A hostel-ward for new long stay patients: Sixteen years' progress

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Abstract
The present study evaluates the progress and outcomes of the first hostel-ward established in this country, sixteen years after its original opening. In this period seventy percent of residents have been discharged, the majority into supported hostel accommodation in the community. Although characteristics of residents admitted to the hostel have remained unchanged over the sixteen year period, the duration of stay of residents before discharge has reduced by almost fifty percent. In terms of long-term outcomes, the second cohort admitted has proved to be more successful than the first. A number of variables were associated with better outcome following discharge. These were: planned discharges to supported hostel accommodation, a diagnosis other than schizophrenia and fewer behavioural problems and higher levels of functioning at discharge. Compared to community-based hostels, fewer patients have been transferred to alternative hospital settings. This hostel-ward has, therefore, been able successfully to manage a group of very disabled individuals who have been excluded from community facilities. It is concluded that the "hostel-ward" model of provision should continue to form an important aspect in the spectrum of services for the severely mentally ill.