Artículos de revistas: "Deinstitutionalisation"

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Emerson, Eric y Chris Hatton. "Deinstitutionalisation". Tizard Learning Disability Review 10, n.º 1 (febrero de 2005): 36–40. http://dx.doi.org/10.1108/13595474200500008.

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Munk-Jørgensen, P. "S22.04 Deinstitutionalisation". European Psychiatry 15, S2 (octubre de 2000): 257s. http://dx.doi.org/10.1016/s0924-9338(00)94103-8.

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Emerson, Eric. "Deinstitutionalisation in England". Journal of Intellectual & Developmental Disability 29, n.º 1 (marzo de 2004): 79–84. http://dx.doi.org/10.1080/13668250410001662838.

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Sudesh, G. A. Wasana. "The LPI as an Effective Ground-level Strategy for the Deinstitutionalisation and Quality Alternative Care of Children". Institutionalised Children Explorations and Beyond 7, n.º 2 (septiembre de 2020): 170–82. http://dx.doi.org/10.1177/2349300320937555.

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Deinstitutionalisation and quality alternative care is a topic that is widely discussed in search of policies, strategies and good practices. This issue affects all children directly or indirectly. It is very pertinent to the South Asia region. Children who are in institutional care require deinstitutionalisation process that involves both prevention and a range of alternative care options that are community-based, family-based or family-like care. The Local Process Initiative (LPI), which was implemented in the Devinuwara Divisional Secretariat Division (DSD) in the Matara District of Sri Lanka, is an effective strategy that demonstrates deinstitutionalisation and quality alternative care. SOS Children’s Villages of Sri Lanka in seven locations including Devinuwara DSD since 2017 have carried out the LPI process successfully. It has generated positive outcomes especially in terms of strengthening the ground-level state mechanism for deinstitutionalisation and alternative care for children. The divisional secretary is the lead person in the ‘locational circle’ formed in this process, which composes of a range of field-level government officers involved in childcare and community development as they are the first point of contact for issues related to children and families. The government officers are considered the ‘change agents’, and their empowerment is at the centre of the LPI strategy and its success. From the LPI process in the Devinuwara DSD, it is expected to develop a model to avoid family separation. In here, it is expected to develop a ground-level deinstitutionalisation and a quality alternative care strategy which incorporate solutions from biological, psychological and sociological perspectives to build confidence of stakeholders on deinstitutionalisation and quality alternative care for children, and document evidence including success stories in order to support deinstitutionalisation and quality alternative care of children. This article offers an LPI process in the Devinuwara DSD as an effective strategy for the deinstitutionalisation and quality alternative care of children in South Asia.

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5

Chesters, Janice. "Deinstitutionalisation: an unrealised desire". Health Sociology Review 14, n.º 3 (diciembre de 2005): 272–82. http://dx.doi.org/10.5172/hesr.14.3.272.

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6

Hudson, Bob. "Deinstitutionalisation: What Went Wrong". Disability, Handicap & Society 6, n.º 1 (enero de 1991): 21–36. http://dx.doi.org/10.1080/02674649166780021.

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7

Mundt, Adrian P. "Deinstitutionalisation, imprisonment and homelessness". British Journal of Psychiatry 209, n.º 4 (octubre de 2016): 349. http://dx.doi.org/10.1192/bjp.209.4.349.

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Pijl, Ysbrand J., Herman Kluiter y Durk Wiersma. "Deinstitutionalisation in the Netherlands". European Archives of Psychiatry and Clinical Neuroscience 251, n.º 3 (1 de junio de 2001): 124–29. http://dx.doi.org/10.1007/s004060170046.

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9

Bredewold, Femmianne, Margot Hermus y Margo Trappenburg. "‘Living in the community’ the pros and cons: A systematic literature review of the impact of deinstitutionalisation on people with intellectual and psychiatric disabilities". Journal of Social Work 20, n.º 1 (15 de agosto de 2018): 83–116. http://dx.doi.org/10.1177/1468017318793620.

