MOVING PSYCHIATRIC-PATIENTS FROM HOSPITAL TO COMMUNITY - VIEWS OF PATIENTS, PROVIDERS, AND FAMILIES

Objective: Differences in the perspectives of severely and persistentl y ill patients, their family members, and clinical care providers on k ey aspects of community-based care were examined to help inform commun ity service planning and development. Methods: A sample of 183 patient s being considered for relocation from psychiatric facilities in Alber ta, Canada, to community-based care, were interviewed, as were their p rimary clinical care providers. Family members of 130 patients were al so interviewed. Results: Among the 130 patient-family pairs, 41 percen t disagreed about the desirability of relocation, with fewer patients favoring relocation than families. Forty-nine percent of the pairs dis agreed about the desired proximity to the family of the relocated pati ent, with the patient desiring closer proximity than the family member in about half of these cases. Fifty-three percent of the pairs disagr eed about the amount of financial and emotional support that the famil y would provide after relocation. In half of these cases, patients bel ieved the family would provide a higher level of support than the fami ly indicated it could. Among the patients, 49 percent preferred indepe ndent living, whereas only 10 percent of family members and 17 percent of clinical care providers preferred it. Fifty-five percent of patien ts expressed a clear desire to work, whereas care providers believed t hat only 12 percent of patients were employable. Conclusions: Persiste ntly mentally ill residents of psychiatric facilities express clear pr eferences about key aspects of community-based care when they are aske d, and these preferences often reflect different views from those expr essed by either family members or clinical care providers.