Colin M. Smith

Mental hospital depopulation in Canada: patient perspectives.

This paper reviews briefly the history of mental health depopulation in Canada over the past 30 years. The term “deinstitutionalization” is often used but is unsatisfactory. Using an exploratory, qualitative, methodological approach, data were collected on the problems encountered by a disproportionate, stratified random sample of 139 formerly institutionalized patients living in various geographical locales in Eastern Canada. Adopting a symbolic interactionist theoretical approach, this study, in an effort to fill a neglect in the literature, attempted to discover what the everyday world(s) of Canadian ex-mental patients was really like. Problems encountered related to stigma, poor housing, lack of back living skills, poverty, unemployment and aftercare. Quotations from patients are provided to illustrate such themes. The findings are discussed.

FOLLOW‐UP AND THE MEASUREMENT OF CHANGE IN PSYCHIATRIC PATIENTS

This report describes a follow-up study of psychiatric patients based on self-reports obtained in a controlled interview situation. Some of the methodological difficulties arising in such studies are discussed and a plea is entered for an augmented and more scientific utilization of patient self-reports despite their obvious limitations. Finally an attempt to improve measures of change is described. This involves the planned inclusion of suppressor variables in order to control for sources of variation in the level of reporting and yields a more sensitive index of improvement.

From hospital to community: a system changes.

Interest in the community and institutional aspects of mental health care in Saskatchewan goes back to the early history of the province, but it is the last 15--20 years which have seen the most exciting developments. During this time the province has changed from having one of the highest mental institutionalization rates in the world to one of the lowest. One mental hospital was phased out and the other reduced to a shadow of its former self. An account of the changes which occurred during this period is given together with the story of the stresses generated. Finally, a 1979 perspective is offered on the Saskatchewan psychiatric program.