Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T07:49:58.722Z Has data issue: false hasContentIssue false
  • English
  • Français

Institutionalisation and the Long-Term Course of Schizophrenia

Published online by Cambridge University Press:  02 January 2018

David Abrahamson
David Abrahamson*
Affiliation:
Goodmayes Hospital, Barley Lane, Ilford, Essex IG3 8XJ
Get access Rights & Permissions [Opens in a new window]

Extract

It is ironic, in a field with many other ironies, that a number of studies (Johnstone et al, 1981; Mathai & Gopinath, 1985; Curson et al, 1992) have questioned what Mathai & Gopinath call “the hitherto inviolate (and ingenious) concept of institutionalisation”, at a time when massive deinstitutionalisation is casting into relief some of the practices to which it refers (Team for the Assessment of Psychiatric Services, 1990; Murphy, 1991; Abrahamson, 1993). However, the gap that this creates between theory and practice may be risky for the future. It would certainly be a major failure if the institutional era with which psychiatry's early professional identity was so intimately bound up were to end in unresolved contradictions. With this background, it will be argued here that re-examination of institutionalisation in the context of the longitudinal course of schizophrenic disorders both confirms the validity of the concept and sets a demanding agenda for alternative care in the community.

Type
Point of View
Information
The British Journal of Psychiatry , Volume 162 , Issue 4 , April 1993 , pp. 533 - 538
Copyright
Copyright © Royal College of Psychiatrists, 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abrahamson, D. (1991) The social networks of long–stay patients. British Journal of Psychiatry, 158, 718–719.Google Scholar
Abrahamson, D. (1993) Housing and de–institutionalisation: theory and practice in the development of a resettlement service. In Dimensions of Community Care (eds Muijen, M. & Weller, M.). London: Baillière Tindall. Google Scholar
Abrahamson, D. & Brenner, D. (1978) A Study of Old Long–Stay' Patients in Goodmayes Hospital. Final report of work carried out during tenure of a DHSS grant 1976–78. London: DHSS.Google Scholar
Abrahamson, D. & Brenner, D. (1983) Do long–stay psychiatric patients want to leave hospital? Health Trends, 14, 95–97.Google Scholar
Abrahamson, D., Swatton, J. & Wills, W. (1989) Do long–stay psychiatric patients want to leave hospital? Health Trends, 21, 17–19.Google Scholar
Abrahamson, D., & Fellow–Smith, E. (1991) A combined group and individual long–term out-patient clinic. Psychiatric Bulletin, 15, 486–487.Google Scholar
Barton, R. (1959) Institutional Neurosis. Bristol: John Wright.Google Scholar
Barton, R. (1965) A proposed scale for rating psychiatric hospitals. In Psychiatric Hospital Care (ed. Freeman, H.), pp. 23–35. London: Baillière, Tindall & Cassell. Google Scholar
Bleuler, M. (1978) The Schizophrenic Disorders: Long–Term Patient and Family Studies. New Haven: Yale University Press.Google Scholar
Bickford, J. A. R. (1955) The forgotten patient. Lancet, ii, 917–919.Google Scholar
Cameron, J. L., Laing, R. D. & McGhie, A. (1955) Patient and nurse: Effects of environmental changes in the care of chronic schizophrenics. Lancet, ii, 1384–1386.Google Scholar
Carpenter, W. T. & Kirpatrick, B. (1988) The heterogeneity of the long–term course of schizophrenia. Schizophrenia Bulletin, 14, 645–652.Google Scholar
Carson, J., Shaw, L. & Wills, W. (1989) Which patients first: a study from the closure of a large psychiatric hospital. Health Trends, 21, 117–121.Google Scholar
Carson, J., Glynn, T. & Gopaulen, J. (1993) The role of normalisation for the mentally ill. In Dimensions of Community Care (eds Muijen, M. & Weller, M.). London: Baillière Tindall. Google Scholar
Ciompi, L. (1980) The natural history of schizophrenia in the long term. British Journal of Psychiatry, 136, 413–420.CrossRefGoogle ScholarPubMed
Curson, D. A., Pantelis, P., Ward, J., et al (1992) Institutionalism and schizophrenia 30 years on. Clinical poverty and the social environment in three British mental hospitals in 1960 compared with a fourth in 1990. British Journal of Psychiatry, 160, 230–241.Google Scholar
Cutting, J., Bleuler, M., Ciompi, L., et al (1983) Schizophrenic deterioration. British Journal of Psychiatry, 142, 78–84.Google Scholar
Goldie, N. (1988) “I hated it there but I miss the people”: a Study of What Happened to a Group of ex–Long-stay Patients from Claybury Hospital. Research paper 1, Health & Social Services Research Unit, Department of Social Services, South Bank Polytechnic London.Google Scholar
