Long-stay patients discharged from psychiatric hospitals

BACKGROUND: There have been no large-scale prospective studies evaluating the transfer of care from psychiatric hospitals to district-based services. AIMS: We aimed to compare the quality of life of patients in two north London hospitals scheduled for closure with that in the community homes to which they were discharged. METHOD: The total long-stay population of Friern Hospital and several hundred long-stay patients in Claybury Hospital were assessed with a batch of eight schedules while in hospital. They were followed up after one year in the community and then at five years. RESULTS: Of the 670 discharged patients, 126 died before the five-year follow-up. Data were obtained on 523 (97%) of the survivors. There was no change in the patients' clinical state or in their problems of social behaviour. However, they gained domestic and community living skills. They also acquired friends and confidants. They were living in much freer conditions and the great majority wanted to remain in their current homes. CONCLUSIONS: Community care has enhanced the quality of life of this group of patients, involved in a well-planned and adequately resourced reprovision programme.