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Summary How did deinstitutionalisation affect the lives of people with intellectual disabilities and people with a psychiatric background? This paper contains a systematic literature review on the consequences of deinstitutionalisation for the target groups, their social network and society at large. PubMed and Online Contents were searched from 2004 till February 2016. Inclusion criteria were (1) article describes (a) consequence(s) of deinstitutionalisation, (2) in Western countries and (3) the target group(s) include people with psychiatric or intellectual disabilities. Sixty-one papers were found and analysed to establish positive, negative or mixed results. Findings The positive effects pertain to the quality of life of people with disabilities after deinstitutionalisation. They learned adaptive skills and receive better care. Negative effects relate to more criminal behaviour by the target groups, victimisation of the target groups and physical health issues. Life for the most severely afflicted people with disabilities deteriorated when they moved to smaller group homes in the community. Mixed effects were also found. It is not clear whether deinstitutionalisation leads to real inclusion in the community. It is equally unclear whether it is cheaper than large-scale institutional care. Only a few studies investigate the effects on family members but some show they are overburdened. Applications Social workers catering for people with disabilities should pay attention to risks for their health and safety and keep an eye on family members. Those who are asked to advise on deinstitutionalisation should consider that this may not benefit the most severely afflicted.

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Rogers, Justin M. y Victor Karunan. "Is the deinstitutionalisation of alternative care a ‘wicked problem’? A qualitative study exploring the perceptions of child welfare practitioners and policy actors in Thailand". International Social Work 63, n.º 5 (23 de julio de 2020): 626–39. http://dx.doi.org/10.1177/0020872820940016.

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This study examined deinstitutionalisation in Thailand. Qualitative interviews were conducted with a total of 27 child welfare practitioners and policy actors to explore their perceptions of Thai alternative care provision. Findings show that participants perceive deinstitutionalisation as a complex policy challenge. Some felt that the institutions were necessary in order to meet demand, while others felt that cultural barriers prevent a shift to family-based approaches, such as foster care. However, data suggest that it would be difficult to characterise deinstitutionalisation as a ‘wicked policy problem’ as participants were hopeful for change, citing increased family- strengthening policies alongside efforts to implement foster care.

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11

Khetawat, Devanshi. "Cognitive, Behavioural and Emotional Benefits of Deinstitutionalisation for Children with Disabilities: A Comparative Study of the United Kingdom and India". Institutionalised Children Explorations and Beyond 7, n.º 1 (marzo de 2020): 83–88. http://dx.doi.org/10.1177/2349300319894865.

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Research states that institutionalisation often results in negative outcomes for children’s mental, physical and emotional health and behaviour. Alternatively, deinstitutionalisation can buffer this negative impact across countries and cultures. However, these results have been inadequately replicated with children having disabilities, who are at heightened risk of negative psychosocial outcomes of institutionalisation. Owing to the large number of children with disabilities in institutional care and this seems unrepresentative and undesirable. In the current article, the cognitive, emotional, mental health, and behavioural benefits of deinstitutionalisation for children with varied disabilities in India and UK are discused. For this, the researcher’s compilation of observational data and personal reflections from 4.5 years of practical work with deinstitutionalised children with disabilities is used. Further, interview extracts and reflections from children and their adoptive/foster carers post deinstitutionalisation are included. With this, an attempt is made to advance how and why deinstitutionalisation is beneficial for children with disabilities.

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12

Zaviršek, Darja. "Delayed deinstitutionalisation in post-socialism". European Journal of Social Work 20, n.º 6 (17 de julio de 2017): 834–45. http://dx.doi.org/10.1080/13691457.2017.1344623.

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13

Clark, Fiona. "Deinstitutionalisation and stigma in Russia". Lancet Psychiatry 3, n.º 6 (junio de 2016): 506–7. http://dx.doi.org/10.1016/s2215-0366(16)30082-7.

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14

Bastiampillai, Tarun, Stephen Allison, Richard O'Reilly, Julio Licinio y Steven S. Sharfstein. "Can deinstitutionalisation contribute to exclusion?" Lancet 391, n.º 10136 (junio de 2018): 2210. http://dx.doi.org/10.1016/s0140-6736(18)30779-7.

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15

Salokangas, R. K. R. y S. Saarinen. "Deinstitutionalisation and schizophrenia in Finland". European Psychiatry 11 (enero de 1996): 424s. http://dx.doi.org/10.1016/0924-9338(96)89392-8.

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16

Allen, Steven, Ines Bulic, Eric Rosenthal, Connie Laurin-Bowie, Sylvia Roozen y Vladimir Cuk. "Institutionalisation and deinstitutionalisation of children". Lancet Child & Adolescent Health 4, n.º 11 (noviembre de 2020): e40. http://dx.doi.org/10.1016/s2352-4642(20)30301-1.

