January 1971

Discharged Mental Patients— Are They Really in the Community?

Author Affiliations

San Mateo, Calif
From the Psychiatric Rehabilitation Service, County of San Mateo, San Mateo, Calif.

Arch Gen Psychiatry. 1971;24(1):29-34. doi:10.1001/archpsyc.1971.01750070031004

This study measures the effect of a high-expectation and a low-expectation environment on discharged long-term mental patients randomly assigned to one of two community settings. The high-expectation setting includes a halfway house, a daytreatment center, and a rehabilitation workshop. It demands much in the way of mobility, planning, and accepting responsibility. Low-expectation patients go to boarding homes where docility is valued and little initiative is expected. The boardinghome group is not really in the community. It is like a small ward moved to a community setting. The high-expectation group has a higher rehospitalization rate, but a longer time out of the hospital with a higher level of instrumental performance. The high-expectation group is less segregated, is less likely to be labeled as deviate, and is less stigmatized.