A 3-YEAR TO 6-YEAR FOLLOW-UP OF FORMER LONG-STAY PSYCHIATRIC-PATIENTSIN NORTHERN-IRELAND

Little is known about the first patients who left hospital before and during the official implementation of the hospital discharge policy in Northern Ireland. This study describes patterns of residential provis ion for former long-stay patients (approximately two-thirds of whom ha d an ICD-9 diagnosis of schizophrenia) discharged from the six major p sychiatric hospitals in Northern Ireland between 1987 and 1990 (it = 3 21). It also employs several instruments within a retrospective survey design to examine outcomes for a 35% sample of people (112/321) disch arged between 1997 and 1990 and followed up in 1993. Almost two-thirds (61%) had been discharged to independent living or low-staffed statut ory settings. None of the group was homeless, one person was in prison and three people had committed suicide during the first 2 years after discharge. Almost one-third had to be re-admitted at some stage durin g the 6-year period and 13% had died. 'Moderate' to 'major problems' w ith most daily living skills were reported for less than 25% of people , while 15% or less had problem behaviour. Approximately 90% or more w ere satisfied with most aspects of their new homes and most also repor ted feeling happier (77%), healthier (63%) and more independent (78%) since discharge. However, social, recreational and occupational opport unities were limited. Purchasers, providers and practitioners need to review ways in which former long-stay patients might be empowered to l ive more meaningful and integrated lives in the community, particularl y as the current government strategy for health and social well-being (1997-2002) in Northern Ireland points to the closure of existing psyc hiatric hospitals.