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Social Treatment of Chronic Schizophrenia: A Comparative Survey of Three Mental Hospitals

Medical Research Council, Social Psychiatry Research Unit, Institute of Psychiatry, Maudsley Hospital, London, S.E. 5

ABSTRACT

The clinical condition of samples of chronic female schizophrenic patients in three mental hospitals was assessed by means of standard interviews, and rating scales completed by ward sisters. Information on there strictiveness of the ward routine, the way the patient's day was organized, her personal possessions, and the nurses' opinions of her, was also systematically gathered. Afterdue allowance had been made for differences in distribution of age, length of stay, and social class (occupation of father), marked differences still remained between the groups. A consistent pattern emerged. At Hospital A, where the main emphasis of care was on the long-stay patient, there was least clinical disturbance and most personal freedom, useful occupation, and optimism among the nursing staff. At Hospital C, where reform had not progressed so far, there was most clinical disturbance among patients and least personal freedom, useful occupation and optimism. Hospital B was intermediate in most respects. Alternative explanations are considered and it is concluded that there is good preliminary evidence that social conditions in a mental hospital do influence the mental state of schizophrenic patients. It will be necessary to show an improvement in patients in Hospital C, as the social regime there changes, in order to confirm these results.