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Prospective study of clinical and social outcome of stay in small group homes for people with mental illness

Published online by Cambridge University Press:  03 January 2018

Thomas Middelboe*
Affiliation:
Social Psychiatry Research Unit and Department of Psychiatry E, Community Mental Health Center, Bispebjerg University Hospital, Copenhagen
*
Dr T. Middelboe, Bispebjerg University Hospital. Distriktspsykiatrisk Center, M⊘ntmestervej 17, DK-2400 Copenhagen NV, Denmark. Tel: +45 3888 3100. Fax +45 3110 7846

Abstract

Background

Small group homes operating according to the principles of supported housing have, during the past five years, become a cornerstone of the housing services for the long-term mentally ill in Copenhagen.

Method

During a 2.5-year period, 47 long-term mentally ill persons were examined at the time of entry to a group home programme. Residents' psychopathology, social integration, mastery and quality of life were measured by structured interviews, including the Present State Examination (PSE–10); and their social functioning was recorded by interview with the staff. Forty-four of the residents were re-examined at follow-up after a mean of 1.1 years using the same instruments. Data on hospitalisation were obtained through the Danish Psychiatric Case Register.

Results

Eighty-three per cent of the residents remained in the programme during the first year. They showed a significant improvement in subjective quality of life, PSE total score, social integration, functioning and hospitalisation index. The number of reciprocal supportive contacts in the social network increased. Lower baseline PSE total score was associated with adherence to the programme, and the improvement in quality of life during their stay was predicted by reduction in symptoms and improvement in social integration.

Conclusions

A rehabilitation strategy of supplementing standard psychiatric treatment with a programme of small supportive group homes improves the quality of life, psychosocial functioning and community tenure of the long-term mentally ill.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Aggernaes, A. (1994) On general and need-related quality of life: A psychological theory for use in medical rehabilitation and psychiatry. In Concepts and Measurement of Quality of Life in Health Care (ed. L. Nordenfeldt). London: Kluwer.Google Scholar
Anderson, J., Dayson, D., Wills, W., et al (1993) The TAPS Project. 13: Clinical and social outcomes of long-stay psychiatric patients after one year in the community. British Journal of Psychiatry, 162, (suppl. 19), 4556.CrossRefGoogle Scholar
Andreasen, N. C. (1995) Symptoms, signs, and diagnosis of schizophrenia. Lancet, 346, 477481.CrossRefGoogle ScholarPubMed
Andreasen, N. C. & Olsen, S. (1982) Negative vs positive schizophrenia. Archives of General Psychiatry, 39, 789794.CrossRefGoogle Scholar
Dunn, M., O'Driscoll, C., Dayson, D., et al (1990) The TAPS Project. 4: An observational study of the social life of long-stay patients. British Journal of Psychiatry, 157, 842848.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R., Fleiss, J., et al (1976) The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766771.CrossRefGoogle Scholar
Getler, J. L. & Fisher, W. H. (1993) The linear continuum of transitional residences: debunking the myth. American Journal of Psychiatry, 150, 10701076.Google Scholar
Gibbons, J. S. & Butler, J. P. (1907) Quality of life for ‘new’ long-stay psychiatric in-patients. The effects of moving to a hostel. British Journal of Psychiatry, 151, 347354.CrossRefGoogle Scholar
Hodgins, S., Cyr, M. & Gaston, L. (1990) Impact of supervised apartments on the functioning of mentally disordered adults. Community Mental Health Journal, 26, 507516.CrossRefGoogle ScholarPubMed
Hull, J. T. & Thompson, J. (1901) Factors which contribute to normalization in residential facilities for the mentally ill. Community Mental Health Journal. 17, 107113.CrossRefGoogle Scholar
Lamb, H. R. & Goertzel, V. (1972) High expectations of long-term ex-state hospital patients. American Journal of Psychiatry, 129, 131135.CrossRefGoogle ScholarPubMed
Lavik, N. J. (1983) Utilisation of mental health services over a given period. Acta Psychiatrica Scandinavica, 67, 404413.CrossRefGoogle Scholar
Lehman, A. F., Possidente, S. & Hawker, F. (1986) The quality of life of chronic patients in a state hospital and in community residences. Hospital and Community Psychiatry, 37, 901907.Google Scholar
Middelboe, T. (1995) Community care for the long-term mentally ill. A review of the housing issue. Nordic Journal of Psychiatry, 49, 161168.CrossRefGoogle Scholar
Mosher, L. R. & Menn, A. Z. (1978) Community residential treatment for schizophrenia: Two-year follow-up. Hospital and Community Psychiatry, 29, 715723.Google ScholarPubMed
Mowbray, C. T., Greenfield, A. & Freddollno, P. P. (1992) An analysis of treatment services provided in group homes for adults labeled mentally ill. Journal of Nervous and Mental Disease. 180, 551559.CrossRefGoogle ScholarPubMed
Muijen, M., Marks, I., Connolly, J., et al (1992) Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial. British Medical Journal, 304, 749754.CrossRefGoogle ScholarPubMed
Munk-Jergensen, P., Kastrup, M. & Mortensen, P. B. (1993) The Danish psychiatric register as a tool in epidemiology. Acta Psychiatrica Scandinavica, 87 (suppl. 370), 2732.CrossRefGoogle Scholar
Nelson, G., Hall, G. B., Squire, D., et al (1992) Social network transactions of psychiatric patients. Social Science and Medicine, 34, 433445.CrossRefGoogle ScholarPubMed
Nordentoft, M. (1994) Homelessness, Social Integration and Quality of Life in Psychiatric Patients in Copenhagen. PhD dissertation. Copenhagen: FADL.Google Scholar
Norusis, G. (1992) Statistical Package for Social Sciences (SPSS). Release 5.0. Chicago, IL: SPSS Inc.Google Scholar
Nuechterlein, K. H., Dawson, M. E., Ventura, J., et al (1994) The vulnerability/stress model of schizophrenic relapse: a longitudinal study. Acta Psychiatrica Scandinavica, 89 (suppl. 382), 5864.CrossRefGoogle Scholar
Okin, R. L. & Pearsall, D. (1993) Patients' perceptions of their quality of life 11 years after discharge from a state hospital. Hospital and Community Psychiatry, 44, 236240.Google ScholarPubMed
Phipps, C. & Liberman, R. P. (1987) Community support. In Psychiatric Rehabilitation of Chronic Mental Patients (ed. R. P. Liberman), pp. 285311. Washington, DC: American Psychiatric Press.Google Scholar
Quinlan, D. M., Schuldberg, D., Morgenstern, H., et al (1995) Positive and negative symptom course in chronic community-based patients. A two-year prospective study. British Journal of Psychiatry, 166, 634641.CrossRefGoogle ScholarPubMed
Team for the Assessment of Psychiatric Services (1989) The Basic Everyday Living Schedule. London: TAPS.Google Scholar
Wing, J. K. (1981) From institutional to community care. Psychiatric Quarterly, 53, 139152.CrossRefGoogle ScholarPubMed
Wing, J. K., Babor, T., Brugha, T., et al (1990) SCAN – Schedules for clinical assessment in neuropsychiatry. Archives of General Psychiatry, 47, 589593.CrossRefGoogle ScholarPubMed
World Health Organization (1993) The ICD–10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: WHO.Google Scholar
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