ONE-YEAR AND 2-YEAR OUTCOMES FOR ADULTS WITH LEARNING-DISABILITIES DISCHARGED TO THE COMMUNITY

Background. Long-stay patients with learning disabilities (n=214) were assessed in hospital and 12 and 24 months after discharge in order to examine the effects of relocation. Method. Each resident acted as his /her own control in a prospective repeated-measures design. Skills and behavioural problems were assessed by keyworkers. Self-perceived qual ity of life was obtained during interviews with researchers who also c ompleted an environmental checklist of the residents' accommodation.Re sults. There was little or no change in people's low pre-discharge ski ll levels. Certain aspects of problem behaviour improved after 12 mont hs, although socially unacceptable behaviour increased slightly. Peopl e were less depressed (P less than or equal to 0.01) 12 months after d ischarge (n=119) and were more satisfied (P less than or equal to 0.05 ) with their new 'homes' (n=108). There were few changes in the patter n of a activities or the social networks of people 12 months later. Li ttle or no further change in outcomes was reported 24 months after dis charge. Conclusions. The implementation of the deinstitutionalisation policy in Northern Ireland has been limited by the predominance of res idential and nursing homes and the lack of 'ordinary' accommodation. T here is a need for purchasers and providers to give more attention to ways in which the principles of normalisation could be incorporated in the process of contracting and delivering services.