Abstract
BackgroundChanges in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. This study describes patterns of changes in the residential and care settings of SMI patients and explores associations between these changes, sociodemographics, and clinical characteristics.MethodsFrom January 2006 to January 2012, all data relating to changes in residential and/or care setting by SMI patients (N = 262) were collected from electronic case files. Data covering psychopathology, substance use, and medication adherence were assessed in 2006.ResultsThere were more changes in the residential than in the care setting. In 6 years, only 22% of our sample did not move, 23% changed residence once, 19% twice, 10% three times, and 26% four or more times. Substance use predicted changes of care and/or residential setting and rehospitalisation. The severity of negative symptoms predicted rehospitalisation and duration of hospitalisation. Disorganisation symptoms predicted the duration of hospitalisation.ConclusionsA majority of patients with SMI changed residential and/or care settings several times in 6 years. Patients with substance use or severe negative and disorganisation symptoms may need more intensive and customised treatment. Further research is needed to investigate prevention programmes for highly-frequent movers.
Highlights
Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences
Patients were grouped into the categories ‘living independently’, ‘sheltered housing’ and ‘psychiatric hospital’ on the basis of their situation on 01–01–2006
This study reports on unique data about patterns of changes in residential and care settings in SMI patients
Summary
Changes in the residential and care settings of patients with severe mental illness (SMI) are a concern because of the large variety of possible negative consequences. The mental health-care system aims to allocate patients to the most appropriate house setting where they can stay for a long time. This seems straightforward, studies show that patients change address frequently [1,2,3]. Changing from one care setting to another usually involves changing residence too Allocating patients to another care setting is related to changing personal needs and abilities, but may be associated with efforts to cut psychiatric beds in mental health care, which is an important goal in the Western world. The Netherlands has de Mooij et al BMC Psychiatry (2016) 16:431 much more intramural capacity than other Western countries [14]
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