A political decision to decentralize psychiatric care in a county in Sweden was arrived at in October 1984. This will lead to the closure of the only large psychiatric hospital in the area, which will be replaced by three smaller units. The long-term care in the hospital will cease completely and be replaced by district-based psychiatric services. All patients in the hospital's long-term unit were studied over one year at an early stage of deinstitutionalization. The results showed that 12% of patients were discharged during that year, mostly to other institutions, only 2 patients to their homes. Twenty-five per cent died, and one-year mortality was 40% for patients with severely impaired ADL functioning. The demented patients deteriorated significantly in ADL functioning.
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