Supporting the transition to community-based mental health and social care
Practical guide to the deinstitutionalization of psychiatric hospitals
Overview
This practical guide supports psychiatric hospital leaders and decision-makers to advance deinstitutionalization (DI) for adults who have experienced long stays in psychiatric hospitals. It responds to the continuing dominance of institutional care, which can absorb substantial mental health resources while separating people from communities, limiting their autonomy and exposing them to risks of human rights violations.
DI requires system-wide reform: aligning policies, laws and funding; developing comprehensive community-based mental health services and housing supports; and reshaping care practices and cultures. The guide builds on WHO’s existing policy guidance to outline adaptable, evidence-informed actions across three phases – plan, prepare and provide – and three areas of hospital influence: reducing admissions and lengths of stay; transforming care within hospitals; and increasing supported discharge, continuity of care and community participation. Actions are organized by leadership, partnership and mandate responsibilities, recognizing that lasting change requires coordination across hospitals, authorities, people with lived experience, families, workers and community services.
