Deinstitutionalised patients, homelessness and imprisonment: Systematic review

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)421-428
Number of pages8
JournalBritish Journal of Psychiatry
Issue number5
Early online date3 May 2016
Publication statusE-pub ahead of print - 3 May 2016


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