The TAPS Project. 7: Mental Hospital Closure - A Literature Review of Outcome Studies and Evaluative Techniques

O'Driscoll, Catherine

doi:10.1192/s0007125000292192

Cited by 43 publications

(26 citation statements)

References 62 publications

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“…This result fits with original suggestions that NC residents come t o live in National Health Service (NHS)-funded facilities because of their difficulties finding appropriate placements within the community (Bollini et al, 1986;O'Driscoll, 1993). On the other hand, this difference could also be a factor of the type of care provided, such that the social difficulties in NC were a product of the NC environment.…”

Section: Discussionsupporting

confidence: 85%

“…There is a common view that nursing care (NC) settings provide care for a select group of highly dependent elderly, who because of their special medical and/or psychiatric needs, have proven to be difficult to place elsewhere (Bollini et al, 1986;O'Driscoll, 1993). These people with special needs include many individuals with dementia, a mental illness that involves a complex mix of psychological, social, and physical changes that many community and residential services find difficult to manage (Aronson et al, 1992;Chester & Bender, 1999).…”

mentioning

confidence: 95%

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An Evaluation of Needs in Elderly Continuing-Care Settings

Martin¹,

Hancock

Richardson

et al. 2002

Int. Psychogeriatr.

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This article describes the met and unmet needs of elderly residents of nursing care (NC) and residential care (RC) settings. Thirty-four residents of an RC home and 40 residents of two NC settings were assessed. Each resident and a respective staff member were interviewed using the Camberwell Assessment of Need for the Elderly (CANE) to indicate the resident's current met and unmet needs. The Clifton Assessment Procedure for the Elderly-Behaviour Rating Scale (CAPE-BRS) was completed by the staff member to indicate the participant's current level of dependency. In addition, the Mini-Mental State Examination was administered to participants and DSM-IV diagnosis was recorded. A high number of needs were found in both RC and NC settings, the level of dependency being proportional to level of need. There was a core set of needs in both samples related to difficulties with accommodation, food preparation, and self-care. Both NC and RC homes were meeting these needs; however, RC residents had a significantly greater level of unmet need for suitable daytime activities. The greatest predictor of type of setting was gender and there were significantly more females in RC. Controlling for gender, participants in NC had greater levels of dependency, particularly problems with apathy and social skills, as measured on the CAPE-BRS. It is possible that the greater level of social needs in NC residents had led to their placement in the more specialized NC settings. On the other hand, NC settings may be left caring for a group of residents that, because of their specific needs, have been difficult to place into RC. These findings have clinical implications for the future development of continuing care for the elderly. This study also highlighted that there is a substantial need for specialist services to address the unmet needs in these two types of continuing-care settings, such as interventions for social disturbances in NC and suitable daytime activities in RC. The CANE is a useful instrument to evaluate such needs in long-term-care settings.

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Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 95%

An Evaluation of Needs in Elderly Continuing-Care Settings

Martin¹,

Hancock

Richardson

et al. 2002

Int. Psychogeriatr.

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“…Notwithstanding the magnitude of this development, many studies have investigated small samples of residents and used a cross-sectional design [3][4][5]. Only a few longitudinal studies have yielded important information about this population, consistently indicating the difficulties involved in discharging and placing these patients in independent accommodations [6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy

Girolamo

Candini

Buizza

et al. 2013

Soc Psychiatry Psychiatr Epidemiol

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Background A growing number of severely ill patients require long-term care in non-hospital residential facilities (RFs). Despite the magnitude of this development, longitudinal studies surveying fairly large resident samples and yielding important information on this population have been very few. Aims The aims of the study were (1) to describe the socio-demographic, clinical, and treatment-related characteristics of RF patients during an index period in 2010; (2) to identify predictors and characteristics associated with discharge at the 1-year follow-up; (3) to evaluate clinicians' predictions about each patient's likelihood of home discharge (HD). Methods A prospective observational cohort study was conducted involving all patients staying in 23 mediumlong-term RFs of the St John of God Order with a primary psychiatric diagnosis. A comprehensive set of sociodemographic, clinical, and treatment-related information was gathered and standardized assessments (BPRS, HO-NOS, PSP, PHI, SLOF, RBANS) were administered to each participant. Logistic regression analyses were run to identify independent discharge predictors. Results The study involved 403 patients (66.7 % male), with a mean age of 49 years (SD = 10). The participants' average illness duration was 23 years; median value for length of stay in the RF was 2.2 years. The most frequent diagnosis was schizophrenia (67.5 %). 104 (25.8 %) were discharged: 13.6 % to home, 8.2 % to other RFs, 2.2 % to supported housing, and 1.5 % to prison. Clinicians' predictions about HD were generally erroneous. Conclusions Very few patients were discharged to independent accommodations after 1 year. The main variables associated with a higher HD likelihood were: illness duration of \15 years and effective social support during the previous year. Lower severity of psychopathology and higher working skill levels were also associated with a significantly greater HD likelihood.

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“…In fact, the variability in study design and the wide diversity of research focus make it unlikely that a more systematic review would yield much in the way of definitive evidence to support one model of supported housing over another. Only one systematic review (Quilgars, 2000) of low intensity support services and two relevant literature reviews (O'Driscoll, 1993;Thornicroft & Bebbington, 1989) were found during the search process. Consequently this review should be seen as a preliminary attempt to provide an overview of existing literature that identifies areas where more research might be required in future.…”

Section: Search Strategymentioning

confidence: 99%

Supported Housing Services for People with Mental Health Problems: A Scoping Study

O’Malley

Croucher

2005

Housing Studies

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This paper discusses the findings of a scoping study that aimed to explore evidence relating to models of good practice with regard to accommodation and related services for people with mental health problems in the UK. The literature reveals that there has tended to be an assumption that patients will progress from high(er) to low(er) levels of supported accommodation over time, thereby marginalising the needs of a core group of people with particularly challenging behaviour who require long-term, permanent accommodation with high levels of support. The paper concludes by examining the implications of the scoping study for current UK policies towards those with mental health problems.

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The TAPS Project. 7: Mental Hospital Closure - A Literature Review of Outcome Studies and Evaluative Techniques

Cited by 43 publications

References 62 publications

An Evaluation of Needs in Elderly Continuing-Care Settings

An Evaluation of Needs in Elderly Continuing-Care Settings

Is psychiatric residential facility discharge possible and predictable? A multivariate analytical approach applied to a prospective study in Italy

Supported Housing Services for People with Mental Health Problems: A Scoping Study

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