SOCIAL FACTORS IN THE PLACEMENT OF THE CHRONIC SCHIZOPHRENIC PATIENT

Our findings are that the ataraxic drugs do improve the condition of chronic patients sufficiently to effect leave for 25% as compared with 1%-4% in the past, and that various social factors appear related to leave potential. We are left, nonetheless, with 60% to 75%⁷ of the chronic patient population on our hands in the 20 to 50 years of age and 2 to 10 years hospitalized group, even after intensive drug treatment.

The best planning now stresses the need to strengthen community ties—to build mental health centers and various day, night and other bridging facilities,⁸ to decentralize hospitals and/or see them as only one posibility in a whole gamut of services and the drugs have made this more than ever possible for the majority of new and acute patients. But when we look at the chronic patient, we are led to ask, "What community ties?" and to suggest that for the chronic patient we have not only to strengthen ties but possibly to build and preserve a whole community—a community so shaped that in it he, too, can make a functional contribution.