Grant: CIHR New Investigator

Individuals living with mental health problems have traditionally been segregated from the general population and placed in large psychiatric hospitals. The separation of psychiatric patients from family and the stigma that results from forcing mentally ill individuals to essentially live outside of the greater community has been seriously criticized. Partly as a result of these issues, throughout Canada and the world, psychiatric beds are being closed and large hospitals are shutting their doors. Increasingly, the delivery of psychiatric services is being transferred to community settings. Consistent with this approach, the British Columbia Ministry of Health has put into place a plan to close Riverview Hospital. Despite the staggering fiscal and humanitarian implications of implementing such dramatic changes in health policy, we have very little research to inform our understanding of the effects of moving psychiatric patients out of large hospitals and relocating them in the community. Given the dramatic gap between knowledge and practice, our team will intensively track the movement of a cohort of psychiatric patients for a 2-year period initially, and ultimately for 5 and 10 years, to determine pre-post transfer changes in patients': (1) mental health, physical health, and health related behaviours (e.g., substance misuse); (2) contacts with social agencies (e.g., homeless shelters, criminal justice system), and (3) quality of life and satisfaction with the setting and services. Our study will provide previously unavailable information to guide mental health policy in Canada and abroad. The results will also have important clinical relevance to the Canadian and international health communities.