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17

JOHNSON, KELLEY. "Deinstitutionalisation: The management of rights". Disability & Society 13, n.º 3 (junio de 1998): 375–87. http://dx.doi.org/10.1080/09687599826696.

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18

Fisher, Karen R., Deborah Lutz, Friederike Gadow, Sally Robinson y Sandra Gendera. "A Transformative Framework for Deinstitutionalisation". Research and Practice in Intellectual and Developmental Disabilities 2, n.º 1 (2 de enero de 2015): 60–72. http://dx.doi.org/10.1080/23297018.2015.1028089.

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19

Forber-Pratt, Ian, Qiuchi Li, Zijing Wang y Connie Belciug. "A Review of the Literature on Deinstitutionalisation and Child Protection Reform in South Asia". Institutionalised Children Explorations and Beyond 7, n.º 2 (16 de julio de 2020): 215–28. http://dx.doi.org/10.1177/2349300320931603.

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Knowledge about child protection system reform and deinstitutionalisation in South Asian countries is scarce. This study explores the legislative frameworks and literature on deinstitutionalisation in eight South Asian countries, to consolidate the knowledge, explore the challenges and propose strategies to overcome the difficulties associated with this reform. South Asia, home to almost 25per cent of the world’s population, or 1.8 billion people ( The World Bank, 2019 ), is culturally complex and requires a variety of solutions to keep all its children safe. This study introduces three strategies that could promote deinstitutionalisation in South Asia: (1) utilising a regional approach, (2) decentralised implementation and (3) capitalising on traditional alternative care practices. Future studies are needed to evaluate the effectiveness of these strategies in each country.

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20

Genienė, Rasa. "DeCovidation = Deinstitutionalization. Independent Living and Inclusion in the Community". Socialinė teorija, empirija, politika ir praktika 21 (16 de septiembre de 2020): 26–36. http://dx.doi.org/10.15388/stepp.2020.21.

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The global coronovirus (Covid-19) pandemic has been revealed what about half of the world’s deaths are recorded in large institutions of the elderly and people with disabilities, and these are later thought to be incentives for states to take active deinstitutionalisation efforts. In order for deinstitutionalisation actions to respond to its ideological origins, which lie in the provisions of the United Nations Convention on the Rights of Persons with Disabilities, in the necessary legal instruments and in clarifying that Member States are responsible. The article reveals how the deinstitutionalisation processes that have already started are implemented and evaluated in Central and Eastern Europe and discusses their problems. Content analysis was used to investigate the Soviet regime, leading to the implementation of official and alternative (shadow) reports on the United Nations Convention on the Rights of Persons with Disabilities.

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21

Turnpenny, Agnes. "Commentary on “Occupational identity of staff and attitudes towards institutional closure”". Tizard Learning Disability Review 19, n.º 3 (2 de julio de 2014): 142–45. http://dx.doi.org/10.1108/tldr-04-2014-0008.

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Purpose – The purpose of this paper is to reflect on Vesala et al.'s (2014) findings on the occupational identity of staff and attitudes towards institutional closure. Design/methodology/approach – This commentary reviews some of the research around staffing, organisational hygiene and service management in countries that have already implemented deinstitutionalisation, and draws out some key considerations for countries and organisations that are planning the transition from institutions to community-based care. Findings – There is increasing evidence around approaches that are more likely to lead to positive service user and staff outcomes. Particularly person-centred active support and practice leadership have emerged as effective approaches in facilitating organisational change and high-quality services. Originality/value – Some of the experiences and practices in post-deinstitutionalisation countries around active support and practice leadership can provide valuable considerations for planning institutional closure programmes in countries currently implementing deinstitutionalisation.

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22

Atkinson, Dave. "How deinstitutionalisation affects quality of life". Learning Disability Practice 22, n.º 3 (30 de mayo de 2019): 8. http://dx.doi.org/10.7748/ldp.22.3.8.s8.

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23

Walsh, D. "Psychiatric deinstitutionalisation in Ireland 1960–2013". Irish Journal of Psychological Medicine 32, n.º 4 (7 de julio de 2015): 347–52. http://dx.doi.org/10.1017/ipm.2015.20.

