THE PSYCHIATRIC PATIENT IN THE COMMUNITY

IN their article on page 801 of this issue, Gordon Parker and Ron Barr have brought into focus the dilemma which faces the administrators of mental hospitals and mental health services with respect to the care of longterm patients. This is not the first time this issue has been raised in the past decade. Ever since mental hospitals embarked on a programme of placing psychiatric patients in the community, there has been conflict concerning whether or not such patients are gaining their freedom and independence or are being callously neglected in "a life of rootless wandering". There is not much doubt any more about the reality of institutionalization and the undesirable side-effects of prolonged confinement to a psychiatric hospital. Through the last three decades, mental hospitals in all parts of the world have seen various reform movements under such names as "total push", "milieu therapy", various types of therapeutic community and an almost infinite variety of rehabilitation and socialization programmes.