SUMMARYTwo projects were established to help elderly people with mental health problems move from continuing care hospital wards to local authority residential care homes. The projects were part of a larger programme established in the 1980s to test new policy and practice options. Each hospital resident was interviewed and assessed prior to commencing any programme of activities designed to prepare them for resettlement in the community. Data came from hospital patients themselves, from staff and from interviewer observations. Most of the people who moved from hospital were reinterviewed and reassessed approximately 9 months after discharge. The evaluation revealed that quality of life in residential homes was certainly not inferior to hospital but was less expensive. The residential homes offered more lively and psychologically pleasing environments than hospital. Residents' levels of participation were higher according to staff, and residents had more social contacts. The quality of social contacts also appeared to improve. The two projects thus provided a cost-effective alternative to hospital for elderly people with mental health problems.

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ulimia nervosa has recently emerged as a major mental health problem. Bulimics, usually women, suffer B episodes of uncontrollable eating following by purging and/or vomiting behaviours to rid themselves of the food.Previous work has examined the role of hostility in binge-purge behaviour, and clinical observation has noted the presence of strong guilt feelings. Most studies of hostility have used the Hostility and Direction of Hostility Questionnaire. Very little work has been done on the role of guilt in bulimia. Studies of both guilt and hostility in bulimia were absent. This study used the Buss-Durkee Inventory (1957) to compare a clinical sample of bulimic women (n = 17) with nonbulimic female students (n = 20) on guilt and overt and covert hostility. As predicted, bulimics scored significantly higher than students on guilt, one-tailed t(35) = 7.17, p c .05, and covert hostility, one-tailed (34) = 5.23, p c .05, but did not differ on overt hostility. A distinctive pattern of associations between measures of guilt, covert hostility, and eating behaviours was found for the bulimic women. These results suggested that women with high guilt and covert hostility might be more susceptible to bulimia than women who were less guilty or hostile. Longitudinal studies examining these variables throughout the teenage and young adulthood years would clarify the roles of guilt and covert hostility as possible etiological factors for bulimia.

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