Organizational and psychological problems in developing community mental health services: A case study (original) (raw)

III. Organizational Analysis of Deinstitutionalization in a Psychiatric Hospital

The Canadian Journal of Psychiatry, 2000

Background: Few studies have been conducted ofthe organizational aspects that impact on the course ofpsychiatric deinstitutionalization. Method: A case study was undertaken of 10 years ofdeinstitutionalization in a Montreal psychiatric hospital. Results: Deinstitutionalization has forged ahead in the hospital over the past few years, although the course it has taken is not the one initially plotted by its promoters. Care management ofdeinstitutionalized patients remains under the control ofthe psychiatric hospital and its physicians. However, the patients' well-being has remained a focus of concern and does not seem to have been detrimentally affected by this development. Conclusion: Deinstitutionalization is both a solution to the criticisms levelled at the hospital-psychiatric approach of managing persons with severe and persistent mental disorders and an extremely usefitl tool in the power struggle among the various stakeholders in mental health services reform. Deinstitutionalization has become unavoidable.

Social Conceptions of a Psychiatric Hospital in the Process of Closure

Temas em Psicologia, 2016

The study aims to understand the social conceptions of a psychiatric hospital in closing process. Participants live in a residential neighborhood near to the hospital, where three therapeutic residences (TRs) are located, whose residents are egress of the hospital. Through ethnographic perspective, 22 interviews were realized, addressing the evocations about the psychiatric hospital, its closure and the destiny of the egress. The psychiatric hospital was conceived as a reference to the inhabitants, being represented as a halfway house and conceived as a necessary place. The participants showed displeasure with the closure, but at the same time, a favorable position to its deactivation, based on interaction with the former inmates of the hospital that lives in the neighborhood, represented as non-aggressive. Participants suggested that TRs are transferred to remote locations. The representations observed indicate the need of keep the psychiatric hospital open or the creation of other similar spaces, providing the social withdrawal of the egresses. Thus, it is necessary to discuss the possibility for coexistence between supposedly different groups, since the tendency to removal, as observed in this study, can be as a process necessary for the defense of group identity, but must be fought.

Community psychiatry then and now: An introduction

Psychiatric Quarterly, 1991

The papers included in this special issue of Psychiatric Quarterly were presented at a symposium in honor of Alan M. Kraft, M.D. on April 17, 1991 at the Capital District Psychiatric Center (Alan Kraft Auditorium) in Albany, N.Y. Alan Kraft was chairman of the Department of Psychiatry at Albany Medical College from 1967 to 1990 and was the founding director of the Capital District Psychiatric Center. When I was asked to succeed Alan Kraft as the (interim) chairman of the department by then Dean of Albany Medical College, Nancy Gary, I asked Dr. Gary for funds to support this symposium. She immediately agreed, and the current dean, Dr. Anthony Tartaglia, concurred. The theme of the symposium, ~¢Community Psychiatry Then and Now," looks historically at the organization of psychiatric services, the community psychiatry movement, in which Alan Kraft has played such a significant role. It also looks at the enduring issues, which continue to concern those involved in organizing services for those who suffer from mental illness.

2010 Essay Competition Winner: Transformation at a community mental health centre

Psychodynamic Practice, 2011

The community mental health centre affords an opportunity for psychodynamic practice that is both challenging and rewarding. The experience of psychoanalytic education and supervision at a suburban mental health centre is described in terms of its transformative effect on the participants and the clinical setting. A parallel clinical transformative process is illustrated through an extended vignette of one client's experience in group psychotherapy. In both situations-that of the mental health team and that of the group therapy client-an initial jarring impact of the psychodynamic process gives way to a broad transformative experience.

The last half-century of psychiatric services as reflected in psychiatric services

Psychiatric services (Washington, D.C.), 2000

The last half-century of psychiatric services in the United States is examined through developments and trends reported in the 50 years of publication of Psychiatric Services. The journal, earlier named Mental Hospitals and then Hospital and Community Psychiatry, was launched by the American Psychiatric Association in January 1950 and marks its 50th anniversary this year. The author organizes his review of psychiatric services largely around the locus of care and treatment because the location of treatment--institution versus community--has been the battleground for the ideology of care and for the crystallization of policy and legal reform. He uses "dehospitalization" to describe the movement of patients out of state hospitals, rejecting the widely used term "deinstitutionalization" as inappropriate; one reason is that the term wrongly implies that many settings where patients ended up were not institutional. Also covered in detail, as reflected in the journal, ...