Social role behaviour of patients with long-term schizophrenia in the community during sharp decline in number of psychiatric beds

Abstract

Objective: Social role behaviour (SRB) was studied among patients with long-term schizophrenia living in the community when the number of psychiatric beds was decreasing.

Methods: A representative national sample of 2502 schizophrenia patients discharged from mental hospitals in 1986, 1990 and 1994 in Finland were interviewed three years after discharge. During the study period, the number of psychiatric beds decreased from 3.3 to 1.2 beds per 1000 people. Social role behaviour (SRB) was evaluated at follow-up and predicted with data at discharge.

Results: More than four-fifths of patients had considerable problems in at least one area of SRB. In the majority of SRB areas, men had more problems than women. Later discharge years associated with poor SRB at follow-up, although the effects of other (confounding) factors were taken into account. Being married and having good psychosocial functioning and ability to work, as well as having paranoid schizophrenia, associated with fewer problems in SRB at follow-up.

Conclusions: SRB of long-term schizophrenia patients in the community is extensively damaged. Decrease in psychiatric beds is associated with increase in SRB of long-term schizophrenia patients. Men have more SRB problems than women. The situation at discharge strongly predicts patient's SRB also in the community.

Keywords:

• Service delivery issues
• role behaviour
• community
• decline of beds
• gender differences