Residential Treatment Programs and Aftercare for the Chronically Institutionalized

Abstract

Residential treatment settings for the chronically mentally ill consist of such institutions as mental hospitals, mental health centers, and community extended-care facilities. Their defining feature is that clients reside in the facility 24 hours per day to receive treatment. Although, in current practice, admissions to residential treatment facilities are often based on other grounds, their reason-for-being is that the clients’ disturbance and functioning is too burdensome or too dangerous to allow treatment in a less restrictive setting (Paul, in press, a). Thus, the primary goal of residential treatment should be to provide effective programs for the most severely disabled of the mentally ill. Intramural residential programs should improve the clients’ functioning to a level allowing their return to less restrictive community settings. Integrated extramural or community programs should provide effective treatment for the less severely disabled persons who do not require residential treatment. These programs should also maintain and further improve functioning of those returned from residential treatment settings—at least to a level that does not require their readmission to residential treatment (HHS Steering Committee, 1980; Paul, 1978).