Abstract

The extent of crime, vagrancy, death, and readmission in a prospective cohort of long-term mentally ill patients was measured during their first year out of hospital. All 278 long-stay psychiatric patients discharged during the first three years (1985-1988) of the closure of Friern and Claybury Hospitals were included. One patient was imprisoned, one committed suicide, and one became vagrant; five others may also have become vagrant. The mortality rate was similar for the leavers and their matched controls, who remained in hospital. There was one suicide among the matches. Mental deterioration most often caused readmission. On recovery, most patients returned to their community home. Six per cent of the cohort were readmitted and have remained in hospital for a year or more. With careful planning and a financial 'dowry' for each patient, the closure of large mental hospitals does not lead to a marked increase in vagrancy, crime, and mortality for the long-term mentally ill. However, the patients who have yet to leave have more problems of social behaviour and are likely to be more difficult to resettle.

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