Rachlin S
Psychiatr Q. 1978 Fall;50(3):202-10. doi: 10.1007/BF01064710.
Deinstitutionalization of the chronically mentally ill has only recently been recognized as a phenomenon which may not be in the best interests of the patients involved. The reasons for this include the lack of adequate community-based resources for domiciliary, treatment, and rehabilitative services, plus the response of society to deviant behavior. However, the most fundamental problem is likely to be the severity of the illnesses with which we are concerned, so that the solution cannot be as simple as the sending "home" of the long-term patients. Prevention of institutionalization is seen as a more feasible goal than its cure. This requires a comprehensive program incorporating, among other things, a recognition of the necessary role of the mental hospital, and the need to improve the quality of care provided therein.
慢性精神病患者的非机构化治疗直到最近才被视为一种可能不符合相关患者最佳利益的现象。其原因包括缺乏足够的基于社区的居家、治疗和康复服务资源,以及社会对异常行为的反应。然而,最根本的问题可能是我们所关注的疾病的严重性,因此解决方案并非简单地将长期患者“送回家”。预防机构化被视为比治愈更可行的目标。这需要一个综合计划,其中包括认识到精神病院的必要作用,以及提高其提供的护理质量的必要性。