Some perspectives on deinstitutionalization
Some perspectives on deinstitutionalization
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DOI：
10.1176/appi.ps.52.8.1039
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发表时间：
2001-08-01
影响因子：
3.8
通讯作者：
Bachrach, LL
中科院分区：
文献类型：
--
作者：
Lamb, HR;Bachrach, LL
作者讨论了我们从去机构化的经验中可以学到什么。精神病患者的非机构化有三个组成部分：将这些人从医院释放到社区，使他们不再住院，以及发展替代性社区服务。最大的问题是创造足够和可获得的社区资源。在社区服务全面可用的地方，大多数严重精神病患者都受益匪浅。另一方面，非机构化产生了意想不到的后果-新一代非机构化的人患有严重的精神疾病，无家可归，或被定罪，对服务系统构成重大挑战。从非机构化中吸取的经验教训包括：成功的非机构化不仅仅涉及改变护理地点;服务规划必须适合每个人的需要;必须向需要的人提供医院护理;服务必须具有文化相关性;必须让严重精神病患者参与其服务规划;服务系统不应受到先入为主意识形态的限制;必须实现护理的连续性。
The authors discuss what can be learned from our experience with deinstitutionalization. The deinstitutionalization of mentally ill persons has three components: the release of these individuals from hospitals into the community, their diversion from hospital admission, and the development of alternative community services. The greatest problems have been in creating adequate and accessible community resources. Where community services have been available and comprehensive, most persons with severe mental illness have significantly benefited. On the other hand, there have been unintended consequences of deinstitutionalization-a new generation of uninstitutionalized persons who have severe mental illness, who are homeless, or who have been criminalized and who present significant challenges to service systems. Among the lessons learned from deinstitutionalization are that successful deinstitutionalization involves more than simply changing the locus of care; that service planning must be tailored to the needs of each individual; that hospital care must be available for those who need it; that services must be culturally relevant; that severely mentally ill persons must be involved in their service planning; that service systems must not be restricted by preconceived ideology; and that continuity of care must be achieved.