Beruflich Dokumente
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compared with 46 percent for the I
0
plans must be perceived by pa- have restricted their lives to a per- lenge. Edited by Jones BE. Washing-
ton, DC, American Psychiatric Press,
tients as relevant and meaningful petual search for survival.
1986
to their needs (20,2 1). The authors Deinstitutionalization was envi- 8. Roth D, Bean GJ: New perspectives
believe that if assistance is de- sioned as a process through which on homelessness: findings from a state-
signed with this principle in mind, patients could be cared for in the wide epidemiological study. Hospital
and Community Psychiatry 87:712-
patients are more apt to accept community. This study suggests
719, 1986
services and comply with treat- that the principles underlying the 9. Barrow 5, Lovell AM: Evaluation of
ment. This point is illustrated by policy were not wrong. It is possi- Project Reach Out 1981-1982. New
the fact that although 7 1 percent of bbe to maintain patients in the York, New York State Psychiatric In-
stitute, 1982
experimental subjects were admit- community humanely if compre-
10. Segal SP, Baumohl J: Engaging the
ted to the index hospitalization in- hensive and integrated resources disengaged: proposals on madness and
voluntarily, they all accepted resi- exist. By pursuing community psy- vagrancy. Social Work 25:358-365,
dential placement at discharge. chiatric treatment with greater 1980
However, services must be economic and social vigor, while 1 1. Talbott JA, Lamb HR: Summary and
recommendations, in The Homeless
more than simply meaningful; they acknowledging our limitations, we
Mentally Iii. Edited by Lamb HR.
must also provide the patient with can develop a mental health care Washington, DC, American Psychiat-
a sense of decency, security, and system with the capacity to make nc Association, 1984
dignity. We suggest that it is not deinstitutionalization a viable actu- 12. Stein LI, Test MA (eds): Alternatives
meaningful, humane, or ,therapeu- ality rather than a discarded social to Mental Hospital Treatment. New
York, Plenum, 1978
tic to offer a fragile individual shel- theory. 13. Cohen CI, Sichel WE, Berger D: The
ter in an overcrowded facility use of a mid-Manhattan hotel as a
where clients prey upon those Acknowledgments support system. Community Mental
even more unfortunate than them- HealthJournal 12:76-83, 1977
The authors gratefully acknowledge 14. Fairweather GW: The prototype lodge
selves. the contributions of Anne Hardesty, society: instituting group process prin-
The configuration of the service Ph.D., Gary Gulbenkian, Adam ciples. New Directions for Mental
delivery system must be malleable Smith, Lou Cuoco, Peter Micheels, Health Services 7:13-32, 1980
enough to accommodate patients Rose Occhino, the clinical staff of the 15. Cutler DL, Beigel Al: A church-based
functioning at different levels or New York University Medical Center program of community activities for
chronic patients. Hospital and Com-
manifesting different types or de- and Bellevue Hospital Center, and the
munity Psychiatry 29:497-501, 1978
grees of psychopathology. There staff of the St. Francis Residence.
16. Levine IS: Service programs for the
are some patients for whom resi- mentally ill, in The Homeless Mentally
dential treatment such as that pro- Ill. Edited by Lamb HR. Washington,
References DC, American Psychiatric Association,
vided at the St. Francis Residence
1984
is not appropriate. Some patients 17. Burdock El, Hardesty AS: The Struc-
1. Lipton FR, Sabatini A: Constructing
may be too functionally disabled to support systems for homeless chronic tuned Clinical Interview. New York,
be maintained in a community set- patients, in The Homeless Mentally Ill. Springer, 1967
ting, while others may not tolerate Edited by Lamb HR. Washington, DC, 18. Caton C, Muller C, Spitzer R: The
American Psychiatric Association, 1984 Community Care Schedule. New
the degree of structure imposed on York, New York State Psychiatric In-
2. Bachrach U.: The homeless mentally ill
them by such a program. In con- and mental health services: an analyti- stitute, 1981
trast, there may be some patients cal review of the literature, in The 19. FleissJL, Dunner DL, Stallone F, et al:
who are capable of more indepen- Homeless Mentally Ill. Edited by Lamb The life table: a method for analyzing
HR. Washington, DC, American Psy- longitudinal studies. Archives of Gen-
dent living than is offered by resi-
chiatric Association, 1984 en Psychiatry 33:107-112, 1976
dential treatment. 20. Bachrach LL: Overview: model pro-
3. Fischer PJ, Breakey WR: Homeless-
The effects of deinstitu- ness and mental health: an overview. grams for chronic mental patients.
tionalization should no longer be International Journal of Mental Health American Journal of Psychiatry
the focus of political or psychiatric 14:6-41, 1985 137:1023-1031, 1980
4. Arce AA, Tadlock M, Vergare MJ, et 21. Goldfinger SM, Chafetz L: Developing
debates. We would better serve
al: A psychiatric profile of street peo- a better service delivery system for the
our patients and the community by pie admitted to an emergency shelter. homeless mentally ill, in The Home-
focusing attention on developing Hospital and Community Psychiatry less Mentally Ill. Edited by Lamb HR.
strategies for improving care and 34:812-817, 1983 Washington, DC, American Psychiat-
quality of life. By permitting chron- 5. Bassuk El, Rubin L, Lauriat A: Is home- nc Association, 1984
lessness a mental health problem? 22. Pardes H, StockdillJW: Survival strat-
ic patients to live on the streets,
American Journal of Psychiatry 141: egies for community mental health
clothed in tattered rags, scavenging 1546-1550, 1984 services in the 1980s. Hospital and
through trash for sustenance, and 6. Lipton FR, Sabatini A, Katz SE: Down Community Psychiatry 35:127-132,
sleeping over street grates for and out in the city: the homeless men- 1984
warmth, have we not allowed the tallyill.Hospital and Community Psy- 23. Bachrach a: Is the least restrictive
chiatry 34:817-821, 1983 environment always the best? Socio-
concept of least restrictive envi- 7. Lipton FR, Micheels P, Sabatini A: logical and semantic implications. Hos-
ronment (23) to reach its surrealis- Characteristicsand service needs of the pital and Community Psychiatry
tic endpoint? By denying patients homeless mentally ill, in Treating the 31:97-103, 1980