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Putting mental health deinstitutionalisation back on track: A scoping review of what empirically hinders and drives deinstitutionalisation of adults who experience mental illness

2025-11-26Journal article Open access
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datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorSá-Fernandes, Luís
dc.contributor.authorSacchetto, Beatrice
dc.contributor.authorPires, Johann
dc.contributor.authorOrnelas, José
dc.contributor.authorVargas-Moniz, Maria
dc.date.accessioned2025-12-11T16:34:11Z
dc.date.available2025-12-11T16:34:11Z
dc.date.issued2025-11-26
dc.description.abstractMental health deinstitutionalisation continues to be a global human rights priority. After over half a century, the discharge to the community often means the transition to smaller-scale institutions, segregation environments, and limited opportunities for community inclusion. This scoping review aims to identify what hinders and drives the deinstitutionalisation process of adults experiencing mental health challenges. Method: A scoping review was conducted following the Joanna Briggs Institute methodology and reported under the PRISMA extension for scoping reviews (PRISMA-ScR). A systematic search of four electronic databases, PubMed, APA PsycINFO, Web of Science, and Scopus, was undertaken between January and March 2024. Only empirical studies focusing on the deinstitutionalisation process of adults with mental health challenges, published in English, from 1991 to 2024 were eligible for inclusion. A template in Microsoft Excel was created for data extraction. Results were descriptively synthesised and organised into the system change framework’s four fundamental dimensions (norms, resources, regulations, and operations). A total of 57 studies were included. Most of those included studies, 53% were qualitative (  = 30), 60% were published from 2014 to 2024 ( = 34), 26% were from North Americas ( = 15), and 25% were from Europe ( = 14). Factors that hindered mental health deinstitutionalisation included the exclusiveness of the medical model, social discrimination, insufficient community services, transinstitutionalisation, lack of support for community inclusion, most funds allocated to institutionalisation, economic incentives for institutionalisation, institutional policies, inefficient governance, professional control, and limited advocacy. Drivers included a model for community inclusion, an inclusive society, resourcing community alternatives, independent housing, individualised context-oriented support, economic pressures, policy and legal reform, consumer participation in services, and consumer advocacy. The study findings constitute an important basis to inform the ongoing or future deinstitutionalisation processes of adults with mental illness diagnoses.en
dc.description.sponsorshipFundação para a Ciência e Tecnologia - FCT
dc.identifier.citationSá-Fernandes, L., Sacchetto, B., Pires, J., Ornelas, J. H., & Vargas-Moniz, M. J. (2025). Putting mental health deinstitutionalisation back on track: a scoping review of what empirically hinders and drives deinstitutionalisation of adults who experience mental illness. BMC Public Health, 25(1), 4152. https://doi.org/10.1186/s12889-025-24496-0
dc.identifier.doi10.1186/s12889-025-24496-0
dc.identifier.issn1471-2458
dc.identifier.urihttp://hdl.handle.net/10400.12/13702
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSpringer Science and Business Media LLC
dc.relationFCT/UID/05299.
dc.relation.ispartofBMC Public Health
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectVIPP-SD
dc.subjectParenting intervention
dc.subjectSocioemotional development
dc.titlePutting mental health deinstitutionalisation back on track: A scoping review of what empirically hinders and drives deinstitutionalisation of adults who experience mental illnesseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage27
oaire.citation.issue1
oaire.citation.startPage1
oaire.citation.titleBMC Public Health
oaire.citation.volume25
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameSacchetto
person.familyNameOrnelas
person.familyNameVargas-Moniz
person.givenNameBeatrice
person.givenNameJosé
person.givenNameMaria
person.identifier.ciencia-id3817-2CFF-DAAA
person.identifier.ciencia-idE01A-C48E-88FD
person.identifier.ciencia-id7D1A-ED64-7218
person.identifier.orcid0000-0001-7305-4614
person.identifier.orcid0000-0002-8972-7518
person.identifier.orcid0000-0002-4875-9118
person.identifier.ridC-1812-2018
person.identifier.scopus-author-id57189039683
person.identifier.scopus-author-id56009640900
relation.isAuthorOfPublicationb4c6bd27-7302-4c73-951e-2b5438b24b6f
relation.isAuthorOfPublication8ac69004-40e4-4835-8057-ef0cd90be446
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relation.isAuthorOfPublication.latestForDiscoveryff4cc1ca-a7be-4f3a-939d-51c3a45094fb

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