Quality of life and social functioning of former long-stay psychiatric patients transferred into the community: a 10 year follow up study

Abstract

Deinstitutionalisation in Ireland began following the impetus of the successful transfer of psychiatric patients into the community in other countries. This study sought to evaluate the quality of life (QoL) and social functioning (SF) of former long-stay institutionalised patients with severe and enduring mental illness who had been relocated into local community settings and followed up 10years later. One month prior to hospital closure, 87 former long-stay psychiatric patients, the majority of whom had a diagnosis of schizophrenia, were assessed on a range of QoL and SF measures. Patients were followed-up 10years later in the community, to evaluate baseline predictors of quality of life and social functioning. Study completers (n = 35) improved significantly on a range of QoL and SF measures over the 10year period. Specific improvements were noted in domestic skills (t = -2.8, p < 0.0008), community skills (t = -4.9, p < 0.001), as well as the activity and social relations measure (t = -4.1, p < 0.001). Increased social function (t = -6.3, p < 0.001) and improvement on the social behaviour scale (t = 7.6, p < 0.001) were noted at follow-up. Linear regression analysis found that less social behaviour problems at baseline predicted QoL 10 years later (t = -2.6, p < 0.02). This study demonstrated that transfer into the community from an institutional environment was associated with long-term improvements in quality of life and social functioning, even in those who spent many years in the institution. Those who demonstrated the greatest improvement in QoL had less social behavioural problems at baseline assessment, providing further evidence of the success of community living for former long-stay patients.