The effects of the community environment on chronic psychiatric patients

The question of where to place the chronically mentally disabled in the community is essential in this era of brief hospitalization practices. This report examines the effects of the social conditions of the environment on the length of stay in the community for a sample of 119 multiple admission schizophrenics in New York City. Patients returned to a variety of family and non-family living arrangements in poor and depressed areas of the city. The relationship between characteristics of the living arrangements and the patients' clinical functioning and rate of rehospitalization was examined. The findings show that there is no significant differential effect of the type of living arrangement on rehospitalization or clinical functioning, and that these factors did not contribute significantly to the prediction of successful adjustment. However, the socio-emotional characteristics of the environment--i.e. social support and interpersonal stress-together are stronger predictors of outcome than are available out-patient treatment programmes. The findings emphasize the importance of environmental variables as factors independent of the effect of treatment on rehospitalization.