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ObjectiveThis paper reviews the decline in numbers in inpatient psychiatric care in Ireland over the past half century.MethodThe relevant policy publications advocating de-institutilisation have been examined. Change has been monitored through successive census reports of the Medico-social Research Board and the Health Research Board.FindingsIreland has moved from having the highest hospitalisation rate of any western country to a position of equality with other comparable countries in the quantum of inpatient care provided. In the public sector virtually no patients remain in 19th century mental hospitals with acute care being provided in general hospital units. Numbers have also decreased in the private sector but to a lesser degree and acute private care is still delivered in stand-alone psychiatric hospitals.

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Holt, Geraldine, Helen Costello y Nick Bouras. "European service perspectives for people with intellectual disabilities and mental health problems". International Psychiatry 5, n.º 1 (enero de 2008): 3–4. http://dx.doi.org/10.1192/s1749367600005361.

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Services for people with intellectual disabilities, in the UK as elsewhere, have changed dramatically over the last 30 years; deinstitutionalisation has probably been the largest experiment in social policy in our time. The vast majority of people with intellectual disabilities, their families and carers have benefited from having a better quality of life as a result of deinstitutionalisation. However, much still needs to be done to integrate this population more into society and to ensure they are offered the appropriate supports to meet their needs.

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Taylor, T. L. "International differences in the value for money provided by institutions in european countries at different stages of deinstitutionalisation and with different economies". European Psychiatry 26, S2 (marzo de 2011): 2146. http://dx.doi.org/10.1016/s0924-9338(11)73849-4.

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BackgroundIndividuals with a diagnosis of schizophrenia or schizoaffective disorder may require longer term care. Due to the complexities of caring for this population and the high resource cost of care, it is important to ensure that mental health services are efficient and effective.AimsThis investigation aims to examine international differences in quality of care and service user experience when compared to national health expenditure and the degree of deinstitutionalisation in 10 countries.MethodsThe quality of care provided in 213 units was measured using the Quality Indicator for Rehabilitative Care (QuIRC). Service users living in these units (N = 1750) were asked to assess the care they received. Multilevel models were used to examine the relationships between quality (QuIRC domain ratings), level of deinstitutionalisation and national health care expenditure. As no formalised assessment of deinstitutionalisation has been published, a quantitative tool was developed and validated. Percentage of gross domestic product spent on health care and per capita total health care spend was taken from World Health Organisation data to assess national health care expenditure.ResultsMultilevel models examining the relationships between deinstitutionalisation levels, health care expenditure, quality and service user experience will be presented. Results were adjusted for unit (type and size) and service user (age, gender and level of functioning) characteristics.ConclusionsRecommendations on the best use of resources within a facility providing longer term care and how best to increase the quality of care provided without additional financial expenditure will be discussed in relation to the results.

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Urek, Mojca. "The Right to ‘Have a Say’ in the Deinstitutionalisation of Mental Health in Slovenia". Social Inclusion 9, n.º 3 (26 de agosto de 2021): 190–200. http://dx.doi.org/10.17645/si.v9i3.4328.

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In a time when the deinstitutionalisation of mental health services has become a global and European platform and one of the main forms of care provision, a theme such as the transition of care from large institutions down to a more personal community level care might seem outlived, but the fact is that in some European countries the discussion has revolved for almost 35 years around the most basic question concerning the closure of large, asylum‐type mental health institutions. In this article, I provide a historical overview and analysis of deinstitutionalisation processes in the field of mental health in Slovenia from mid‐1980s onwards, interpreted in terms of achievements and gaps in community‐based care and in user participation in these processes. It demonstrates some of the innovative participatory practices and their potential to transform services. A thematic data analysis was used to analyse the data collected from various primary (a focus group) and secondary sources (autobiographies, newspaper articles, round table reports, blogs) that all bear witness to the different periods of deinstitutionalisation and the user perspective in it.

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Rákó, Erzsébet. "Deinstitutionalisation in Hungarian child protection: Policy and practice changes in historical contexts". Journal of Childhood, Education & Society 3, n.º 3 (19 de noviembre de 2022): 275–92. http://dx.doi.org/10.37291/2717638x.202233191.

