Article

An analysis of treatment services provided in group homes for adults labeled mentally ill

School of Social Work, Wayne State University, Detroit, Michigan 48202.
Journal of Nervous & Mental Disease (Impact Factor: 1.81). 10/1992; 180(9):551-9. DOI: 10.1097/00005053-199209000-00002
Source: PubMed

ABSTRACT Although group homes for adults labeled mentally ill have been the focus of significant attention in deinstitutionalization discussions, substantive research on their operation has been lacking. The present study addresses past limitations by focusing on a well-defined sample of small group homes, with higher staffing levels and in-home treatment provided. Thirty homes were randomly selected; all home residents (N = 253) were studied. Data were collected from case managers, residents, and home staff to assess residents' functioning, services and treatments provided, and the environment of the home. The findings were examined in terms of adequacy and appropriateness of care provided in the home, using accepted guidelines. The results indicated that there are aspects of a homelike environment, emotional support from staff, and skill-development activities within the home. However, an institutional focus still seems prevalent, along with limited rehabilitation and socialization activities. Residents expressed high levels of satisfaction, which may reflect their dislike of the group home alternative, e.g., the state hospital. Policy implications are discussed vis-a-vis current efforts to move away from group homes toward supported housing initiatives.

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    • "However, the rate of violent behaviours reported during the stay in the current residence was low, and limited to a very small group of patients. This result is consistent with figures obtained in other studies (Mowbray et al. 1992 ; Flannery et al. 2000 ; Trieman & Leff, 2002). Many patients with antisocial behaviour are, therefore, likely to settle down in appropriate environments, but a small minority persist with aggression and violence, warranting specific programmes for their treatment. "
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    ABSTRACT: In Italy, Residential Facilities (RFs) have completely replaced Mental Hospitals (MHs) for the residential care of mentally ill patients. We studied all patients resident in 265 randomly sampled Italian RFs (20% of the total). Structured interviews focusing on each patient were conducted by trained research assistants with the manager and staff of each RF. Patients were rated with the HoNOS and the GAF, and comprehensive information about their sociodemographic and clinical status and care history were gathered. Of the 2962 patients living in the sampled facilities, most were males (63.2%) who had never married, more than 70% were over 40 years; 85% on a pension, most commonly because of psychiatric disability. A substantial proportion (39.8%) had never worked and very few were currently employed (2.5%); 45% of the sample was totally inactive, not even assisting with domestic activities in the facility. Two-thirds had a diagnosis of schizophrenia; co-morbid or primary substance abuse were uncommon. Twenty-one per cent had a history of severe interpersonal violence, but violent episodes in the RFs were infrequent. The managers judged almost three-quarters appropriately placed in their facilities and considered that very few had short-term prospects of discharge. Italian RFs cater for a large patient population of severely mentally ill requiring residential care. Discharge to independent accommodation is uncommon. Future studies should attempt to clarify how to match residential programmes with patients' disabilities.
    Psychological Medicine 04/2005; 35(3):421-31. DOI:10.1017/S0033291704003502 · 5.43 Impact Factor
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    • "However, the rate of violent behaviours reported during the stay in the current residence was low, and limited to a very small group of patients. This result is consistent with figures obtained in other studies (Mowbray et al. 1992 ; Flannery et al. 2000 ; Trieman & Leff, 2002). Many patients with antisocial behaviour are, therefore, likely to settle down in appropriate environments, but a small minority persist with aggression and violence, warranting specific programmes for their treatment. "
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    ABSTRACT: An open access copy of this article is available and complies with the copyright holder/publisher conditions. Background. In Italy, Residential Facilities (RFs) have completely replaced Mental Hospitals (MHs) for the residential care of mentally ill patients. We studied all patients resident in 265 randomly sampled Italian RFs (20 % of the total). Method. Structured interviews focusing on each patient were conducted by trained research assistants with the manager and staff of each RF. Patients were rated with the HoNOS and the GAF, and comprehensive information about their sociodemographic and clinical status and care history were gathered. Results. Of the 2962 patients living in the sampled facilities, most were males (63.2%) who had never married, more than 70 % were over 40 years; 85 % on a pension, most commonly because of psychiatric disability. A substantial proportion (39.8%) had never worked and very few were currently employed (2.5 %); 45 % of the sample was totally inactive, not even assisting with domestic activities in the facility. Two-thirds had a diagnosis of schizophrenia; co-morbid or primary substance abuse were uncommon. Twenty-one per cent had a history of severe interpersonal violence, but violent episodes in the RFs were infrequent. The managers judged almost three-quarters appropriately placed in their facilities and considered that very few had short-term prospects of discharge. Conclusions. Italian RFs cater for a large patient population of severely mentally ill requiring residential care. Discharge to independent accommodation is uncommon. Future studies should attempt to clarify how to match residential programmes with patients' disabilities.
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