BackgroundWhereas the majority of long-stay in-patients have been successfully resettled in the community there is a group of such patients who are too disturbed or disturbing to be managed in standard community homes.AimsTo study the long-term outcome of a group of 72 long-stay psychiatric inpatients, regarded as unsuitable for community placement.MethodA prospective cohort study with follow-ups at 1 year and 5 years.ResultsThe patients' mental state remained unchanged after 1 year and 5 years. The level of functioning and social behaviour showed minimal change after 1 year, but then improved over the next 4 years. The profile of problematic behaviours changed significantly over 5 years, with a reduction of 50% in their frequency Physical aggression practically disappeared. The improvements in behaviour enabled 29 patients (40% of the study group) finally to be resettled in various care homes, gaining better access to community amenities and living more independently.ConclusionsA high proportion of patients with severe disabilities, designated as difficult to place’ in the community, could benefit from slow-stream rehabilitation within specialised facilities, enabling them to move into ordinary community homes.
Long-term outcome of patients with acquired chronic pure red cell aplasia (PRCA) following immunosuppressive therapy: a final report of the nationwide cohort study in 2004/2006 by the Japan PRCA collaborative study group
