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The British Journal of Psychiatry 155: 739-753 (1989)
© 1989 The Royal College of Psychiatrists

Deinstitutionalisation--from hospital closure to service development

G Thornicroft and P Bebbington
MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London.

The necessary components of a comprehensive service of local non- institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co- ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages.


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