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Subject: search.filters.subject.Deinstitutionalization

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    Community attitudes toward people with mental illness : the effects of time, location and demographic variables : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 2003) Wakefield, Amber
    Deinstitutionalisation in New Zealand followed the worldwide trend of transferring mentally ill patients from psychiatric institutions into community-based care. The closure of psychiatric hospitals in favour of community care relied on positive and accepting attitudes of community members. At the time of the closure of Lake Alice psychiatric hospital in 1995, the remaining 12 chronically mentally ill patients were transferred into a community mental health facility in Wanganui. The present study investigated whether community attitudes towards mental illness change over time and if attitudes are influenced by geographical proximity to community mental health facilities. The study also investigated the influence of demographic variables, and prior contact, awareness and agreement with the community mental health facility on attitudes. Attitudes among the Wanganui community were measured by survey using the Opinions about Mental Illness scale (OMI, Cohen & Struening, 1959) and the Comfort in Interaction Scale (CI, Beckwith & Mathews, 1994). There were two samples used in the present study, one taken in 1995 comprising of one hundred and fifty seven respondents, and one taken in 1996 comprising of one hundred and forty-one respondents. Time was found to be a partially significant influence on attitudes among the respondents. Geographical proximity was not found to be significant. The results were consistent with the hypothesis that time, awareness of the community mental health facility, occupation and prior contact with people who have a mental illness produced a significant effect on attitudes toward people with mental illness among community members. Overall, attitudes as measured by the OMI and CI were positive and accepting of people with a mental illness.
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    Two year follow-up of long-stay chronically mentally ill inpatients transferred to the community : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology, Massey University
    (Massey University, 1995) Huzziff, Robyn
    The present study was undertaken to evaluate the affect of transferring long-stay chronically mentally ill clients from Lake Alice Hospital to community placements. Thirty chronically mentally ill clients were followed over two years in the community. Follow-up assessments were completed at 12, 18, and 24 months to assess clients' community adjustment. Community adjustment was conceptualised to include measures of general adaptive functioning, maladaptive behaviour, inpatient readmission, client satisfaction, subjective well-being, and levels of distress. The results showed that clients' general adaptive functioning and deviant behaviour remained stable from the hospital baseline assessment into the community follow-up phases. With respect to client characteristics, clients who exhibited more maladaptive behaviour were found to be significantly more likely to be readmitted to a psychiatric unit or hospital, and older clients were more likely to be socially isolated and exhibit poorer levels of adaptive functioning. Many clients remained socially isolated from family and friends, suggesting that if community support were withdrawn neglect may occur. Clients were significantly more satisfied with community than hospital services at 12 months follow-up and clients were found to be globally satisfied with community services. Nevertheless, up to 10% of client's showed poor community adjustment, with frequent readmissions to a psychiatric hospital, poor adaptive functioning, and high levels of maladaptive behaviour and distress. The implications of the findings for chronically mentally ill clients and service providers are discussed, with several recommendations for future research.