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The rehabilitation of discharged mental patients : analysis of the rehabilitation needs and resources of a sample group of male patients leaving Crease Clinic, 1952-53 Sutherland, Robert Murray

Abstract

The return of the patient to the community is the goal of institutional treatment programs for mentally ill persons. The attention and effort made in recent years toward improved care of mental patients in hospital has also included consideration of the material and emotional needs of the patient at the point of leaving the hospital. This study examines the discharge situations of male patients treated at the Crease Clinic of Psychological Medicine at Essondale; and describes the role of social workers in patients’ re-establishment in the community. The needs and problems revealed by the study are examined in the perspective of a comprehensive rehabilitation service for discharged mental patients. The method used in the study was to compile pertinent information from the case records of 100 male patients discharged in a recent year. The information was extracted from the case records by means of a schedule. From this information was tabulated some of the common needs of patients leaving Crease Clinic. An analysis was then made of resources within the Clinic and in the community at large whereby the recorded needs might be met. A selection of case summaries was made to illustrate some typical problems. The factual material illustrated the variety and frequency of rehabilitation needs. For the mental patient these included not only material needs for housing and a job, but also intangible needs for support and help with continuing emotional stress. The interrelationship of outer material needs and inner emotional problems was noted. It was found that needs for housing and a job were a problem for approximately one patient in five; and that the proportion of patients who required help with inner stresses was approximately one in three. An examination of the resources available for meeting needs revealed significant gaps and limitations in the provision of subsidized boarding care and in the financing of vocational training. An over-all deficiency was apparent in the numbers of professionally trained social workers. In the concluding chapter there is suggested an operational definition of rehabilitation: a process whereby needs are met which enable the patient to become re-established as a citizen. There is a discussion of ways and means of narrowing the gap between needs and resources, and of the role of the social worker in community action. The development of social welfare resources for discharged mental patients is related to a network of community facilities concerned both with civilian rehabilitation and with mental health maintenance.

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