Attitudes of longstay psychiatric patients with regard to discharge
In an are with dehospitalization as a central theme of `de jure' health policy little is known about patients' attitudes with regard to their actual living condition, discharge and alternative care. In this respect three key questions were tackled in a Dutch study:
- How many longstay patients (2 years) of mental hospitals are positively or negatively inclined towards discharge?
_ Do patients' attitudes differ according to length of inpatient stay?
_ Are residents of sheltered homes (former longstay patients) more positive about their actual place of residence compared with the attitudes of hospitalized longstay patients (eligibles for sheltered homes)?
For answering these questions data of a random sample of 276 longstay patients in five mental hospitals and 179 former longstay patients in sheltered homes were analyzed. In this study the VOL III was used, _ a prestructured Dutch interview schedule consisting of 25 items. The schedule was checked on test-retest interrater reliability and internal consistency in a pilot study (Haveman 1987).
It was found that 38 percent of the hospitalized patients had positive attitudes towards discharge. Just a many patients (36%) had ambivalent feelings, whereas 26 percent of the patients were unfavourably disposed towards discharge. Especially the hospital-residents with an inpatient stay of ten years or longer were strongly attached to their present place and style of living and did not show any inclination towards discharge. This result was consistent for different groups of patients according to sex, age, marital state, psychiatric diagnosis, physical handicaps, skills and level of social integration. Significant differences were found between former longstay patients in sheltered homes and longstay hospital patients (who are eligible for sheltered homes) in like or dislike of their residence. The residents of sheltered homes were much more in favour of their place of living, than patients still living in mental hospitals.