The need for continuing asylum and sanctuary

Deinstitutionalization of the chronically mentally ill does not mean they no longer need social support, protection, and relief from the pressures of life--in other words, asylum and sanctuary. The authors address the questions of why asylum should be provided, for what patients, the relationship between asylum and rehabilitation, and the implications for mental health professionals. They point out that while many chronic patients eventually attain high levels of social and vocational functioning, many cannot meet simple demands of living, even with long-term rehabilitative help. Many consciously limit their exposure to stimuli and pressure not from laziness but from a well-founded fear of failure. Professionals must realize that whatever degree of rehabilitation is possible for each patient cannot take place unless support and protection--whether from family, treatment program, board-and-care home, or public hospital--are provided at the same time.