Hall, P. (1991) The history of Powick Hospital. In The Closure of Mental Hospitals (eds Hall, P. & Brockington, I. F.), pp. 43–50. London: Gaskell.Google Scholar
Huber, G., Gross, G. & Schuttler, R. (1975) A long–term follow-up study of schizophrenia: psychiatric course of illness and prognosis. Acta Psychiatrica Scandinavica, 2, 49–57.Google Scholar
Johnstone, E. C., Crow, T. J., Frith, C. D., et al (1978) The dementia of dementia praecox. Acta Psychiatrica Scandinavica, 57, 305–324.Google Scholar
Johnstone, E. C., Owens, D. G. C., Gold, A., et al (1981) Institutionalisation and the defects of schizophrenia. British Journal of Psychiatry, 139, 195–203.Google Scholar
Johnstone, E. C., Owens, D. G. C., Frith, C. D., et al (1991) Clinical findings. Abnormalities of the mental state and movement disorder and their correlates. British Journal of Psychiatry, 159 (suppl. 13), 21–25.Google Scholar
Jones, K. (1987) Mental Hospital Closures: The Way Forward? York: Institute of Advanced Architectural Studies.Google Scholar
Kanter, J. (1985) The process of change in the long–term mentally ill: a naturalistic perspective. Psychosocial Rehabilitation Journal, 9, 55–69.Google Scholar
King's Fund Forum (1987) Consensus Statement: The Need for Asylum in Society for the Mentally Ill or Infirm. London: King's Fund Centre.Google Scholar
Lancet (1987) The need for asylum for the mentally ill. Lancet, ii, 546–547.Google Scholar
Lawrence, R. E. (1991) The impact of community care on the course of schizophrenia in Kidderminster. In The Closure of Mental Hospitals (eds Hall, P. & Brockington, I. F.). London: Gaskell.Google Scholar
Lewis, S. W. (1990) Computerised tomography in schizophrenia 15 years on. British Journal of Psychiatry, 157 (suppl. 9), 16–24.Google Scholar
Lin, K–M & Kleinman, A. M. (1988) Psychopathology and clinical course of schizophrenia: a cross–cultural perspective. Schizophrenia Bulletin, 14, 555–567.Google Scholar
Macmillan, D. (1970) Mapperley Hospital. In Institutionalism and Schizophrenia: A Comparative Study of Three Mental Hospitals 1960–1968 (eds Wing, J. K. & Brown, G. W.). London: Cambridge University Press.Google Scholar
McGlashen, T. H. (1988) A selective review of recent North American long–term follow up studies of schizophrenia. Schizophrenia Bulletin, 14, 515–542.Google Scholar
McGlashen, T. H., Carpenter, W. T. & Bartko, J. J. (1988) Issues of design and methodology in long–term follow up studies. Schizophrenia Bulletin, 14, 569–574.Google Scholar
Mandiberg, J. M. & Telles, L. (1990) The Santa Clara clustered apartment project. Psychosocial Rehabilitation Journal, 14, 21–28.Google Scholar
Marks, I. M. (1992) Innovations in mental health care delivery. British Journal of Psychiatry, 160, 589–597.Google Scholar
Mathai, P. J. & Gopinath, P. S. (1985) Deficits of chronic schizophrenia in relation to long–term hospitalisation. British Journal of Psychiatry, 148, 509–516.Google Scholar
Michaelson, S., Leslie, F. & Thompson, A. (1990) Two years after discharge. In Better Out Than In? (ed. Thornicroft, G.). Report from the Fifth Annual Conference of the Team for the Assessment of Psychiatric Services (TAPS). London: North East Thames Regional Health Authority.Google Scholar
Miller, L. E. & Cohen, D. G. (eds) (1987) Schizophrenia & Aging. New York: The Guilford Press.Google Scholar
Murphy, E. (1991) After the Asylums: Community Care for People with Mental Illness. London: Faber & Faber.Google Scholar
Porter, R. (1990) Mind–Forg'd Manacles. London: Penguin Books.Google Scholar
Scull, A. (1979) Museums of Madness. London: Allen Lane.Google Scholar
Strauss, J. S., Hafez, H., Lieberman, P., et al (1985) The course of psychiatric disorders: longitudinal principles. American Journal of Psychiatry, 142, 289–296.Google Scholar
Team for the Assessment of Psychiatric Services (1990) Better Out Than In? (ed. Thornicroft, G.). Report from the Fifth Annual Conference. London: North East Thames Regional Health Authority. Google Scholar
Tomlinson, D. (1991) Utopia, Community Care and the Retreat from the Asylums. Milton Keynes: Open University Press.Google Scholar
Wing, J. K. (1961) A simple and reliable subclassification of chronic schizophrenia. Journal of Mental Science, 107, 862–875.Google Scholar
Wing, J. K. (1992) Comment on institutionalism and schizophrenia 30 years on. British Journal of Psychiatry, 160, 241–243.Google Scholar
Wing, J. K. & Brown, G. W. (1970) Institutionalism and Schizophrenia: A Comparative Study of Three Mental Hospitals 1960–1968. London: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.