IMPROVING THE QUALITY-OF-LIFE OF PEOPLE WITH SEVERE MENTAL-DISORDERS

In the last forty years, there has been a movement (deinstitutionalization) to displace the locus of care of people with severe and persistent mental illness from the psychiatric hospitals to more community-based networks of services. In connection with this movement, the concept of quality of life (objective and subjective) has profoundly altered the perception of the type of cam that should be offered to this clientele, as well as the objectives of that care. This paper will first consider the context in which the concept of quality of life first appeared in the mental health field. The work accomplished in this area of interest over the past fifteen years will then be reviewed. Based on descriptive and comparative studies, it will be possible to identify the factors that contribute to the subjective assessment of quality of life-as-a-whole and compare quality of life in clinical and general populations and in different life settings. The paper reports what can be learned from evaluative studies about the contribution of services to quality of life, and concludes with a discussion of ways to improve the quality of life of people with severe mental disorders.