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The personal possessions of long-stay patients in mental hospitals
Abstract
The personal possessions of 200 chronic psychiatric patients admitted from eleven hospitals in the Birmingham Region to the regional rehabilitation hospital were studied and the number and range of this property is described. The patients had markedly fewer possessions than did inhabitants of other institutions that were studied. Women patients had more than twice as many possessions as men. The eleven hospitals varied widely in the number of their patients' possessions. Possible reasons for this are discussed. The hospital's attitude and the degree of severity of the patient's illness were found to be the most important factors. Length of stay (in the case of men), the intelligence of the patient, and the continuing existence of contact with relatives (in the case of women) were found to be subsidiary factors. Three years after the inventories of their property had been made, male patients with more possessions had responded more successfully to their course of rehabilitation regardless of their clinical condition. Given space, money and a favourable hospital attitude, patients had acquired more property. That it is humane to encourage this is not in doubt, but it is suggested that it may also be therapeutic.
... 1967, cited David & Weinstein, 1987. A related finding was that by Morgan and Cushing who noted that for chronic psychiatric patients, personal posseSSions may playa therapeutic role (Morgan & Cushing, 1967). ...
... In studies of treasured possessions, Csikszentmihalyi and Rochberg-Halton (1981) found that possessions were highly treasured by some individuals but not by others. There is also evidence to show that possessions have a therapeutic value for the elderly (Sherman and Newman 1977-1978) and mentally ill (Carroll 1968; Morgan and Cushing 1966). Also, various transition objects including security blankets seem to bolster self-confidence among infants when they are separated from their mothers (Furby and Wilke 1982; Halonen and Passman 1978; Passman 1976; Passman and Adams 1982; Passman and Halonen 1979; Passman and Longeway 1982; Passman and Weinberg 1975; Weisberg and Russell 1971). ...
The research agendas of psychologists and economists now have several overlaps, with behavioural economics providing theoretical and experimental study of the relationship between behaviour and choice, and hedonic psychology discussing appropriate measures of outcomes of choice in terms of overall utility or life satisfaction. Here we model the relationship between values (understood as principles guiding behaviour), choices and their final outcomes in terms of life satisfaction, and use data from the BHPS to assess whether our ideas on what is important in life (individual values) are broadly connected to what we experience as important in our lives (life satisfaction).
Representing the belief that material objects are important and valuable, materialism indicates to what extent individuals or groups attach importance to material assets. People exhibit high materialistic behavior if material assets are significant for them, and low materialistic behavior if they are insignificant. In materialism, consumer behavior is regarded as a multifaceted phenomenon that covers various scientific fields such as marketing, psychology, economics, advertising, and social sciences. Today, the materialistic values and the concepts of cognitive buying and post-purchase behavior have an undeniable focus on the consumers' shopping behaviors. These concepts are significant due to the relationship between themselves and their mutual effect.
The main purpose of the research is to examine the effect of materialistic values on cognitive buying and post-purchase behavior. The material values, cognitive buying, and post-purchase behavior scales were used within the scope of the research. The research covers 1034 consumers in the provinces of Edirne, Tekirdağ, and Kırklareli. The collected data were analyzed using SPSS 22.0 statistical software package and the structural equation model was analyzed using the AMOS 24 statistical software.
According to the findings, the variables of success, centrality, and happiness, which are the sub-dimensions of the material values scale, were found to have a direct effect on the rationality variable, a sub-dimension of the cognitive buying scale. Success and centrality variables, which are sub-dimensions of the material values scale, were found to have a direct effect on the wisdom of purchase and concern over deal, which are sub-dimensions of the post-purchase cognitive dissonance scale.
Any discussion of a topic in social psychiatry demands some statement as to how social and clinical terms are being used by the participants, otherwise the main subject matter, which always concerns the interaction between social and clinical factors, must be imprecise and confusing. This will be particularly true in a volume such as this with a multiple and international authorship. The title of this chapter could be construed in a broad or in a narrow sense. The term “institution” is often used to designate very broad social functions such as those of government, business, the church or the family. The term “mental disorder” is even more susceptible to broad interpretation. At the extreme, therefore, it would be legitimate to include a discussion of the mental status of the average adult in paleolithic times or in dynastic Egypt, compared with that of middle-class America as described by desurDavid Riesman (1950), or with the alarming symptom list apparently characteristic of the West African villagers surveyed by desurLeighton and desurLambo (1963). At the other extreme, it would also be legitimate to devote the whole chapter to a consideration of the problems of the long-stay schizophrenic population of mental hospitals, since this aspect of the subject has attracted more scientific attention from sociologists and psychiatrists than most others, and the relevant literature is rich enough to deserve such a comprehensive review. However, this would mean leaving out other important issues, such as the effects of admission to hospital on people with acute mental illnesses, the usefulness of the “therapeutic community” and the value of what has come to be known as “community care”.
