In Canada, only heart disease surpasses mental illnesses in hospitalization costs. Mental health care reform will decrease the number of psychiatric beds in demand, and increase the number of clients served in the community. The use of appropriate models of discharge planning, and community integration will be critical for success. There is, however, very little research about this topic.

This four-year, $930,000 study is testing a new approach to supporting people with chronic mental illness as they make the transition from the hospital to the community. It involves 380 discharged patients from Regional Mental Health Care London/St. Thomas (formally known as London/St. Thomas Psychiatric Hospital), the Centre for Mountain Health Care, St. Joseph's Health Care, Hamilton (formally known as Hamilton Psychiatric Hospital) and the Whitby Mental Health Centre.

The overall objective of this study is to assist individuals hospitalized with a chronic mental illness in successful community living. The specific objectives are to determine the cost and effectiveness of a transitional discharge model of care, and compare it to the standard model of discharge. The transitional model focuses on interpersonal relationships. This new model includes:

    (a) peer support, which is assistance from former clients of the mental health care system who promote friendship, provide understanding, teach community living skills, and encourage current clients in making a transition from psychiatric hospital to community, and

    (b) overlap of in-patient and community staff in which the in-patient staff continue to treat clients until the clients have a working relationship with a community care provider.

The Mental Health Rights Coalition of Hamilton and Can-Voice of London have been working with the project to develop a training program for peers. This will include a generic training manual. At present, sixteen consumer groups are partnered with the project to provide the peer support.

Outcome measures include quality of life and costs. It is hypothesized that, in the year following discharge from a psychiatric hospital, individuals participating in the transitional discharge model will:

    (a) have an improved quality of life; and

    (b) incur fewer health and social services costs compared to individuals receiving standard discharge care.