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Assessment and Communication for People with Disorders of Consciousness
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Understanding psychiatric institutionalization: a conceptual review.

Winnie S Chow1, Stefan Priebe

  • 1Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Newham Centre for Mental Health, Queen Mary University of London, London E13 8SP, UK. w.chow@qmul.ac.uk

BMC Psychiatry
|June 19, 2013
PubMed
Summary

Psychiatric institutionalization is understood through four themes: physical structures, policies, clinical relationships, and patient adaptation. These concepts inform current debates on developing psychiatric care and the role of institutional settings.

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Published on: November 19, 2014

Area of Science:

  • Psychiatry
  • Mental Health Services Research
  • Sociology of Mental Health

Background:

  • Deinstitutionalization, the shift from large psychiatric hospitals to community care, has been a key concept since Goffman's work.
  • Despite deinstitutionalization, the precise meaning of psychiatric institutionalization in contemporary practice remains unclear.
  • This review addresses the evolving understanding of psychiatric institutionalization from the 1960s to the present.

Purpose of the Study:

  • To clarify the multifaceted concept of psychiatric institutionalization.
  • To analyze the historical and contemporary meanings of institutionalization in psychiatry.
  • To identify key themes defining institutionalization in psychiatric care.

Main Methods:

  • A conceptual review methodology was employed.
  • Thematic analysis was utilized to synthesize findings on institutionalization.
  • Literature review focused on psychiatric institutionalization since the 1960s.

Main Results:

  • Four primary themes emerged in conceptualizing psychiatric institutionalization.
  • These themes include the physical aspects of care facilities ('bricks and mortar').
  • Additional themes encompass policy/legal frameworks, clinical responsibility/paternalism, and patient adaptive behaviors within institutional settings.

Conclusions:

  • Psychiatric institutionalization is a complex concept defined by four distinct themes.
  • These themes offer critical insights for contemporary discussions on psychiatric care development.
  • The findings highlight the ongoing relevance of institutional care within evolving psychiatric frameworks.