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Survey of long-stay patients on acute psychiatric wards

  • Martin Commander (a1) and Dharjinder Rooprai (a2)
Abstract
Aims and Method

To describe the profile of patients staying on acute wards for longer than 6 months and to compare staff appraisals of accommodation needs with patients' placements at 2 years.

Results

Long-stay patients consistently occupied around a fifth of all acute beds. the nursing and medical staff recommendations and patients' placements at 2 years showed only moderate agreement. Aside from remaining in hospital, patients were most likely to be living in a residential or nursing home at follow-up.

Clinical Implications

There is a need to sharpen the focus of mental health strategy on non-acute hospital provision and 24-h-staffed community facilities. In particular, it is important to recognise the contribution of clinical expertise to the assessment and placement of long-stay in-patients.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Survey of long-stay patients on acute psychiatric wards

  • Martin Commander (a1) and Dharjinder Rooprai (a2)
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eLetters

Rehabilitation teams and resettlement

David Abrahamson, Consultant Psychiatrist
23 November 2008

Commander and Rooprai (Psychiatric Bulletin October 2008, 32, 380-383) draw attention to the importance of specialist rehabilitation teams for successful resettlement from acute hospital wards. Experience with onesuch team in another socially deprived, multi-ethnic inner-city area over more than 20 years fully supports their conclusions.

Rehabilitation teams can ensure resettlement is more than freeing beds. Over this period, the team has supported preparation-for-discharge houses that provide humane alternatives to wards and are a portal to long-term rehabilitation and recovery. Initially situated on a hospital campus and later in the community, they enhance domestic and social skills and inform assessments and patient choice. The network of staffed and supported housing (increasingly the latter) to which their residents have access is also actively supported by the rehabilitation team, greatly easing transitions and ensuring the continuity that is now often confined to such teams (Abrahamson, 1993).

In addition, the team runs a combined group and individual out-patient clinic for resettled and other long-term patients. This facilitates its other clinical and support work, enlightens staff-patient relationships and adds a peer support dimension that is also evident in the social club that developed from it (Abrahamson & Fellow-Smith, 1991). The extra options these provide are clearly enjoyed by even the most withdrawn patients, who are particularly at risk of isolation ‘in thecommunity’.

Official commitment to rehabilitation teams has nationally been intermittent and variable and needs to be settled and explicit.

ABRAHAMSON,D. (1993) Housing and Deinstitutionalisation : theory and practice in the development of a rehabilitation service. In: Dimensions ofcommunity mental health care. London: W.B. Saunders Company Ltd.

ABRAHAMSON, D. & FELLOW-SMITH, E. (1991) A combined group and individual long-term out-patient clinic. British Journal of Psychiatry, 15: 486 487.
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Conflict of interest: None Declared

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