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Article 29.docx

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University of Guelph
PSYC 3690
Benjamin Gottlieb

1 Article 29: Metal Hospitals and Deinsitiutionalzatin (Lamb) Terms -Aftercare -after hospitalization, a continuing program of treatment and rehabilitation designed to reinforce the effects of therapy and to help patients adjust to their environment -Board-and-Care Home -a congregate living facility in the community for persons with mental illness -provide room, board, minimal staff supervision and in some states, dispensing of medication -Deinstitutionalization -the mass exodus of mentally ill persons from living in hospitals to living in the community -Gravely disabled -a condition in which a person, as a result of a mental disorder, is unable to provide his or her basic personal needs for food, clothing or shelter -Institutionalism -a syndrome characterized by lack of initiative, apathy, withdrawal, submissiveness to authority, and excessive dependence on the institution Background -In the 1960’s, it was found that people who spent long periods in mental hospitals developed what has come to be known as institutionalism -Sociologists argue that in “total institutions” (e.g. state mental hospitals) impersonal treatment can strip away patient’s dignity and individuality and foster regression -The deviant person is locked into a degraded, stigmatized, deviant role. -Others, observed that institutionalism is probably not entirely the outcome of living in dehumanizing institutions --it may be in large part be characteristic of the schizophrenic process itself -Mental health professionals, and society at large, are coming to recognize the crippling limitations of mental illnesses that in many cases do not yield to current treatment methods Functions of State Hospital -In the state hospitals treatment and services that did exist were under one administration. In the community, now services and treatment are under various administrative jurisdictions and in various locations -Patients can easily get lost in the community; in a hospital, they may have been neglected but at least their whereabouts were known -The fact that the chronically mentally ill have been deinstitutionalized does not mean they no longer need social support, protection and relief, either periodic or continuous, from external stimuli and the pressures of life -Need asylum and sanctuary in the community -Asylums took on an almost sinister connotation -If society does not take into account this need for asylum and sanctuary in the community from many of the stresses of life, living in the community may not be possible at all for many chronically and severely mentally ill persons Origins of Deinstitutionalization -In 1955, number of people in US statehopsitals reached its highest -Now there are far less (from a much larger population) 2 Hospital vs. Community -Unfortunately, deinstitutionalization efforts have often confused locus of care and quality of care and quality of care -Where mentally ill persons are treated has been deemed to be more important than how or how well they are treated -The long-term mentally ill are not a homogeneous population; what is appropriate for some is not appropriate for others -This less than satisfactory result has often been seen as series of failures on the part of both mentally ill persons and mental health professionals -One consequence has been an alienation of a number of long term mentally ill persons from a system that has not met their needs, and some mental health professionals have become disenchanted with their treatment as well New Generation of Chronically Mentally Ill -The problem that has proved most vexing was almost totally unforeseen by the advocates of deinstitutionalization --the treatment of the new generation of severely mentally ill persons that has emerged since deinstitutionalization -The large homeless population with major mental illness (schizophrenia, schizoaffective disorder, bipolar illness, and major depression with psychotic features) has tended to be young -When one is s
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