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Tijdschrift voor Psychiatrie 30 (1988) 6

New research

Chronic patients in mental health care: an epidemiological investigation of their needs for care

D. Wiersma, R. Giel, H.W. Hoek, A. de Jong, F. Nienhuis, M. Rüphan, A.J. Tholen

Some epidemiological findings on the chronically mentally ill in the mental health care in The Netherlands are reviewed. Dutch policy with respect to deinstitutionalization of chronic patients in general mental hospitals is currently focussed on substitution of 2000 beds by places in sheltered living accommodations in the community, although it is not quite clear for which patients this all is set up. Our research included three groups: (1) inpatients on intensive care units, (2) residents of sheltered accommodations within the premises of the hospital, and (3) residents of private sheltered accommodations in the community. The research team of psychiatrists and psychologists assessed to what extent each patient was adequately housed and cared for. The assessment procedure was based on work of Wykes, Sturt and Creer in their Camberwell High Contact Study. Needs happened to be adequately met in two thirds of our sample (n = 96). The remaining one third fell apart in two groups, one group whose needs were overmet (14%) and one group who was underserved (21%): particularly patients and residents being within the premises of the hospital were in need of more guidance and rehabilitation. This aspect of `more care' does not seem to be taken into account properly.