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Can deinstitutionalised care be provided for those at risk of violent offending?

Published online by Cambridge University Press:  11 October 2011

Claire Henderson ,
Jonathan Bindman  and
Graham Thornicroft
Claire Henderson
Affiliation:
Institute of Psychiatry, London, UK
Jonathan Bindman
Affiliation:
Institute of Psychiatry, London, UK
Graham Thornicroft
Affiliation:
Institute of Psychiatry, London, UK
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Summary

Objective - The aim of this article is to explain the current status of deinstitutionalisation and of community care development in the UK. Design — Literature review of articles and reports on deinstitutionalisation. Setting — Articles included in the review related either to the whole of the UK, to England and Wales, or to a specific area such as London. Main outcome measures — The review was carried out pertaining to the question of the extent to which community care can or should take over the functions of the asylum, with particular reference to those at risk of behaving violently. These functions include those that are manifest, or explicit, and those that are latent, or unintended but implicit (Bachrach, 1976). Results — The example of patients at risk of violent behaviour is one that highlights the continuing relevance of both these sets of functions, which are argued to be exerting a powerful influence on the processes of asylum closure and community care development. This influence is seen in delayed asylum closure, transinstitutionalisation (the shift of some patients from asylums to other institutions), and the institutionalisation of aspects of community care. Conclusions — Both the manifest and the latent functions of asylums must be acknowledged by those involved in planning community care; where it is felt desirable that community care does not take over certain functions, the consequences of this must be anticipated so that they can be prevented or dealt with in other ways.

Riassunto

Scopo — Lo scopo di questo lavoro e spiegare l'attuale situazione della deistituzionalizzazione e dello sviluppo della community care in Gran Bretagna. Disegno — Rassegna di articoli e rapporti sulla distituzionalizzazione. Setting — Articoli inclusi in rassegne che si riferiscono o all'intera Gran Bretagna, all'Inghilterra e al Galles o alia specifica area di Londra. Principali misure utilizzate — La rassegna e stata realizzata avendo come obiettivo il problema della misura in cui la community care pud o dovrebbe assumere le funzioni dell'ospedale psichiatrico, con particolare riferimento ai pazienti a rischio di comportamento violento. Queste funzioni comprendono sia quelle manifeste o esplicite, sia quelle latenti, o non esplicitate, ma implicite (Bachrach, 1976). Risultati — L'esempio di pazienti a rischio di comportamento violento mette in luce la continua rilevanza di entrambi questi gruppi di funzioni, che si suppone esercitino una forte influenza sui processi di chiusura degli ospedali psichiatrici e sullo sviluppo della community care. Questa influenza si manifesta nella ritardata chiusura degli ospedali psichiatrici, nella trans-istituzionalizzazione (il passaggio di alcuni pazienti dagli ospedali ad altre istituzioni) e l'istituzionalizzazione di aspetti della community care. Conclusioni — Sia le funzioni manifeste che quelle latenti degli ospedali psichiatrici devono essere riconosciute da coloro che sono coinvolti nella pianificazione della community care; qualora si ritenga desiderabile che la community care non assuma certe funzioni, e necessario prevederne le conseguenze, cosicche esse siano gestite in altro modo.

Keywords

deistituzionalizzazionetrans-istituzionalizzazionecommunity carefunzioni manifeste e latenticomportamento violentodeinstitutionalisationtransinstitutionalisationcommunity caremanifest and latent functionsviolent behaviour
Type
Articles
Information
Epidemiology and Psychiatric Sciences , Volume 7 , Issue 1 , April 1998 , pp. 42 - 51
Copyright
Copyright © Cambridge University Press 1998

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