The pattern of frequent discharges and readmissions which characterizes most psychiatric hospitalization in this country today was described, and it was argued that the costs of this “revolving door” outweigh such benefits as might be derived from it. An alternative stepwise progression model of aftercare was proposed. This model identified community tenure as the most appropriate goal for initial aftercare efforts.
Attempts to identify correlates of the establishment of community tenure by mental hospital releasees were reviewed. It was found that the ex-patient's ability to remain in the community is not highly correlated with the extent to which he manifests deviant behavior. This finding was interpreted as an indication that environmental factors may play significant part in ex-patients’ avoidance of rehospitalization.
Data were presented which indicated that a clear majority of mental hospital releasees take up residency immediately with family members. It was hypothesized, then, that measurable family variables are correlated with the ability of the ex-patient to achieve community tenure.
An attempt was made to examine this hypothesis in the light of relevant research. Studies of the issue which contained substantive empirical support were categorized into four topic areas: family tolerance of the ex-patient's symptomatic behavior, kin role which the family affords to the ex-patient, familial expectations of the ex-patient's performance, and family attitudes and personality characteristics.
After reviewing the studies of authors who attempted to assess the degree of correlation between the capacity of the ex-patient’s family to tolerate symptomatic behavior on the part of the ex-patient and the ex-patient’s ability to avoid rehospitalization, it was concluded that the linear correlation between the two variables which would be predicted logically may not exist.
A review of studies of the relationship between the kin role which the ex-patient's family affords to him and the ex-patient's ability to achieve community tenure yielded a tentative conclusion that returning to the social biological role of “child” (son or daughter) as opposed to the kin role of spouse was positively correlated with remaining in the community.
After examining studies which attempted to explore the relationship between familial expectations of instrumental performance on the part of the ex-patient and the ability of the ex-patient to avoid rehospitalization, it was concluded that little support was provided for the hypothesis that the two variables are related.
A survey of attempts to identify family attitude and personality characteristic correlates of ex-patient achievement of community tenure resulted in arrival at the conclusion that such efforts, as a whole, have met with little success, although significant correlations between two general family attitudes toward mental illness and ex-patient avoidance of rehospitalization were found.
Considering the findings which were reviewed as a whole, it was concluded that little support was provided for the hypothesis that measurable family variables are correlated with the ability of the ex-patient to achieve community tenure. The rather limited aftercare practice applications which could be drawn from the few correlations that have been discovered were described, and implications of the over-all finding for future research were discussed.
| Identifer | oai:union.ndltd.org:pdx.edu/oai:pdxscholar.library.pdx.edu:open_access_etds-2655 |
| Date | 01 January 1973 |
| Creators | Chambers, Thomas Mack |
| Publisher | PDXScholar |
| Source Sets | Portland State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Dissertations and Theses |
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