King's College London

Research portal

Deinstitutionalised patients, homelessness and imprisonment: Systematic review

Research output: Contribution to journalArticle

Petr Winkler, Barbara Barrett, Paul McCrone, Ladislav Csémy, Miroslava Janoušková, Cyril Höschl

Original languageEnglish
Pages (from-to)421-428
Number of pages8
JournalBritish Journal of Psychiatry
Issue number5
Early online date3 May 2016
Accepted/In press12 Oct 2015
E-pub ahead of print3 May 2016

King's Authors


Background: Reports linking the deinstitutionalisation of psychiatric care with homelessness and imprisonment have been published widely. Aims: To identify cohort studies that followed up or traced back long-term psychiatric hospital residents who had been discharged as a consequence of deinstitutionalisation. Method: A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalised patients were examined in detail. Results: Twenty-three studies of unique populations assessed homelessness and imprisonment among patients discharged from long-term care. Homelessness and imprisonment occurred sporadically; in the majority of studies no single case of homelessness or imprisonment was reported. Conclusions: Our results contradict the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and an increasing number of people with mental health problems who were homeless or in prison.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454