Surviving psychiatric insritutionalisation: a case study

Abstract

This paper looks at the impact of psychiatric hospital treatment on the life of a man who spent almost forty years in a large mental hospital in Northern Ireland. Patient behaviour and staff experience of this behaviour are examined within the conceptual framework proposed by Erving Goffman. This man's story once again challenges the notion of the ail-pervading power of the institution, and affirms the ability of some individuals to maintain a strong personal identity in spite of being officially labelled as deviants and separated from society because of this label. It also challenges the assumption that institutional living in itself, stigmatises and therefore isolates an individual from normal social networks. It is argued that in order to predict the impact of voluntary or compulsory institutionalisation, not only must the identity-construct of the individual be considered, but also the social position of the institution within the community.

Understanding psychiatric institutionalization: a conceptual review

“…Linked to this, psychiatric institutionalization has been seen as providing protection and care to patients who are chronically mentally ill [46,48-51]. It has been highlighted that even the best community care does not offer enough care and protection for the many chronically mentally ill and the need for sanctuary and asylum can only be provided as an institution of some kind [48].…”

“…Samuel, a typical case of a single patient, who spent 36 years in a large mental hospital in Northern Ireland, was reported as an example of a patient utilizing the hospital as a lodging house. Meanwhile he did odd jobs such as gardening for his fellow churchgoers and went to church regularly in his last ten years [51]. He had been an involuntary patient for the first 25 years of his stay and then refused to be discharged from the institution because he was happy with his life at the time.…”

Working in the public and private domains: staff management of community activities for and the identities of people with intellectual disability

“…Disclosure of a stigmatized identity has been declared to be a problem for a number of groups of people ( Edgerton 1967; Goffman 1968; Levitin 1975; Plummer 1975; Ponse 1976; Schneider & Conrad 1980; Matthews & Matthews 1986; Miall 1986; Alonzo & Reynolds 1995; Prior 1995), and the implications of a particular distribution of knowledge concerning an identity and the social interests it serves have been widely commented upon (see, Plummer 1975; Ponse 1976). Typically, the stigmatized individual is considered responsible for managing ‘closed awareness contexts’.…”

“It is a different world in here”: collective identification and shared experiential knowledge between psychiatric inpatients

“…Most research concerning everyday life in psychiatric wards dates back to the 1990s and before (e.g. Blau , Caudhill , Goffman , Prior , Rogers and Pilgrim ), while only a few studies have investigated inpatient hospital care today (e.g. Lincoln , Phillips and Johnson , Pols , Quirk et al .…”