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The aim of the study is to present the historical changes in child protection in Hungary and the process of deinstitutionalisation, which is still shaping child protection work in this country. The research seeks to answer the question of how the process of institutionalisation and deinstitutionalisation was implemented in Hungary in the socialist era and after the introduction of Act XXXI of 1997 on the Protection of Children and on the Directorate for Guardianship (Act XXXI of 1997), which was a milestone in the Hungarian child protection for the 0-3-year olds. The study employs a case study methodology with secondary data corpus including legislation and data provided by the Central Statistical Office in Hungary. The scientific approach of the study is mainly historical, presenting the main features of child protection in three distinct periods 1950-1970, 1980-1995 and 1996-2018. The findings indicate that the socialist era has had a prevailing influence on child protection for many decades, but the years following the transition into democracy brought major transformation in child protection, a "transition of the child protection system", paving the way for the process of deinstitutionalisation and the emergence of alternative forms of care.

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MacKinnon, Dolly y Catharine Coleborne. "Introduction: Deinstitutionalisation in Australia and New Zealand". Health and History 5, n.º 2 (2003): 1. http://dx.doi.org/10.2307/40111450.

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Brunton, Warwick. "The Origins of Deinstitutionalisation in New Zealand". Health and History 5, n.º 2 (2003): 75. http://dx.doi.org/10.2307/40111454.

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30

Young, Louise y Adrian F. Ashman. "Deinstitutionalisation in Australia Part I: Historical Perspective". British Journal of Development Disabilities 50, n.º 98 (enero de 2004): 21–28. http://dx.doi.org/10.1179/096979504799104029.

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Mansell, Jim. "Deinstitutionalisation and community living: An international perspective". Housing, Care and Support 8, n.º 3 (septiembre de 2005): 26–33. http://dx.doi.org/10.1108/14608790200500022.

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32

Carrigan, Nicky. "Deinstitutionalisation – time to move on to legislation?" Irish Journal of Psychological Medicine 28, n.º 4 (diciembre de 2011): 182–84. http://dx.doi.org/10.1017/s0790966700011617.

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Vázquez-Barquero, J. L. y J. Garcia. "SES16.04 Deinstitutionalisation and Psychiatric Reform in Spain". European Psychiatry 15, S2 (octubre de 2000): 294s. http://dx.doi.org/10.1016/s0924-9338(00)94288-3.

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Luchenski, Serena April, Suzanne Fitzpatrick, Nigel Hewett, Robert W. Aldridge y Andrew C. Hayward. "Can deinstitutionalisation contribute to exclusion? – Authors' reply". Lancet 391, n.º 10136 (junio de 2018): 2210–11. http://dx.doi.org/10.1016/s0140-6736(18)30755-4.

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Salisbury, Tatiana Taylor y Graham Thornicroft. "Deinstitutionalisation does not increase imprisonment or homelessness". British Journal of Psychiatry 208, n.º 5 (mayo de 2016): 412–13. http://dx.doi.org/10.1192/bjp.bp.115.178038.

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SummaryClosing long-stay psychiatric beds remains contentious. The review by Winkler et al in this issue examines 23 studies of deinstitutionalisation for the outcomes of people discharged from psychiatric hospitals after an admission of 1 year or longer. The majority of these studies identified no cases of homelessness, incarceration or suicide after discharge from hospital.

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Goldman, Philip S., Marinus H. van Ijzendoorn y Edmund J. S. Sonuga-Barke. "Institutionalisation and deinstitutionalisation of children – Authors' reply". Lancet Child & Adolescent Health 4, n.º 11 (noviembre de 2020): e41. http://dx.doi.org/10.1016/s2352-4642(20)30302-3.

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Thornicroft, Graham y Paul Bebbington. "Deinstitutionalisation — from Hospital Closure to Service Development". British Journal of Psychiatry 155, n.º 6 (diciembre de 1989): 739–53. http://dx.doi.org/10.1192/bjp.155.6.739.

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The necessary components of a comprehensive service of local non-institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co-ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages.

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Lamb, H. Richard. "Lessons Learned from Deinstitutionalisation in the US". British Journal of Psychiatry 162, n.º 5 (mayo de 1993): 587–92. http://dx.doi.org/10.1192/bjp.162.5.587.

