Deinstitutionalization and community psychiatry in Jamaica - abstract

ABSTRACT

The process of deinstitutionalization in the 120-year-old, 3,000-bed Bellevue State Mental Hospital, Jamaica is described. The resident population fell by 58 percent from 3,094 in 1960, to 1,296 in 1990, a rate of 54 per 100,000, which compares with the rate of 110 per 100,000 in the USA in 1981, and 160 per 100,000 in England and Wales in 1977. The implementation of mental health legislation, training of psychiatric personnel, establishment of a rehabilitation programme and establishment of a community psychiatric service in the 30-year period required to bring about this change, are described. By 1990, the community service had a case load of 14,149 patients per year - a rate of 590 per 100,000, and the admission rate to Bellevue Hospital had fallen by 64 percent to 24 per 100,000. A vigorous `pick-up' programme was instituted by the community psychiatric service to keep the mentally ill homeless off the street. The results from this third world country are discussed in relation to deinstitutionalization programmes in other parts of the world (AU)