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. METHOD: 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. CONCLUSION: 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.
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. METHOD: 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. CONCLUSION: 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.