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Reports linking the deinstitutionalisation of psychiatric care with
homelessness and imprisonment have been published widely.
To identify cohort studies that followed up or traced back long-term
psychiatric hospital residents who had been discharged as a consequence
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.
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.
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.
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