Title
Second-generation deinstitutionalization, II: The impact of Brewster v. Dukakis on correlates of community and hospital utilization
UMMS Affiliation
Department of Psychiatry
Publication Date
1990-08-01
Document Type
Article
Subjects
Adult; Age Factors; Aged; Chronic Disease; Community Mental Health Services; Deinstitutionalization; Female; Follow-Up Studies; Hospitals, Psychiatric; Hospitals, Public; Hospitals, State; Humans; Life Tables; Male; Massachusetts; Mental Disorders; Middle Aged; Patient Advocacy; Patient Readmission; Social Adjustment
Disciplines
Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology
Abstract
On the basis of the principle that patients have the right to be treated in the least restrictive setting appropriate to their needs, all 368 patients at Northampton State Hospital (Massachusetts) were discharged over a 10-year period. Three-quarters were discharged to community settings. Half of the patients were never rehospitalized, but many others continued to display patterns of recidivism. On the assumption that socially dysfunctional behavior would improve after discharge, the funded community system emphasized assessments, residential placements, and crisis intervention and deemphasized treatment. The findings raise many questions about the efficacy and wisdom of attempting to serve an entire state hospital population in the community.
Source
Am J Psychiatry. 1990 Aug;147(8):988-93.
Journal/Book/Conference Title
The American journal of psychiatry
Related Resources
PubMed ID
2375464
Repository Citation
Geller, Jeffrey L.; Fisher, William H.; Simon, Lorna J.; and Wirth-Cauchon, J. L., "Second-generation deinstitutionalization, II: The impact of Brewster v. Dukakis on correlates of community and hospital utilization" (1990). Implementation Science and Practice Advances Research Center Publications. 156.
https://escholarship.umassmed.edu/psych_cmhsr/156
