Outcome of long stay psychiatric patients resettled in the community: prospective cohort study

Objective To examine the outcome of a population of long stay psychiatric patients resettled in the community. Design Prospective study with 5 year follow up. Setting Over 140 residential settings in north London. Subjects 670 long stay patients from two London hospitals (Friern and Claybury) discharged to the community from 1985 to 1993. Main outcome measures Continuity and quality of residential care, readmission to hospital, mortality, crime, and vagrancy. Results Of the 523 patients who survived the 5 year follow up period, 469 (89.6%) were living in the community by the end of follow up, 310 (59.2%) in their original community placement A third (210) of all patients were readmitted at least once. Crime and homelessness presented few problems. Standardised mortality ratios for the group were comparable with those reported for similar populations. Conclusions When carefully planned and adequately resourced, community care for long star psychiatric patients is beneficial to most individuals and has minimal detrimental effects on society.