People with learning disabilities and complex mental health problems are often most at risk of being placed in services a long way from their homes, their families and any natural support systems they may have built up.

This study interviewed 17 service users directly affected in this way: they had all been placed away from their local areas in distant in-patient psychiatric units.

The interviews covered such areas as safety and security, food, facilities, day time activities, education, opportunities for socialisation, clinical, cultural and religious needs, carer involvement and access to information. In addition to covering those issues, each of the individuals was asked directly about where they would prefer to live if they left the hospital.

The authors did find some positive stories, but these were very much in the minority.

They found people describing limited opportunities for involvement in any therapeutic or educational experiences, little chance for building any real supportive relationships with staff or indeed with other residents (given that many moved at very short notice0 or for developing their religious and cultural identities.

The authors conclude on top of the problems that are well known and associated with large institutional living, additional strains were placed on relationships with family members because of the long distance from home.

They recommend that commissioners should seriously consider the impact of these additional strains when considering placing service users with complex mental health needs in services out of area.

Psychiatric in-Patients Away From Home: Accounts by People With Intellectual Disabilities in Specialist Hospitals Outside Their Home Localities, Chinn, D. et al, in Journal of Applied Research in Intellectual Disabilities, 24: 50–60.