Staff perception of their roles during the transition of psychiatric care into the community

The new neighbor: experiences of living next door to people suffering from long-term mental illness

The transition from hospital to community care for people with long-term mental illness is of growing concern. The aim of the present study was to illuminate if and how people with long-term mental illness have affected their neighbourhood after re-establishing themselves in apartments of their own. Nineteen neighbours of group homes for people with long-term mental illness, in seven different communities in eastern Norway, have been interviewed. The grounded theory procedures as well as the constant comparative method were employed to analyse the findings. From the data, one main category was identified: the need for information.

Leaving the asylum: a psychodynamic observation study of a move from a long stay psychiatric ward to the community

Regular observations were made of a group of residents and staff on a long stay psychiatric ward and in the early months following their move to the community. During the period before the move, staff and residents colluded to prevent residents' active involvement in the preparations. Immediately following the move, staff seemed unsure of their roles and value, and residents expressed continued uncertainty about their identity as psychiatric patients versus members of the community. The results were interpreted in terms of the threat that transition from hospital to community represents to the defensive social structures developed by each group to cope with the anxieties inherent in their position. For the residents, this threat is to their already ambiguous identities as neither "mad" nor "normal". For the staff, it means greater intimacy with the residents and raises expectations of improvement that may not be fulfilled.

A descriptive study of multidisciplinary mental health staff moving to the community: the demographic and educational issues

Mental health care philosophy has moved from the containment of patients within institutions to the integration of clients within the community. 'Caring for People' (a Department of Health report) and the subsequent legislation enshrined the philosophical shift in law. Previous policy reports had indicated that staff required training to move from hospital-based service to a community-based service, but did not propose content, and no systematic study of the needs of mental health staff has been carried out. Therefore, this study aimed to identify the skill and information needs of a group of multidisciplinary staff in preparation for the movement from hospital to community settings. The study design was a descriptive survey sampling of a total multidisciplinary population in Scotland. Data were collected using questionnaires and semistructured interviews with a small volunteer subsample of respondents. This paper presents the first set of study findings related to the demographic and educational issues. Differences between hospital and community staff and between health care assistants and qualified staff are demonstrated for demographic and educational factors. Proposals are made for managers, professionals, educators and researchers.