of long-stay patients with schizophrenia: the 2-year social and clinical outcome of a comprehensive intervention program in Japan. Aust N Z J Psychiatry 40:462–470CrossRefPubMed
21.
Thornicroft G, Bebbington P, Leff J (2005) Outcomes for long-term patients one year after discharge from a psychiatric hospital. Psychiatr Serv 56:1416–1422CrossRefPubMed
22.
Heinssen RK, Liberman RP, Kopehwicz A (2000) Psychosocial skills training for schizophrenia: lessons from the laboratory. Schizophr Bull 26:22–46CrossRef
23.
Bellack AS, Ph D, Schooler NR, Ph D, Marder SR, Kane JM, Brown CH, Ph D, Yang Y (2004) Do clozapine and risperidone affect social competence and problem solving? Am J Psychiatry 161:364–367CrossRefPubMed
24.
Cella M, Stratta P, Chahal K, Huddy V, Reeder C, Wykes T. Elsevier BV (2014) Measuring community functioning in schizophrenia with the Social Behaviour Schedule. Schizophr Res 153:220–224CrossRefPubMed
25.
Lavelle E, Ijaz A, Killaspy H, Halloway F, King M, Keogh F, McDonough C, Spelman L, Goggins R, Daly I et al. (2007) Mental health rehabilitation and recovery services in Ireland: a multicentre study of current service provision, characteristics of service users and outcomes for those with and without access to these services Funded by the Mental Health Commission Res. Res Scholarsh Program 2007:60
26.
Jeste DV, Gladsjo JA, Lindamer LA, Lacro JP (1996) Medical comorbidity in schizophrenia. Schizophr Bull 22:413–430CrossRefPubMed
27.
Lohr J, Flynn K (1992) Smoking and schizophrenia. Schizophr Bull 8:93–102CrossRef
28.
Feeney S, Hallahan B (2011) Tobacco Smoking and Mental Illness: Important Considerations. Ir J Psychol Med 28:i–vCrossRefPubMed
29.
Das-Munshi J, Ashworth M, Gaughran F, Hull S, Morgan C, Nazroo J, Roberts A, Rose D, Schofield P, Stewart R et al. Springer Berlin Heidelberg (2016) Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study. Soc Psychiatry Psychiatr Epidemiol;51:627–638CrossRefPubMedPubMedCentral
Metadata
Title
Quality of life and social functioning of former long-stay psychiatric patients transferred into the community: a 10 year follow up study
Authors
S. J. McInerney
S. Finnerty
E. Walsh
L. Spelman
N. E. Edgar
B. Hallahan
C. McDonald
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 8/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-018-1520-3

Other articles of this Issue 8/2018

Social Psychiatry and Psychiatric Epidemiology 8/2018 Go to the issue

Correction

Correction to: Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study

Original Paper

Burnout and hopelessness among farmers: The Farmers Stressors Inventory

Review

Participatory research: real or imagined

Original Paper

Who is seeking whom? A person-centred approach to help-seeking in adults with currently untreated mental health problems via latent class analysis

Original Paper

Social distance in Lithuanian psychology and social work students and professionals

Original Paper

Psychiatric morbidity and subsequent divorce: a couple-level register-based study in Finland