The model presented is based on current literature and can be used to analyse the use of psychotropic drugs by chronic mental patients in intramural settings. This model contains information about the psychiatric setting, the psychiatric population, the type and variety of drugs used, polypharmacy, the dosage and means of administration (oral or depot).

The use of psychotropic drugs in the sheltered housing facilities of the St. Bavo, a mental hospital in Noordwijkerhout (The Netherlands), is described and compared to secundary data from other projects. Medication patterns observed in hospital wards in 1982 are compared to medication patterns in the sheltered housing facilitites in 1984. These data were obtained from a population of chronic mental patients who moved in 1982 from hospital wards to the housing facilities. In both instances the study points to a high use of psychotropics and extensive polypharmacy, in particular anti-psychotic drugs.

A longitudinal follow-up study is planned to determine the causes of the increase in drug use that was shown to occur. Two possible explanations come to the fore. The increased use of drugs could be attributed to changes within the population, newly admitted patients being more disturbed and somewhat younger. Another possible explanation is that a higher rate of drug use reflects the influence of psychosocial stressors in the sheltered housing environment. Apart from these hypotheses higher average dosage rates of neuroleptics might be ascribed to the more frequent administration of depot neuroleptics.