Community Mental Health Journal

, Volume 40, Issue 3, pp 223–234 | Cite as

The Impact of Day Hospital Closure on Social Networks, Clinical Status, and Service Use: A Naturalistic Experiment

  • Kim Goddard
  • Tom Burns
  • Jocelyn Catty
Article

Abstract

Objective: Little research is conducted on service closures. We examined the social, clinical and service use impact of the closure of a partial hospitalisation service (day hospital) on its users. Methods: Patients attending the closing day hospital were studied at closure and one year after, and compared to patients at an unchanged day hospital. Results: The closure did not increase use of inpatient beds, primary care or emergency room. Overall clinical improvements were similar for both groups as were costs. Social networks of the discharged patients decreased. Conclusions: Closures of services need to be as carefully evaluated as new developments.

partial hospitalization mental illness service closure 

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References

  1. Asberg, M., Montgomery, S. A., Perris, C., Schalling, D., & Sedvall, G. (1978). A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica, Supplementum, 5-27.Google Scholar
  2. Beck, A., Croudace, T., Singh, S.P., & Harrison, G. (1997). Nottingham acute bed use study 1: alternatives to admission. British Journal of Psychiatry 170, 247-252.PubMedGoogle Scholar
  3. Beecham, J., & Knapp, M. (1992). Costing psychiatric interventions. In G. Thornicroft, C. R. Brewin, & J. Wing (Eds.) Measuring Mental Health Needs (pp. 163-191). London: Gaskell.Google Scholar
  4. Catty, J., Burns, T., Knapp, M., Watt, H., Wright, C., Henderson, J., & Healey, A. (2002). Home treatment for mental health problems: A systematic review. Psychological Medicine, 32, 383-401.PubMedGoogle Scholar
  5. Coid, J. (1994). Failure in community care: psychiatry's dilemma. BMJ, 308, 805-806.Google Scholar
  6. Cooper, J. E. (1979). Crisis admission units and emergency psychiatric services. In Public Health in Europe, No. 2. Copenhagen.Google Scholar
  7. Cutler, D. L., Tatum, E., & Shore, J. H. (1987). A Comparison of Schizophrenic Patients in Different Community Support Treatment Approaches. Community Mental Health Journal, 23, 103-113.PubMedGoogle Scholar
  8. Drake, R. E., Becker, D. R., Biesanz, J. C., Torrey, W. C., McHugo, G. J., & Wyzik, P. F. (1994). Rehabilitative Day Treatment vs. Supported Employment: I. Vocational Outcomes. Community Mental Health Journal, 30, 519-531.PubMedGoogle Scholar
  9. Dunn, M., O'Driscoll, C., Dayson, D., Wills, W., & Leff, J. (1985). The TAPS Project. 4: An observational study of the social life of long-stay patients. British Journal of Psychiatry, 157, 842-848.Google Scholar
  10. Goddard, K. (1999) Impact of Day Hospital Closure on Social Networks, Clinical Status and Service Use: A Controlled Trial. Report to South West London and St. George's Mental Health NHS Trust.Google Scholar
  11. Knapp, M. (1993). The costing process: background theory. In A. Netten & J. Beecham (Eds.) Costing Community Care. Theory and Practice. Aldershot: Ashgate.Google Scholar
  12. Knapp, M., & Beecham, J. (1993). Reduced list costings: examination of an informed short cut in mental health research. Health Economics, 2, 313-322.PubMedGoogle Scholar
  13. Mbaya, P., Creed, F., & Tomenson, B. (1998). The different uses of day hospitals. Acta Psychiatrica Scandinavica, 98, 283-287.PubMedGoogle Scholar
  14. Netten, A., & Dennett, J. (1997). Unit Costs of Health and Social Care. Canterbury: University of Kent: Personal Social Services Research Unit.Google Scholar
  15. Phelan, M., Slade, M., Thornicroft, G., Dunn, G., Holloway, F., Wykes, T., Strathdee, G., Loftus, L., McCrone, P., & Hayward, P. (1995). The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry, 167, 589-595.PubMedGoogle Scholar
  16. STATA Corp (1999) Statistical Software 6.0. College Station TX: STATA Corp.Google Scholar
  17. Torrey, W. C., Clark, R. E., Becker, D. R., Wyzik, P K., & Drake, R. E. (1997). Switching from rehabilitative day treatment to supported employment. In Kennedy, L. L. (Ed.) Continuum, Developments in Ambulatory Mental Health Care (pp. 27-38). San Francisco: Jossey-Bass.Google Scholar
  18. Wright, C., Catty, J., Burns, T., & Watt, H. (submitted to Acta Psychiatrica Scandinavica). Beyond Research Studies: the Sustainability of Experimental Services in Home Treatment Studies and their Classification.Google Scholar

Copyright information

© Human Sciences Press, Inc. 2004

Authors and Affiliations

  • Kim Goddard
    • 1
  • Tom Burns
    • 2
  • Jocelyn Catty
    • 3
  1. 1.South West London and St. George's Mental Health NHS TrustLondon
  2. 2.Department of PsychiatrySt. George's Hospital Medical SchoolLondon
  3. 3.St. George's Hospital Medical SchoolLondon

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