Deinstitutionalized patients, homelessness and imprisonment: A systematic review

Petr Winkler, Barbara Barrett, Paul Richard McCrone, L. Csémy, M. Janoušková, Cyril Höschl

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)
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Background: Reports linking psychiatric deinstitutionalization to homelessness and imprisonment have been published widely in scientific literature.
Aims: This review aimed to identify cohort studies which followed up or traced back long-term psychiatric patients who were discharged from psychiatric hospitals as a consequence of deinstitutionalization.
Methods: A broad search strategy was used and 9435 titles and abstracts were screened, 416 full articles reviewed and 171 articles from cohort studies of deinstitutionalized patients were examined in detail.
Results: 23 studies of unique populations assessed homelessness and/or imprisonment among discharged long-term patients. Results demonstrate that homelessness and/or imprisonment occurred sporadically; in the majority of studies there was no single case of homelessness and/or imprisonment reported.
Conclusions: The results of this review are contradictory to the findings of ecological studies which indicated a strong correlation between the decreasing number of psychiatric beds and increasing number of those with mental health problems living in either homelessness or prisons.
Declaration of interest: None
Original languageEnglish
Pages (from-to)421
Number of pages428
JournalBritish Journal of Psychiatry
Issue number421-428
Publication statusPublished - 3 May 2016


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