What Have We Learned From Deinstitutionalisation In Australia?

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By May 11, 2015 No Comments

Authors: Liz Newton, Coletta Hobbs, Alan Rosen, Chris Tennant

Year: 2000

Event: 2000 TheMHS Conference

Subject: book of proceedings, FACTS [Factors Affecting Community Tenure Study] project for Northern Sydney Health.

Type of resource: Conference Presentations and Papers

Abstract: FACTS [Factors Affecting Community Tenure Study] project for Northern Sydney Health.
The FACTS project involved pre [6 months], and post [2 years] discharge follow up of 47 long stay residents as they moved from hospital to community. The project had three components:
• quantitative,
• qualitative,
• economic,

A post 6 year follow up is currently being undertaken and preliminary findings will be reported.

The two year study showed that for change/recovery to take place for people that have spent the major portion of their adult life in an institution, there needs to be planned and resourced commitment from Government [and this includes funding for long-term evaluation beyond the initial re-entry period].

Progress is slow for this group of people. There needs to be a range of supported accommodation and care with 24 hour staffing prior to semi-independent accommodation. Transition to the community requires intensive individual case management to assist in relearning life skills required to maintain successful community tenure and enhance quality of life. Once this is achieved, staff can be redeployed for the next stage of rehabilitation.

A range of accommodation options is desirable. Our project resettled residents initially into larger style group homes [10 in each] and a block of four, three bedroom flats. Learning skills en masse is not a normalising experience. Those who relocated to the flats developed skills much more readily within individualised spaces. Residents in the larger households subsequently took up opportunities to move to smaller households with less supervision. A range of respite / inpatient accommodation is also useful in the early days for residents who have an exacerbation of symptoms or require commencement on new medications [eg, clozapine].

Generally our findings showed that given the support, people who have been deinstitutionalised after 2-43 years can manage in the community with no clinical or functional deterioration, and move on in their lives.

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