In der ersten Auflage des Handbuches „Psychiatrie der Gegenwart“finden sich in Band III („Soziale und angewandte Psychiatrie“, 1961) bereits verschiedene Beiträge, die sich mit der psychiatrischen Versorgung hospitalisierter psychisch Kranker und speziell auch mit der Organisation psychiatrischer Einrichtungen befassen, so vor allem die Beiträge von Hans Merguet über „Psychiatrische Anstaltsorganisationen (Arbeitstherapie, Milieugestaltung, Gruppentherapie)“, von Max MüLler über „Neue Strömungen in der praktischen Psychiatrie“und von Paul H. Hoch über die Sozialpsychiatrie. Wenig später (1964) erschien die umfangreiche Monographie von Fr. Panse über „Das psychiatrische Krankenhauswesen“, in der ein umfassender Überblick über die Entwicklung des psychiatrischen Krankenhauswesens im Laufe der Jahrhunderte, den neuesten Stand dieser Entwicklung in den verschiedenen Ländern der Erde und die Zukunftsperspektiven gegeben wird. Dank der in ihr enthaltenen zahlreichen konkreten Beispiele ist die Monographie zu einem unentbehrlichen Nachschlagewerk geworden. — Schließlich sei noch auf das Buch von Walter Schulte „Klinik der Anstalts-Psychiatrie“(1962) hingewiesen, das im besonderen den Problemen der psychiatrischen Großkrankenhäuser gewidmet ist.
Summay.-160 citations on ownership, possession, and ptoperry are presented alphabetically, with notations indicating general topics, e.g., business psychology, instinct theory, child development, child language, moral theory, and semantic analysis. Property concepts and behaviors are important in the daily lives of most people and are central issues in legal, political, and ideological confrontations. Within psychology, interest in ownership, possession, and property dates back at least to Aristotle and has continued throughout the history of psychology to the present. Unfortunately, however, literature on ownership, possession, and property is not readily accessible through Psychological Abstracts or ERIC. This bibliography presents 160 citations on ownership, possession, and property which were identified through journal and textbook indexes, through references in articles and through the Social Science Citarion Index, 1966 to 1985. An effort was made to represent the variety of modern psychological literature concerned with ownership, possession, and property and to include psychological literature from Europe and from other social science fields. The extensive literatures on territoriality and personal space were omitted because
Using a longitudinal content analysis of advertisements appearing in popular U.S. magazines between 1900 and 1980, we assess the image of life depicted during this period. While little evidence is found to support some critics' contention that advertising has visually portrayed a progressively more luxurious and comfortable lifestyle, the themes employed in advertising do lend support to such an assertion. In addition, there is evidence that recent advertising has increasingly portrayed consumption as an end in itself rather than as a means to consumer well-being.
One hundred older people (75 females, 25 males), in nursing homes rated as above or below a combined criterion (based on Lieberman and Tobin's scales of physical attractiveness, affiliation fostering, and tolerance for deviancy), responded to questionnaires on cherished possessions and on adaptation to the nursing home. The main findings indicated: 1) relative to those residents without possessions, those with possessions were better adapted to the nursing home; 2) possessions served the major functions of historical continuity, comforter, and sense of belongingness; 3) relative to men, significantly more women had cherished possessions and were more likely to associate them with self-other relationships; and 4) relative to residents in nursing homes below the mean of the combined criterion, those in homes above the mean felt more in control, less helpless, more supported by staff, and were judged as more realistic in response to conflict. Interpretations regarding the role of possessions in adaptation and suggestions for institutional policies concerning possessions are discussed.
The total cost of a psychiatric rehabilitation service for long-stay patients has been measured by studying the hospital's first 200 consecutively admitted patients and their careers over the ten years, 1961 to 1970. Account has been taken of every known direct cost to the national economy, of which the Health Service cost is only a part. Account has also been taken of every known direct financial contribution to the economy by successfully resettled patients. No attempt has been made to include indirect costs or contributions. The maintenance cost in the rehabilitation hospital was about 70% higher throughout the period than the average cost in the hospitals from which the patients came. Despite this, the total net cost of the cohort under rehabilitation was 6% less than it would have cost to keep all 200 patients throughout the ten years in their previous hospitals. The extent to which the cost of additional resources has already been offset by some of the patients' successes in achieving independent lives has therefore been demonstrated. The trend is likely to continue. All 200 persons who are the subjects of this study entered the decade under review as long-stay patients. Of these, 82 enter the subsequent decade as independent citizens. Their continuing independence is not only clinically gratifying but promises to offset even further the cost of the original investment in an additional rehabilitation service.
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.
St. Wulstan's Hospital, Malvern, opened in November, 1961. It is the first hospital in Great Britain to be given the specific function of rehabilitating selected chronic psychiatric patients from other hospitals. The original plans for its use were made by the Mental Health Services Advisory Panel of the Birmingham Regional Hospital Board. In 1959 this panel was confronted with overcrowding in the Board's twelve existing mental hospitals; it was offered the use of a tuberculosis sanatorium that would shortly be closing for lack of patients, and it was impressed by the results reported from other hospitals of giving chronic patients industrial work to do. Accordingly the panel formulated plans to reopen the former sanatorium as a psychiatric rehabilitation hospital. The execution and development of these plans are described in this paper.
