Social approaches to mental patient care / by Morris S. Schwartz, Charlotte Green Schwartz, and Mark G. Field [and others].

  • Schwartz, Morris S.
Date:
1964
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Licence: In copyright

Credit: Social approaches to mental patient care / by Morris S. Schwartz, Charlotte Green Schwartz, and Mark G. Field [and others]. Source: Wellcome Collection.

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    a socio-economic class, an ethnic group, or an age category—and of its relation to the particular facility and the other psychiatric resources. For example, a private psychiatric hospital that extends itself into the community through a variety of programs can hardly be considered as engaged in comprehensive community psychi- atry, regardless of the merits of the programs, as long as it con- tinues to channel particularly difficult or potentially chronic pa- tients to the state mental hospital. Thus, paradoxically, efforts to remove the barriers may have the effect of reinforcing the differential use of psychiatric facilities. (Hollingshead and Redlich, 1958.) These and other unantici- pated effects may accompany the programs if practitioners remain unaware of and are unconcerned with some of the differences in emphasis and context that we have been discussing. With regard to our second issue, the significance of being de- fined as a mental patient, many practitioners assume that it would be beneficial to remove or lessen the distinction between patient- hood and non-patienthood. The objective is particularly associ- ated with the developments that permit a “quasi-patient’”’ status, such as in day or night hospitals, or with procedures that facilitate entry and exit. The distinction between being and not being a patient is not always clearly separated from the more general notions of barriers between the hospital and the community. Sometimes, for example, it is assumed that facilitating entry and exit from the hospital makes an inmate less of a patient. However, it is one thing for a hospital to facilitate various forms of movement in and out of the hospital, and another for the patient not to know when he is an in-patient and when he is not. In the first instance, the hos- pital is attempting to prevent certain negative consequences ap- parently due to the traditional “patient role,” with its rigid isola- tion from normal community life. In the second instance, the hospital is attempting to prevent the development of any in- patient role whatever and in this way may hinder the recognition by the person of his illness and his situation—a recognition be- lieved by some practitioners to be a prerequisite for therapeutic progress. Confusion in the rationale and processes of entry and