The deinstitutionalization of care for the mentally ill has been in vogue for about fifty years. Broadly speaking, this transition can be seen to exhibit the following main trends: a dramatic decline in the inpatient population of psychiatric hospitals, coupled with a corresponding increase in community facilities such as psychiatric units in general hospitals, day hospitals, and day centres. It has been claimed that deinstitutionalization ends previously enforced seclusion, enhances human dignity and allows individual privacy. The deinstitutionalization movement has inevitably led both to large numbers of former long-stay patients being cared for in the community and to significant numbers of individuals developing enduring mental illness in the community without ever having had a long inpatient tenure. The findings of recent studies (Gould 1992, Brockington et al. 1993) suggest that there is a positive public attitude towards the mentally ill. However, Kelly (1997), while carrying out Quality of Life research, found that over half of the community-based long-term mentally ill he surveyed reported that they had experienced harassment/victimization. This paper is not a report on the Quality of Life research but a discussion on the theme of victimization that has emerged from the study. The extent of the problem is discussed as are the implications for mental health professionals.
|Journal||Journal of Psychiatric and Mental Health Nursing|
|Publication status||Published (in print/issue) - Jun 1997|
Bibliographical noteReference text: Bachrach L. (1982) Deinstitutionalisation: An Analytical Review
and Sociological Perspective. US Department of Health,
Education and Welfare, Washington DC.
Barton R. (1959) Institutional Neurosis. John Wright, Bristol.
Berscheid E, Walster E. H. & Bohrnstedt G. (1984) The happy
American body. In: Social Stigma (ed E. E. Jones). Freeman,
Barham P. & Hayward R. (1991) From the Mental Patient to the
Person. Routledge, London.
Braginsky B. M., Braginsky D. & Ring K. (1969) Methods of
Madness. Holt, Rinehart and Winston, New York.
Brightman J. G. (1991) Social Psychiatry (2nd ed). Harper
Collins, New York.
Brockington I. Hall P. Levings J. et al. (1993) The community’s
tolerance of the mentally ill. British Journal of Psychiatry 162,
Dencker S. J. & Dencker K. (1994) Does community care reduce
the need for beds for schizophrenia patients. Acta Psychiatrica
Scandinavica 89 (suppl 382), 74–79.
Dencker S. J. & Dencker K. (1995) The need for quality assurance
for a better compliance and increased quality of life in chronic
schizophrenia patients. International Clinical Pharmacology 9
(suppl 5), 35–40.
Freeman H. L., Fryers T. & Henderson J. H. (1985) Mental
Health Services in Europe: 10 Years On. World Health
Glasson, J. (1996) The public image of the mentally ill and
community care. British Journal of Nursing 5, 615–617.
Goffman E. (1961) Asylums. Pelican, Harmondsworth.
Goffman E. (1964) Stigma. Penguin, London.
Goldman H. H., Gattozzi A. A., Taube C. A. (1981) Defining and
counting the chronically mentally ill. Community Psychiatry
Gould N. (1992) Public prejudice. Nursing Times 88, 36–39.
Jones E. E. (1984) Social Stigma. Freeman, New York.
Kelly (1997) Quality of life of people with enduring forms of
mental illness. PhD Thesis (ongoing), University of Ulster.
La Piere R. T. (1934) Attitudes vs actions. Social Forces 13,
Lerner M. J. (1980) The Belief in a Just World: A Fundamental
Delusion. Plenum, New York.
Milner G. & Hassall C. (1990) Worcester Development Project:
the closure and replacement of a mental hospital. Health
Trends 22, 141–145.
Morris M. (1995) How can community care tragedies be avoided.
British Journal of Nursing. 4, 1109–1110.
Murphy B. M., Black P., Duffy M. (1993) Attitudes towards the
mentally ill in Ireland. Irish Journal of Psychological Medicine.
O’Driscoll C. (1993) The TAPS Project 7; mental hospital
closure: a literature review of outcome studies and evaluative
techniques. British Journal of Psychiatry 162 (suppl 19)
Prior L. (1991) The Social Worlds of Psychiatric and ex
Psychiatric Patients in Belfast. Health and Health Care
Research Unit, The Queen’s University of Belfast.
Rabkin J. G. (1974) Opinions about mental illness: a review of
the literature. Psychological Bulletin 77, 153–171.
Sarbin T. R. & Mancuso J. C. (1972) Paradigms and moral
judgements: improper conduct is not disease. Journal of
Consulting and Clinical Psychology 39, 6–8.
Thomas L. (1984) Late Night Thoughts on Listening to Mahler’s
Ninth Symphony Bantam Books, New York.
Tissier G. (1993) Neighbours. Community Care 14, 16–17.
Tringo J. C. (1970) Hierarchy of preference towards disability
groups. Journal of Special Education 4, 295–306.
Whitehead E. (1995) Prejudice in practice. Nursing Times 91,
Wray S. (1995) Maintaining momentum in Community Care.
Mental Health Nursing 14, 9–11.
- community care
- enduring mental illness