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Transition of Mental Health Services from Institutional to Community-Based Care Abroad and Its Context for Slovenia—Advantages and Risks

Author

Listed:
  • Katja Horvat Golob

    (University Psychiatric Clinic Ljubljana, Chengdujska 45, 1000 Ljubljana, Slovenia)

  • Alenka Temeljotov Salaj

    (Department of Civil and Environmental Engineering, Faculty of Engineering, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway)

  • Brigita Novak Šarotar

    (University Psychiatric Clinic Ljubljana, Chengdujska 45, 1000 Ljubljana, Slovenia
    Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia)

Abstract

Deinstitutionalization is a transition from psychiatric hospitals and other mental health institutions as the primary setting for treatment of individuals with chronic mental health disorders to a range of services, including psychiatric care, that support independent functioning of an individual within the community. The transition has been encouraged by guidelines from the European Expert Group and further specified in the Slovenian Resolution on the National Programme of Mental Health 2018–2028. This integrated systematic and narrative literature review includes 47 international articles from PubMed, along with information on Slovenian mental health legislation and its implementation, to provide insights into deinstitutionalization abroad and its relevance for Slovenia. Although the transition to community-based care is welcomed for promoting independence and respecting individuals’ wants, there are cases where institutional care remains necessary to ensure safety and treatment during the exacerbation of chronic mental health disorders. The quality of care and outcomes generally improve with community-based care. However, the closure of institutions can lead to many unintended consequences, such as the revolving door phenomenon and transinstitutionalization. Both the advantages of community-based care and the important roles of mental health hospitals and other institutions are emphasized.

Suggested Citation

  • Katja Horvat Golob & Alenka Temeljotov Salaj & Brigita Novak Šarotar, 2025. "Transition of Mental Health Services from Institutional to Community-Based Care Abroad and Its Context for Slovenia—Advantages and Risks," IJERPH, MDPI, vol. 22(7), pages 1-31, July.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1066-:d:1694102
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    References listed on IDEAS

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    1. Minna Sadeniemi & Nerea Almeda & Jose A. Salinas-Pérez & Mencía R. Gutiérrez-Colosía & Carlos García-Alonso & Taina Ala-Nikkola & Grigori Joffe & Sami Pirkola & Kristian Wahlbeck & Jordi Cid & Luis Sa, 2018. "A Comparison of Mental Health Care Systems in Northern and Southern Europe: A Service Mapping Study," IJERPH, MDPI, vol. 15(6), pages 1-15, May.
    2. Francisco Balbuena Rivera, 2024. "From asylums to deinstitutionalization and after: an analytic review," International Journal of Social Psychiatry, , vol. 70(8), pages 1392-1401, December.
    3. Mauro G Carta & Matthias C Angermeyer & Anita Holzinger, 2020. "Mental health care in Italy: Basaglia’s ashes in the wind of the crisis of the last decade," International Journal of Social Psychiatry, , vol. 66(4), pages 321-330, June.
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    5. Vandoni, Maria & D'Avanzo, Barbara & Barbato, Angelo, 2024. "The transition towards community-based mental health care in the European Union: Current realities and prospects," Health Policy, Elsevier, vol. 144(C).
    6. Kebogile Elizabeth Mokwena & Amukelane Ngoveni, 2020. "Challenges of Providing Home Care for a Family Member with Serious Chronic Mental Illness: A Qualitative Enquiry," IJERPH, MDPI, vol. 17(22), pages 1-11, November.
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