OBJECTIVE: The study compared the quality of life of long-stay
psychiatric patients after they had been discharged to community residences
for one year with that of long-stay patients who remained hospitalized.
METHODS: Long-stay patients (that is, those with stays of at least one
year) who were discharged from two psychiatric hospitals in London were
closely matched with patients likely to stay in the hospital for another
year. Baseline (in-hospital) and one-year follow- up assessments were
conducted using six instruments to measure factors related to quality of
life such as problems in social functioning and size of the social network.
RESULTS: A total of 494 discharged patients were compared with 279 patients
who remained in the hospital. The death rate did not differ between the two
groups. Only six discharged patients became vagrants, and only two were
imprisoned, one briefly. Discharged patients were living under much less
restrictive conditions, they preferred their life in the community, and the
number of their friends increased, as did the number of acquaintances in
the community such as neighbors. No adverse effects of discharge on mental
state or social behavior were noted. CONCLUSIONS: The results indicate that
community care is a beneficial alternative to long-term care in psychiatric
hospitals for the majority of patients, provided it is well planned and
adequate resources are available.