Patients In Mental Institutions

A total institution is defined by Goffman as a place of residence and work where a large number of like-situated, individuals, cut off from the wider society for an appreciable period of time, together lead an enclosed, formally administered round of life. Prisons serve as a clear example, providing we appreciate that what is prison-like about prisons is found in institutions whose members have broken no laws. This volume deals with total institutions in general and, mental hospitals, in particular. The main focus is, on the world of the inmate, not the world of the staff. A chief concern is to develop a sociological version of the structure of the self. Each of the essays in this book were intended to focus on the same issue--the inmate's situation in an institutional context. Each chapter approaches the central issue from a different vantage point, each introduction drawing upon a different source in sociology and having little direct relation to the other chapters. This method of presenting material may be irksome, but it allows the reader to pursue the main theme of each paper analytically and comparatively past the point that would be allowable in chapters of an integrated book. If sociological concepts are to be treated with affection, each must be traced back to where it best applies, followed from there wherever it seems to lead, and pressed to disclose the rest of its family.

The 1970s constitute the decade of decisions about state mental hospi tals! These large, monolithic, and seemingly impervious institutions are being phased out in some states and their basic purpose for exis tence is being seriously questioned in almost all others. Since 1970, hospitals have closed in California, Illinois, Kentucky, Massachusetts, Minnesota, New York, Oklahoma, Washington, and Wisconsin. Simi lar closings have occurred in several provinces of Canada, in Great Britain, and in some European countries. The purpose of the book is to examine the multiple issues growing out of the hospital closings: Why are the state hospitals being closed? What is the impact of closings on patients, hospital staff, and the communities where the hospitals are located? What has been the impact on the communities receiving these patients? What are the trends for the future, in terms of numbers of closings and types of hospitals which will remain? Is there a role for the state hospital in the care of the mentally ill or is it an obsolete institution? The impetus for the closings is diverse. The discovery and wide spread use of the tranquilizing drugs in the early 1950s allowed more patients to be returned to the community-under medication.

“Mikita Brottman is one of today’s finest practitioners of nonfiction.” —The New York Times Book Review Critically acclaimed author and psychoanalyst Mikita Brottman offers literary true crime writing at its best, taking us into the life of a murderer after his conviction—when most stories end but the defendant's life goes on. On February 21, 1992, 22-year-old Brian Bechtold walked into a police station in Port St. Joe, Florida and confessed that he’d shot and killed his parents in their family home in Silver Spring, Maryland. He said he’d been possessed by the devil. He was eventually diagnosed with schizophrenia and ruled “not criminally responsible” for the murders on grounds of insanity. But after the trial, where do the "criminally insane" go? Brottman reveals Brian's inner life leading up to the murder, as well as his complicated afterlife in a maximum security psychiatric hospital, where he is neither imprisoned nor free. During his 27 years at the hospital, Brian has tried to escape and been shot by police, and has witnessed three patient-on-patient murders. He’s experienced the drugging of patients beyond recognition, a sadistic system of rewards and punishments, and the short-lived reign of a crazed psychiatrist-turned-stalker. In the tradition of One Flew Over The Cuckoo’s Nest, Couple Found Slain is an insider’s account of life in the underworld of forensic psych wards in America and the forgotten lives of those held there, often indefinitely.

The Saskatchewan Mental Hospital at Weyburn has played a significant role in the history of psychiatric services, mental health research, and providing care in the community. Its history provides a window to the changing nature of mental health services over the 20th century. Built in 1921, Saskatchewan Mental Hospital was considered the last asylum in North America and the largest facility of its kind in the British Commonwealth. A decade later the Canadian Committee for Mental Hygiene cited it as one of the worst facilities in the country, largely due to extreme overcrowding. In the 1950s the Saskatchewan Mental Hospital again attracted international attention for engaging in controversial therapeutic interventions, including treatments using LSD. In the 1960s, sweeping healthcare reforms took hold in the province and mental health institutions underwent dramatic changes as they began transferring patients into communities. As the patient and staff population shrunk, the once palatial building fell into disrepair, the asylum’s expansive farmland went out of cultivation, and mental health services folded into a complicated web of social and correctional services. Erika Dyck’s "Managing Madness" examines an institution that housed people we struggle to understand, help, or even try to change.

A great deal has been written about the decarceration movement which involves the transfer of mental patients from the mental hospital to the community. Here the authors look at the impact of that process as it affects patients and staff alike once the patients leave the hospital. The book deals with a number of matters raised by decarceration, not the least about the types of care to be experienced by the patients and the likelihood of offering forms of rehabilitation.

Mental Institutions in America: Social Policy to 1875 examines how American society responded to complex problems arising out of mental illness in the nineteenth century. All societies have had to confront sickness, disease, and dependency, and have developed their own ways of dealing with these phenomena. The mental hospital became the characteristic institution charged with the responsibility of providing care and treatment for individuals seemingly incapable of caring for themselves during protracted periods of incapacitation. The services rendered by the hospital were of benefit not merely to the afflicted individual but to the community. Such an institution embodied a series of moral imperatives by providing humane and scientific treatment of disabled individuals, many of whose families were unable to care for them at home or to pay the high costs of private institutional care. Yet the mental hospital has always been more than simply an institution that offered care and treatment for the sick and disabled. Its structure and functions have usually been linked with a variety of external economic, political, social, and intellectual forces, if only because the way in which a society handled problems of disease and dependency was partly governed by its social structure and values. The definition of disease, the criteria for institutionalization, the financial and administrative structures governing hospitals, the nature of the decision-making process, differential care and treatment of various socio-economic groups were issues that transcended strictly medical and scientific considerations. Mental Institutions in America attempts to interpret the mental hospital as a social as well as a medical institution and to illuminate the evolution of policy toward dependent groups such as the mentally ill. This classic text brilliantly studies the past in depth and on its own terms.