Towards local care: A statewide model for deinstitutionalization and psychosocial rehabilitation

Abstract This paper reviews the coordinated development of a statewide psychosocial rehabilitation system (called Towards Local Care or TLC) to support the deinstitutionalization of long-term psychiatric inpatients from South Carolina State Hospital. The process of developing stakeholder buy-in is detailed along with the essential clinical components of the effort. The development of community residential options that met the vaned supervision needs of the clients was critical to the development of effective programming. Of the 558 persons with mental illnesses who were served since the TLC program became operational in 1993, none have become homeless, only one has been incarcerated, and acute hospital utilization by this population has decreased 89% over pre-TLC rates. The gains that the individuals made in the hospital were maintained when they were transferred to the community. The individuals expressed a high degree of satisfaction with the services. The authors conclude that the TLC effort serves as a successful model for implementing psychosocial rehabilitation programming on a coordinated statewide basis.