Residential care and regional psychiatric care: Migration of patients within community mental health services

Objectives: In Linz, capital of the province of Upper Austria, there is a considerable shortage of supported housing. Yet the rate of places available reaches 0.9/1000 inhabitants, thus already exceeding the recommended number. Methods: A comprehensive investigation was started concerning all persons living in supported housing facilities. Services for psychiatric patients (n 190) were included as well as services for homeless persons (n 159). Results: Only 41 % of the psychiatric patients and 31 % of the homeless people actually belonged into the region. Also among those who have been living less than one year in the facility, 45% of the psychiatric and 67% of the homeless persons come from outside, thus indicating, that the migration of patients is still going on. Among the homeless 69 % were mentally ill. While in the psychiatric services schizophrenic and affective psychoses were predominant, addictive disorders prevailed in the services for the homeless. Conclusions: It is the aim of mental health services in Upper Austria to care for the patients within their home regions. All regions are providing a fair amount of places for supported housing. Despite this a considerable number of patients keeps coming to the provincial capital. The causes and consequences of this process are discussed.