Rehabilitated Long-Stay Schizophrenics in the Community

¹ Consultant Psychiatrist, Roundway Hospital, Devizes, Wiltshire
² Social Worker, Roundway Hospital, Devizes, Wiltshire

1. A follow-up of 42 long-stay schizophrenic men, 24-52 months after discharge from the same mental hospital rehabilitation unit is reported.

2. Thirty (71 per cent.) had not been readmitted to a mental hospital 2 years after discharge, and these were arbitrarily defined as Successes, the rest as Failures. Re-admissions took place at a fairly constant rate throughout the 2-year period, and without exception followed a serious relapse of schizophrenic symptoms. Only one re-admission occurred after 2 years in the community.

3. Re-admissions could not be related to social factors such as type of living group, or certain obvious social stresses such as death of parents, loss of lodgings or job.

4. There was a significant association between Success and regularity in taking maintenance phenothiazine therapy, but it was pointed out that this need not be a causative relationship and that larger scale studies were necessary to confirm or refute this finding.

5. A high level of employment was achieved throughout the group, and using the criterion of regular work for at least three-quarters of their time in the community, or before a first re-admission, the Successes (90 per cent.) and the Failures (75 per cent.) showed little difference in performance.

6. Just over half the Successes (57 per cent.) were also rated as "Nearly Normal" in social behaviour at home. The remainder (43 per cent.) were rated as "Moderately Disturbed", or in 2 cases, "Severely Disturbed".

7. Six of the 11 "Moderately Disturbed" patients also appeared to cause moderate hardship to the living group, and both "Severely Disturbed" patients caused severe family hardship.

8. Attention was drawn to what appeared to be the more important shortcomings of the community after-care provided for the patients, particularly a greater need for sustained support of patients' families.

9. These results have been briefly discussed, and it has been considered more important to set the results accurately in their background of type of hospital rehabilitation programme, the extent to which the series was representative of one hospital's rehabilitatable long-stay schizophrenic population, and the community aftercare facilities provided, rather than to attempt to generalize from the results of one small-scale study.

10. The value of the pre-discharge rehabilitation experiences of these long-stay schizophrenics seemed almost entirely in terms of minimizing their secondary handicaps.

This article has been cited by other articles:

				C. P. O'Brien, K. B. Hamm, B. A. Ray, J. F. Pierce, L. Luborsky, and J. Mintz Group vs Individual Psychotherapy With Schizophrenics: A Controlled Outcome Study Arch Gen Psychiatry, October 1, 1972; 27(4): 474 - 478. [Abstract] [PDF]