Minimizing adverse effects on patients of involuntary relocation from long-stay wards to community residences.

Abstract

This study examined the incidence of, and variables associated with, relocation trauma among 85 patients who moved from long-stay psychiatric wards to community care units as part of a hospital closure in Melbourne, Australia. Some participants moved directly from wards and some moved first to transitional units on the hospital grounds. Preparation for the transition, such as visits to the community care unit before the move, was documented, and severity of symptoms, aggressive behaviors, and preferences for living environments one month before and one month after the move were compared. Relocation trauma was measured one month after the move. After significant factors associated with trauma were determined, additional tests further discriminated these factors. Although 66 percent of participants were happy with community care units one month after the move, 18 percent preferred hospital living. Of 81 participants who had data on relocation trauma, 20, or 25 percent, met relocation trauma criteria. Preparation in a transitional unit reduced the likelihood of trauma, as did making six or more premove visits to the new facility and having a preparation period of more than 16 weeks. When preparation in a transitional unit, number of premove visits, and duration of preparation were considered together, only the number of premove visits and duration of preparation remained significantly associated with relocation trauma. Adverse effects of relocation on long-stay psychiatric patients may be minimized by the preparation of patients over a period of four months or more, with inclusion of six or more visits to the new facility. Moving via a transitional environment is not essential.