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Asylum and chronically ill psychiatric patients.

L L Bachrach

    The American Journal of Psychiatry
    |August 1, 1984
    PubMed
    Summary

    Deinstitutionalization for psychiatric patients can eliminate essential sanctuary. This study examines how planning principles can help meet the need for asylum in community care settings.

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    Area of Science:

    • Psychiatry
    • Public Health
    • Sociology

    Background:

    • The shift from state mental hospitals to community-based care for chronically ill psychiatric patients has had significant consequences.
    • Reducing institutional roles has, in some cases, removed vital sanctuary for vulnerable individuals.
    • Understanding the impact on patient well-being is crucial for effective mental healthcare policy.

    Purpose of the Study:

    • To explore the relationship between deinstitutionalization and the concept of asylum for psychiatric patients.
    • To evaluate the applicability of three planning principles in ensuring adequate asylum within community care.
    • To inform strategies for better supporting chronically ill psychiatric patients post-deinstitutionalization.

    Main Methods:

    • Conceptual analysis of deinstitutionalization and asylum.
    • Examination of three planning principles: functional equivalence, cultural relevance, and potential trade-offs.
    • Literature review on community mental health care and patient sanctuary.

    Main Results:

    • Deinstitutionalization has diminished the sanctuary previously offered by state mental hospitals.
    • The principles of functional equivalence and cultural relevance are key to providing adequate asylum in community settings.
    • Potential trade-offs in community care must be carefully managed to avoid compromising patient sanctuary.

    Conclusions:

    • Effective community care for chronically ill psychiatric patients requires intentional planning to provide sanctuary.
    • Planning principles can guide the development of community mental health services that meet patients' fundamental needs for safety and refuge.
    • Addressing the loss of institutional asylum is critical for successful deinstitutionalization and patient well-being.

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