Ratings of mental symptoms, behaviour in the ward, and attitudes to discharge were made on random samples of male schizophrenic patients, aged under sixty, from two London mental hospitals. Those resident less than two years were omitted.
There was a concentration of unfavourable attitudes to discharge in the longer-stay groups which remained significant when age, and mental symptom category, were allowed for. There was no significant association between mental symptom category and length of stay. There was no significant association between ward behaviour and length of stay except for one single item.
The results suggested that patients gradually develop an attitude of indifference towards events outside the hospital which is part of a syndrome of ‘institutionalism’. No such long-term deterioration in mental symptoms or ward behaviour was demonstrated but relatively rapid changes, or deterioration before the two-year point, could not be excluded.
No detailed and comprehensive system of subclassification of chronic schizophrenia has been generally adopted in this country. Most psychiatrists are content to use the broad categories of simple, hebephrenic, catatonic, paranoid and undifferentiated schizophrenia. Placing a patient into one of these subgroups entails a judgment which is based upon all the information at the clinician's disposal. Such data are necessarily unstandardized; the method of collection varies from doctor to doctor and from patient to patient, and the criteria of classification are not uniformly agreed upon. No objective tests are available which would serve to check the accuracy of the decisions taken. It is inevitable, in these circumstances, that clinical systems of subclassification should not be much used for scientific purposes. The basic essential of a classifying instrument is that it should produce the same results in the hands of different investigators, and that its standards of measurement should not vary from one occasion to another. No study so far published has attempted to deal with this problem, which becomes more serious as the elaboration (and possibly the clinical usefulness) of the classification increases. Leonhard's system (1, 4, 5) for example, would gain enormously if its reliability could be demonstrated.
Definition of Medical Rehabilitation
A full definition of medical rehabilitation should contain three parts. The first is a statement of aim: ideally, to settle or resettle an individual in his normal domestic setting, and in work appropriate to his talents. Most patients and doctors can measure their success against these two practical indices, although what is regarded as socially desirable varies widely and some individuals prefer a highly idiosyncratic way of life.
A survey was made of the functional handicaps of a sample of long-stay schizophrenic patients under 60 years of age. Forty-five per cent. were judged to be moderately ill clinically, 19 per cent. showed coherently expressed delusions as the predominant symptom, 30 per cent. had severe incoherence or poverty of speech, and 7 per cent. were mute. Other handicaps were enumerated, and the resettlement problems of the various clinical subgroups discussed. Nineteen (13 per cent.) patients appeared likely to be able to hold down stable jobs and be discharged from hospital within a few months time. It was not possible to say how many more would eventually reach this condition, but progress was likely to be slow.
The measurement of behaviour in chronic schizo-phrenica. Acta psychiat, neurol A simple and reliable subclassification of chronic schizo-phrenia
- J K Wing
WING, J. K.: The measurement of behaviour in chronic schizo-phrenica. Acta psychiat, neurol, scan& 35, 245 (1960). A simple and reliable subclassification of chronic schizo-phrenia. J. ment. Sci. 107, 862 (1961).
Errors of psychotherapy
- Sr~astian
- De
Sr~ASTIAN DE GI~AZlA: Errors of psychotherapy, p. 10--11.
Drinking practices and their social func-tion Alcohol and civilization
- Brunn
- P~ttil
BRUNN, P~TTIL: Drinking practices and their social func-tion. In LucIA, S. P. (ed.): Alcohol and civilization. New York: McGraw-Hill 1963, p. 227.
JAQurs: The technological order
- Elluli
ELLuLI, JAQurs: The technological order. In Technology and culture. Vol. III, No. 4, Fall, 1962, p. 394--421.
Asylums. New York: Anchor Books. 1961. Ministry of Health: National Health Service Hospital Costing Returns Part I for the Years Ending
- H M S O London
- E Go~fman
London: H. M. S. O. 1960. GO~FMAN, E. : Asylums. New York: Anchor Books. 1961. Ministry of Health: National Health Service Hospital Costing Returns Part I for the Years Ending March 31st 1953, 1956, 1957, 1961 and 1962. London: H. M. S. O. 1962.
The American way: Model or warning? Regina: University of Saskatchewan 1965
- H H Wilson
WILSON, H. H.: The American way: Model or warning? Regina: University of Saskatchewan 1965. Mimeographed.
Asylums. New York: Anchor Books
- E Goffman
National Health Service Hospital Costing Returns Part I for the Years Ending
- Ministry
- Health
Freudenberg: A survey of long-stay schizophrenic patients
- A G Catterson
- D H Bennett
- A. G. Catterson