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Deinstitutionalisation is at an advanced stage in the US, both in duration, and in reduction in state hospital beds. The new generation of chronically and severely mentally ill persons has posed the greatest problems. They no longer receive life-long hospital admission and thus permanent asylum from the demands of the world. Resistance to treatment and substance abuse are problems. Early proponents of deinstitutionalisation believed it would be cheaper, better, and give the mentally ill their freedom. In reality, good community care does not cost less. While a number of community programmes in the US have been impressive, they have served only a small proportion of the total population of severely mentally ill persons. More freedom has been of benefit for many, but has proved difficult for some patients. Some patients have been deinstitutionalised who cannot be effectively treated in the community. The homeless mentally ill epitomise all these problems.

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Dalrymple, John. "Deinstitutionalisation and Community Services in Greater Glasgow". Tizard Learning Disability Review 4, n.º 1 (enero de 1999): 13–23. http://dx.doi.org/10.1108/13595474199900004.

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Mansell, Jim. "Deinstitutionalisation and Community Services in Greater Glasgow". Tizard Learning Disability Review 4, n.º 1 (enero de 1999): 24–26. http://dx.doi.org/10.1108/13595474199900005.

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41

Mansell, Jim. "Deinstitutionalisation and Community Living: An International Perspective". Tizard Learning Disability Review 10, n.º 1 (febrero de 2005): 22–29. http://dx.doi.org/10.1108/13595474200500006.

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Kinsella, Peter. "Life Without Walls ‐ Stories of Successful Deinstitutionalisation". Tizard Learning Disability Review 10, n.º 1 (febrero de 2005): 41–45. http://dx.doi.org/10.1108/13595474200500009.

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Giannakopoulos, George y Dimitris C. Anagnostopoulos. "Psychiatric reform in Greece: an overview". BJPsych Bulletin 40, n.º 6 (diciembre de 2016): 326–28. http://dx.doi.org/10.1192/pb.bp.116.053652.

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SummaryLeros became infamous worldwide in the 1980s because of a scandal in its mental institution, the Leros asylum. The scandal provoked universal outrage and the international pressure triggered the Greek mental health reform. Under the reform projects Leros I and Leros II (1990–1994), numerous interventions took place in the Leros asylum as part of deinstitutionalisation. Following that, the Psychargos programme advanced developments for community-based services. Deinstitutionalisation and development of community mental health services have advanced significantly since the 1980s. However, this reform is still incomplete, given that sectorisation, adequate primary care policies, inter-sectoral coordination and specialised services are under-developed. This problematic situation is further complicated by the severe impact of the current financial crisis.

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Cambridge, Paul, John Carpenter, Jennifer Beecham, Angela Hallam, Martin Knapp, Rachel Forrester‐Jones y Alison Tate. "Twelve Years On: The Long‐term Outcomes and Costs of Deinstitutionalisation and Community Care for People with Learning Disabilities". Tizard Learning Disability Review 7, n.º 3 (1 de julio de 2002): 34–42. http://dx.doi.org/10.1108/13595474200200027.

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This paper reports on the key findings of a study into the outcomes and costs of community care for a large cohort of people with learning disabilities, supported in 12 study sites across England, who left various long‐stay hospital 12 years ago as part of a centrally monitored and evaluated government policy initiative on deinstitutionalisation. It represents the last follow‐up of a raft of linked longitudinal evaluations, conducted at four time points over a twelve‐year period. The paper identifies the findings from the last follow‐up and interprets and presents them as summary observations and trends in relation to the findings in learning disability, briefly reviewing them in relation to wider evidence on deinstitutionalisation and community care in England.

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Lesage, Alain D. "Evaluating the closure or downsizing of psychiatric hospitals: social or clinical event?" Epidemiologia e Psichiatria Sociale 9, n.º 3 (septiembre de 2000): 163–70. http://dx.doi.org/10.1017/s1121189x00007855.

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SummaryObjectives – The evaluation matrix recently proposed by Tansella and Thornicroft suggests that the field of social and epidemiological psychiatry has focussed more on the individual/patient level of mental health care services than the system level. Moreover, phenomena such as deinstitutionalisation have been examined more as clinical events than as social ones. The aims here are to deepen our understanding of deinstitutionalisation, particularly as regards the downsizing/closure and role of psychiatric hospitals. Methods – I begin by reviewing the manifest and latent functions of psychiatric hospitals. This is followed by a discussion of how these functions must be met by any comprehensive community-oriented system of mental health care for severely mentally ill patients. Also, in order to reframe the downsizing/closure of psychiatric hospitals as a social event for the field of social psychiatry and psychiatric epidemiology, I posit that the process of deinstitutionalisation is driven today by the same forces that were present at the outset of the movement. Results – I review four recent series of studies addressing primarily the outcomes, but also other aspects, of the downsizing/closure of psychiatric hospitals, with a view to illustrating the methods used, the results obtained and the blind angles missed in this research. Conclusions – Lessons are drawn on how to fill certain vacant cells of the matrix.

