Can deinstitutionalisation work? Mental health reform from 1993 to1998 in Victoria, Australia

Gerrand, Valerie

doi:10.5172/hesr.14.3.255

Cited by 23 publications

(25 citation statements)

References 3 publications

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“…However, it was lower than rates reported in Victoria (Lawton-Smith, 2005; Burgess et al, 2006;Light et al, 2012) in spite of similar shifts from hospital-based care to community services in the late 1980s to early 90s (Gerrand, 2005;Lawrence, et al, 2001). Although it is important to take into account differences in how use is measured, varying rates might also suggest that different types of patient are being placed on CTOs, so limiting the generalisability of studies from one jurisdiction to another.…”

Section: Discussioncontrasting

confidence: 42%

Changes in determinants of compulsory community treatment over 11 years. A population-based analysis of linked mental health databases

Kisely

Xiao

Jian

2015

Psychiatry Research

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Changes in determinants of compulsory community treatment over 11 years. A populationbased analysis of linked mental health databases, Psychiatry Research, http://dx.doi.org/10.1016/j.psychres. 2015.09.027 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. were used to further examine potential predictors of a CTO. The incidence of CTOs, and the characteristics of patients placed on these orders, showed little change over 11 years. They tended to be younger and male with schizophrenia or other non-affective psychotic disorders.Previous health service use as an inpatient or outpatient also predicted compulsory community treatment. Psychiatrists in Western Australia appear to be applying community treatment orders to similar types of patient as elsewhere, but unlike other jurisdictions, use has not increased. We need further research to establish the relative contribution of patient characteristics, legislation and service setting toward the use and outcome of CTOs.

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Section: Discussioncontrasting

confidence: 42%

Changes in determinants of compulsory community treatment over 11 years. A population-based analysis of linked mental health databases

Kisely

Xiao

Jian

2015

Psychiatry Research

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“…In addition to the research on mentally ill crime victims, there has also been considerable public and professional debate about whether rates of crime and victimisation amongst people with severe mental illness have increased following deinstitutionalisation [1,19,20]. While increases in offending by people with mental illness over the period of deinstitutionalisation have been mirrored among the general population [21,22], much less is known about rates and types of victimisation over this period.…”

Section: Introductionmentioning

confidence: 99%

A case-linkage study of crime victimisation in schizophrenia-spectrum disorders over a period of deinstitutionalisation

et al. 2013

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BackgroundDespite high rates of self-reported crime victimisation, no study to date has compared official victimisation records of people with severe mental illness with a random community sample. Accordingly, this study sought to determine whether persons with schizophrenia-spectrum disorders have higher rates of recorded victimisation than the general population, and to explore whether there have been changes in rates of recorded victimisation over a period of deinstitutionalisation.MethodsThe schizophrenia-spectrum cases were drawn from a state-wide public mental health register, comprising all persons first diagnosed with a schizophrenic illness in five year cohorts between 1975 – 2005. The criminal histories of 4,168 persons diagnosed with schizophrenic-spectrum disorders were compared to those of a randomly selected community sample of 4,641 individuals.ResultsCompared to community controls, patients with schizophrenia-spectrum disorders were significantly more likely to have a record of violent (10.1% vs. 6.6%, odds ratio 1.4) and sexually violent victimisation (1.7% vs. 0.3%, odds ratio 2.77), but less likely to have an official record of victimisation overall (28.7% vs. 39.1%, odds ratio 0.5). Over the approximate period of deinstitutionalisation, the rate of recorded victimisation has more than doubled in schizophrenia-spectrum patients, but stayed relatively constant in the general community.ConclusionsPeople with schizophrenic-spectrum disorders are particularly vulnerable to violent crime victimisation; although co-morbid substance misuse and criminality both heighten the chances of victimisation, they cannot fully account for the increased rates. Deinstitutionalisation may have, in part, contributed to an unintended consequence of increasing rates of victimisation amongst the seriously mentally ill.

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“…In terms of the Mental Health Act 1986 (Vic), the closures reflected policy aimed at 'treating mental illness … in the least restrictive environment possible' (MHA 1986 (Vic)). The re-configuration of services was widely applauded for its pace and magnitude (see Gerrand 2005;Lammers 2002;Meadows and Singh 2003). In 2000, for example, the Australian Governments National Mental Health Report stated that 'the degree of structural change achieved by Victoria was greater than the efforts of all other jurisdictions combined' (Commonwealth Department of Health and Aged Care 2000, 36).…”

Section: Introductionmentioning

confidence: 98%

“…In Australia in the 1980s and 90s, the transition from large-scale, standalone psychiatric institutions to so-called 'community-based' services happened first and most rapidly in Victoria (Gerrand 2005). Much can be gleaned from this transitional period to illuminate ongoing concerns about juridical exclusion based on psychosocial disability.…”

Section: Introductionmentioning

confidence: 98%

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‘The government is the cause of the disease and we are stuck with the symptoms’: deinstitutionalisation, mental health advocacy and police shootings in 1990s Victoria

Gooding

2017

Continuum

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Can deinstitutionalisation work? Mental health reform from 1993 to1998 in Victoria, Australia

Cited by 23 publications

References 3 publications

Changes in determinants of compulsory community treatment over 11 years. A population-based analysis of linked mental health databases

Changes in determinants of compulsory community treatment over 11 years. A population-based analysis of linked mental health databases

A case-linkage study of crime victimisation in schizophrenia-spectrum disorders over a period of deinstitutionalisation

‘The government is the cause of the disease and we are stuck with the symptoms’: deinstitutionalisation, mental health advocacy and police shootings in 1990s Victoria

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