Potential for Community Relocation among Residents of Albertas Psychiatric Facilities: A Needs Assessment

Objective: To identify the proportion of residents in Alberta’s psychiatric hospitals who would be relocatable to community-based alternatives to care if appropriate programs were made available. Methods: A survey of a representative sample of residents in all psychiatric hospitals and care centres was undertaken, excluding patients in specialized programs for forensic psychiatry, brain injury, and substance abuse. Results: Findings indicate that 11 % of institutionalized patients could be considered good candidates for relocation to community-based alternative care. A further 35 % were considered to have potential for relocation provided an intensive and complex array of services was first made available. Conclusion: Results support a phased-in approach to hospital downsizing and the need for considerable transitional funding. Because hospital downsizing is unlikely to save dollars, at least in the short term, reforms must remain guided by humanitarian motivations to improve quality of life for persons with severe and persistent mental illnesses. (Can J Psychiatry 1997;42:750–757) Key Words: deinstitutionalization, community care, downsizing, needs assessment In Alberta, interest in conducting psychiatric needs assess-ments has been fostered by an increasing emphasis on evidence-based policy and planning and by a second genera-tion of reform aimed at significantly downsizing remaining psychiatric hospitals. This paper provides a case description of a project commissioned by Alberta’s Provincial Mental Health Board (the Board) to provide planning data. The main aim of the study was to estimate the proportion of the prov-ince’s institutional psychiatric population that could be relo-cated to community-based alternatives if these were made available. Community-based care was understood to span from outpatient ambulatory care to highly structured group treatment environments, but it did not include facility-based care such as nursing homes or auxiliary hospitals. Study findings were intended to inform the Board’s policies related to hospital downsizing by giving some empirical basis for estimating the magnitude of patient populations and associ-ated resources that could be shifted to a community-based system of care