Project Overview

A multi-disciplinary team of researchers from Indiana University, Indiana University-Purdue University at Indianapolis (IUPUI), and Ball State University--with representatives from Central State Hospital, the Division of Mental Health, and consumer groups--is conducting a multifaceted project focused on assessing the impact of closing Central State Hospital.  The program has two main components:  1) a tracking service for the Division of Mental Health, and 2) an in-depth research study of the impact of the closing on the patients, their families, and the employees.  

Tracking Service.  The research and advisory teams have developed and implemented procedures for tracking the location and service status of clients discharged from the hospital for the Division of Mental Health.  This service focuses on all patients discharged from the hospital since March 23, 1992.  Data are collected regularly from the six mental health centers in the Central State Hospital district and supplemented with information from the client and other community sources as required.  The Tracking Service also gathers information on a regular basis about discharged patients such as current health problems, medication use, legal contacts, and days spent in inpatient facilities.  The research team has also expanded the database, maintained by DMH personnel, to monitor in greater detail the costs, special needs, and problems that arise as clients are moved into the community.  

Research Study.  In addition to the tracking service, the research team is also continuing to study the impact of closing Central State Hospital through a series of in-depth interviews with the clients, their families, the workers, and the community.  The baseline data were gathered from several sources. 

Chart Reviews.  A detailed chart review was conducted in order to collect basic demographic and clinical information on all clients in the hospital in March, 1993.

Interviews with the Clients.  Each client living at the hospital was invited to participate in a series of confidential, face-to-face interviews prior to being discharge.  In these interview, clients were asked about a number of areas, including:  opinions and reactions to the decision to close the hospital, overall quality of life, satisfaction and use of hospital and social services, the number and types of personal relationships to others in the hospital and in the community, and various risk behavior.  Annual follow-up interviews are underway with the patients who completed baseline interviews to provide regular information on how they are doing as they make the adjustment to community-based care.

Interviews with Family or Community Members.  With the client's permission, similar, confidential, face-to-face interviews are also conducted with one or more of the client's community caregivers after the client's first follow-up interview.  Interviewers are collecting information on family's reactions and expectations regarding the closing of CSH, the feelings and responsibilities they experience because of the focal client's illness, and their perceptions of the client's overall quality of life.  Annual follow-up interviewers are also planned to assess how their attitudes and experiences change over the next few years.   

Interviews with Hospital Workers.  In the final few months prior to CSH closing, in-depth interviews were also conducted with a number of hospital employees to better understand the practical dimensions of the closure process, how the organizational and work environment had changed during the final year, and how they felt about the decision to close the hospital.  Interviewers also were asked a number of questions regarding the personal impact the closing of the hospital was having on their health and mental health and the social support resources they had available to cope with the stress.  Finally, these employees were asked about their plans for the future.  Annual follow-up interviews are also underway to study what happens to this affected group as well.

The outcome of this comprehensive and multifaceted study will contribute to the national and state debates on the impact of deinstitutionalization of people with severe and persistent mental illness.

Consistent with the professional and ethical regulations governing academic research, the information collected as part of the research study will be held in strict confidence and known exclusively to the principal investigators and project staff.  No reference will ever be made regarding the identity of any respondent, verbally or in writing.  The results of this study will be presented to the community, government personnel, and other interested parties solely in ways which guarantee the anonymity of all study participants.