VI. Comparison of the 1975-85 cohort with the 1970-75 cohort

As part of a study of the contribution of institution-alisation to the disabilities of schizophrenia (Johnstone et al, 1985), all patients fulfilling the St Louis criteria (Feighner et al, 1972) for schizophrenia and discharged from Shenley Hospital between 1 January 1970 and 1 January 1975 were followed up five to nine years later (Johnstone et al, 1981, 1984). Until Northwick Park Psychiatric Unit opened in 1975, psychiatric facilities for Harrow patients were all in Shenley Hospital. In the follow-up study the patients were examined in detail and an account of their social circumstances and functioning was obtained. It was considered that the study provided an opportunity to examine the success of community care in a group of schizophrenic patients who left hospital before very active policies of discharge for such patients had been developed. The results had both positive and negative aspects. For example, 18% of the patients examined had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily, but more than 50% had definite psychotic features. No patients and few relatives sought a return to in-patient care, but severe emotional, social and financial difficulties were commonplace. Moreover, 27% of the sample had no contact with the medical or social services.