Following cuts in the number of beds in psychiatric hospitals and general deinstitutionalisation, and thanks to the catchment area policy, people with major psychiatric disorders are not confined inside hospitals anymore. They can live in the community. These severely handicapped patients, mostly psychotic, often have long-term support, which allows them to live with a degree of autonomy. As they grow old, they become more dependent and need appropriate housing that is no longer psychiatric. The staff in nursing homes are often reluctant to deal with these patients who are weighed down by their disease. Besides, there is rarely genuine continuity in terms of support and treatment from local carers.
Through a partnership established several years ago between public institutions dedicated to dependent persons and their local psychiatric teams, guidelines have been devised for a fruitful collaboration and to allow patients often viewed as complicated, to be looked after by gerontology teams who are more familiar with treating dementia.
Over the course of time, therapeutic strategies - such as planned sequential psychiatric hospitalization - have been set up in order to prevent the patient from relapsing, and nursing staff from becoming exhausted. A reflection will be given on the part played by psychiatric teams similar to liaison psychiatry, with long-term assistance and training for gerontology staff.