Residential placement for the chronic psychiatric patient: A review and evaluation of the literature

Abstract

In recent years there has been a proliferation of community residences with differing programs which serve dissimilar populations of psychiatric patients. These placements and programs are described in this paper. A review of more than 60 studies reveals that it is less expensive to house chronic patients in such facilities than in hospitals. Moreover, these studies would indicate that patients generally prefer such arrangements. Little is known, however, about factors which contribute to the success or failure of these community residences. Environment, staffing, resident selection, programming, and length of stay are considered. Gross measures of outcome such as community tenure, employment, and hospital readmission do not provide an understanding of the process of returning patients to the community. It is necessary to examine more subtle dependent variables and the use of comparison groups is essential. The time for both sensitive and methodologically sound evaluations of residential placement for chronic psychiatric patients is now.