Some factors predisposing to institutionalism in chronic psychiatric patients

Liberakis, Eustace Anastasios (1977) Some factors predisposing to institutionalism in chronic psychiatric patients. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Institutionalism ("institutional neurosis"), the mental and social impoverishment of long-stay psychiatric patients, has been observed by previous researchers to be the result of poverty of the social environment in the mental hospital, the result of lack of contact with the outside world, and the result of idleness. -- The present research includes a survey of all psychiatric patients staying in hospital supervised boarding homes and of a random sample of patients in the wards of the only mental hospital in Newfoundland. The main objective was to determine if certain premorbid factors predispose to institutionalism. -- The researcher examined the patients, interviewed those in charge of the patients, and reviewed the hospital records for "hard data". Institutionalism was measured through the rating scale "social withdrawal", a scale constructed, validated and used by previous researchers of institutionalism. -- Two hundred seventy four patients in boarding homes and fifty random long-stay hospital patients were surveyed. 29.6% of the boarded patients and 80% of the hospital ward patients were found to suffer from institutionalism. Low intelligence, poor education and disabilities in hearing, speech, locomotion and manual dexterity, were significantly associated with institutionalism. Extremes of age on first admission, celibacy, low occupational status in the patient or his father, and visual disability did not prove to be associated with institutionalism. -- Those patients who were found to suffer from institutionalism, despite the fact that they were not cut off from the outside world (i.e. those visited and visiting their homes), tended to be threatening in manner, deluded or affected in their hearing. -- The findings of this research appear to support the following: -- a. Institutionalism is not confined to hospital wards but may appear in boarding homes. The findings of other researchers that social skills of a psychiatric patient do not improve by stay in a boarding home are confirmed. -- b. Some patients are more susceptible to institutionalism than others. -- c. Institutionalism tends to be associated with those biological or social handicaps which affect communication and activity of the patient.

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