The long-term patient in the community: life style patterns and treatment implications

A sample of 99 long-term patients at an urban community mental health-mental retardation center were interviewed to determine how they spent their time and their degree of happiness with their lives and the services they received at the center. More than half the patients were considered by center staff to be only mildly or moderately impaired, but as a group they were distinguished by low levels of educational, financial, and vocational achievement; only 13 per cent were working more than half time. Most of the patients considered themselves happy, but their life style was oriented toward health and social relationships and lacked a work-task orientation. The authors conclude that the patients' life style meshes closely with the orientation of the treatment system; neither places emphasis on achievement of noninterpersonal tasks or enhancement of a work orientation. The authors believe that many chronic users of community mental health services have the potential to work and that practically all could benefit from the ego-enhancing experiences resulting from the successful accomplishment of tasks and development of skills. Therefore they feel programming for long-term patients should address deficits in work and achievement motivation.