Individual and service factors affecting deinstitutionalization and community use of people with intellectual disabilities

Background: The aim was to evaluate the effect of the closure of a small intellectual disability hospital on the community use of those people involved. In addition, the study sought to identify those factors that might influence the community use of people with intellectual disabilities.

Methods: The impact of resettlement was investigated using a mixed design in which changes in the dependent variable (The Guernsey Community Participation and Leisure Assessment, GCPLA scores) were measured within-subjects (before and after leaving hospital) and between-subjects (using a comparison group of people who lived in the community throughout the study). In addition, a standard multiple regression design was employed to explore the relative contribution of client and service variables to GCPLA scores.

Results: Resettlement from hospital corresponded with significant increase in the range and frequency of leisure and community contacts, although community use remained low in comparison with the general population and in relation to other people with intellectual disabilities. Community and leisure use was found to be related to the place of residence, adaptive behaviour and the robustness of community goals within the service user's individual plan.