Literature DB >> 16683973

Deinstitutionalization of long-stay patients with schizophrenia: the 2-year social and clinical outcome of a comprehensive intervention program in Japan.

Yonosuke Ryu1, Masafumi Mizuno, Kei Sakuma, Shunichi Munakata, Toru Takebayashi, Masaaki Murakami, Ian R H Falloon, Haruo Kashima.   

Abstract

OBJECTIVES: The Sasagawa Project aimed to investigate the effects of deinstitutionalization and evidence-based strategies for the treatment of mental disorders among long-stay patients after their discharge from a mental hospital using a quasi-experimental longitudinal study design and to assess the patients' social and clinical outcomes over a 2-year post-discharge period.
METHOD: Seventy-eight patients with schizophrenia were transferred to a community facility (Sasagawa Village) following the closure of Sasagawa Hospital in Koriyama in March 2002. The patients had undergone psychosocial training following the protocol outlined by the Optimal Treatment Project. All evaluations were performed prior to the patients' discharge and were repeated 12 and 24 months after discharge using the Positive and Negative Syndrome Scales, the Global Assessment for Functioning, the Schedule for Assessment of Insight, the Rehabilitation Evaluation Hall and Baker Scale, the Social Functioning Scale, the Drug Attitude Inventory, and the Mini-Mental State Examination.
RESULTS: During the 24-month study period, 18 residents had incidents that made their continued stay at Sasagawa Village impossible. Only four (5.1%) of these residents were readmitted to psychiatric wards because of exacerbations of their conditions. Twelve residents were admitted to hospital because of serious physical illnesses. The 60 residents who remained in the community facility for 2 years demonstrated significant improvements in not only their psychiatric symptoms, but also their social functioning, as evidenced by their scores for Social Activity, Speech Skills, Disturbed Speech, Self-Care and General Behaviour on the Rehabilitation Evaluation Hall and Baker Scale and Withdrawal, Independence (Performance), Independence (Competence), and Employment on the Social Functioning Scale.
CONCLUSIONS: Careful planning that minimized social and clinical dislocation may have contributed to the successful transition from mental hospital to community facility assessed in this study. Patients with a long history of illness showed favourable outcomes with little clinical deterioration and various improvements in their psychiatric symptoms and social functioning.

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Year:  2006        PMID: 16683973     DOI: 10.1080/j.1440-1614.2006.01823.x

Source DB:  PubMed          Journal:  Aust N Z J Psychiatry        ISSN: 0004-8674            Impact factor:   5.744


  10 in total

1.  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
Journal:  Soc Psychiatry Psychiatr Epidemiol       Date:  2018-04-28       Impact factor: 4.328

2.  Role of the general practitioner in the care of patients recently discharged from the hospital after a first psychotic episode: influence of length of stay.

Authors:  Joanna L Norton; Emmanuelle Rivoiron-Besset; Michel David; Isabelle Jaussent; Cindy Prudhomme; Jean-Philippe Boulenger; Anthony H Mann; Karen A Ritchie; Delphine Capdevielle
Journal:  Prim Care Companion CNS Disord       Date:  2011

3.  Clinical Predictors of Delayed Discharges in Inpatient Mental Health Settings Across Ontario.

Authors:  Jerrica Little; John P Hirdes; Christopher M Perlman; Samantha B Meyer
Journal:  Adm Policy Ment Health       Date:  2019-01

4.  Burden of informal care giving to patients with psychoses: a descriptive and methodological study.

Authors:  Lena Flyckt; Anna Löthman; Leif Jörgensen; Anders Rylander; Thomas Koernig
Journal:  Int J Soc Psychiatry       Date:  2011-11-17

5.  The effects of nursing discharge plan (post-discharge education and follow-up) on self-care ability in patients with chronic schizophrenia hospitalized in Razi psychiatric Center.

Authors:  Hamidreza Khankeh; Mehdi Rahgozar; Maryam Ranjbar
Journal:  Iran J Nurs Midwifery Res       Date:  2011

6.  The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry.

Authors:  Coralie Gandré; Jeanne Gervaix; Julien Thillard; Jean-Marc Macé; Jean-Luc Roelandt; Karine Chevreul
Journal:  Int J Environ Res Public Health       Date:  2017-03-21       Impact factor: 3.390

Review 7.  Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review.

Authors:  Samira Salime; Christophe Clesse; Alexis Jeffredo; Martine Batt
Journal:  Front Psychiatry       Date:  2022-03-24       Impact factor: 4.157

8.  Resource Group Assertive Community Treatment (RACT) as a Tool of Empowerment for Clients with Severe Mental Illness: A Meta-Analysis.

Authors:  Tommy Nordén; Ulf Malm; Torsten Norlander
Journal:  Clin Pract Epidemiol Ment Health       Date:  2012-11-16

9.  Hannover study on long-stay hospitalization - part II: Characteristics and care conditions of long-stay hospitalization in cases of chronic mental illness.

Authors:  Stefan M Bartusch; Bernd R Brüggemann; Hermann Elgeti; Marc Ziegenbein; Wielant Machleidt
Journal:  Clin Pract Epidemiol Ment Health       Date:  2007-11-26

10.  Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life.

Authors:  Siew Yim Loh; Amalina Abdullah; Abdul Kadir Abu Bakar; Maniam Thambu; Nik Ruzyanei Nik Jaafar
Journal:  Glob J Health Sci       Date:  2015-05-21
  10 in total

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