Quantitative Utilization of Psychiatric Care Over 5 Years by Schizophrenic Patients Discharged from a Major Psychiatric Hospital

Abstract

The quantitative utilization of various types of psychiatric care by a group of 56 schizophrenic patients was assessed for 1989-1993. This was a period of transformation of psychiatric services in Sweden, with institutionalization in large hospitals giving way to alternative types of care in the community. The group studied consisted of all schizophrenic patients from the southern part of the county council district who in 1989 or later were inpatients on short-term wards of a major psychiatric hospital which was closed down at the turn of 1991/1992. The patients' utilization of psychiatric care in the part of the county council district where they were domiciled was assessed retrospectively by means of various registers and records. With regard to inpatient psychiatric care, the number of utilizers and care occasions diminished markedly in the patient group over the study period. It is evident that the utilization of hospital psychiatric care diminished concurrently with the development of alternative types of residential psychiatric care, such as treatment homes and halfway houses. Most of the patients were discharged to ordinary housing or halfway houses when they left the large psychiatric hospital. Almost without exception, the patients maintained contact with outpatient clinics and therapeutic teams. These contacts, particularly the visits to nurses and mental health nurses, increased significantly during the study period. It seems that these contacts are very important to help the patients to stay out of the hospital.