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46

Pillay, Anthony L. "Is deinstitutionalisation a cheap alternative to chronic mental health care?" South African Journal of Psychology 47, n.º 2 (10 de mayo de 2017): 141–47. http://dx.doi.org/10.1177/0081246317709959.

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Worldwide, there has been a dominant belief that the deinstitutionalisation of the mentally ill is a cost-saving approach, leading health authorities to embark on such initiatives without adequate community-based health and social service resources and supports. These have resulted in disaster, even in high-income countries, when insufficient planning and preparation have been effected. The recent experience in South Africa that saw the deaths of approximately 100 people with chronic mental illness within 1 year of being moved from a mental health facility is further evidence of the need for more concerted and deliberate planning and resourcing of mental health care services. The article examines various issues relating to deinstitutionalisation and urges authorities to re-examine their approach to mental health care and especially the priority accorded to this marginalised group.

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Kielland, Christian. "Deinstitutionalisation in Norway: the process, challenges and solutions". Tizard Learning Disability Review 15, n.º 4 (9 de noviembre de 2010): 15–21. http://dx.doi.org/10.5042/tldr.2010.0589.

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48

Hansen, Vidje, Bjarne K. Jacobsen y Egil Arnesen. "Cause-specific mortality in psychiatric patients after deinstitutionalisation". British Journal of Psychiatry 179, n.º 5 (noviembre de 2001): 438–43. http://dx.doi.org/10.1192/bjp.179.5.438.

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BackgroundSince the late 1970s, the psychiatric service system in Norway has been changed gradually according to the principles of deinstitutionalisation.AimsTo document the mortality of psychiatric patients in a deinstitutionalised service system.MethodsThe case register of a psychiatric hospital covering the period 1980–1992 was linked to the Central Register of Deaths. Age-adjusted death rates and standardised mortality ratios (SMRs) were computed.ResultsPatients with organic psychiatric disorders had significantly higher mortality regardless of cause of death. SMRs ranged from 0.9 for death by cancer in women to 36.3 for suicide in men. For unnatural death, SMRs were highest in the first year after discharge. Compared to the periods 1950–1962 and 1963–1974, there has been an increase in SMRs for cardiovascular death and suicide in both genders.ConclusionsDeinstitutionalisation seems to have had as its cost a relative rise both in cardiovascular death and unnatural deaths for both genders, but most pronounced in men.

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49

Mansell, Jim. "Deinstitutionalisation and community living: Progress, problems and priorities". Journal of Intellectual & Developmental Disability 31, n.º 2 (junio de 2006): 65–76. http://dx.doi.org/10.1080/13668250600686726.

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50

Tsiantis, J., A. Perakis, P. Kordoutis, G. Kolaitis y V. Zacharias. "The Leros PIKPA Asylum. Deinstitutionalisation and Rehabilitation Project". British Journal of Psychiatry 167, S28 (julio de 1995): 10–45. http://dx.doi.org/10.1192/s0007125000298176.

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A three-year deinstitutionalisation and rehabilitation pilot intervention project was implemented at Leros PIKPA for people with severe learning disabilities. Initial conditions at the asylum were appalling. Residents suffered severe deprivation, extreme institutionalisation, and violation of basic human rights. Intervention involved professionals from different disciplines, and involved residents, their families, care staff, the institution, and the local community. As a result, resident care and adaptive behaviour has started to improve. Communication between residents and families has increased. Owing to training and sensitisation, care staff's poor resident-management practices and negative attitudes toward disabled people have changed. Living and hygienic conditions have been upgraded and building renovation is under way. Asylum administration and the local community have been sensitised to residents' needs. Eleven residents have moved to the project's pilot community home in Athens; two others now live with foster families. The results suggest that deinstitutionalisation and rehabilitation can be successfully initiated even in residential institutions of the severest kind.

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