Norman W. Bell

Family-Hospital Relationships in a State Hospital Setting: A Structural-Functional Analysis of the Hospitalization Process

THE mental hospital, like the school, is an institution with a double clientele. Patients are the direct and immediate consumers, but the patient’s family and the community are also involved and influence the patient’s view of himself and what is expected of the hospital. Traditionally, mental hospitals have focused upon the direct consumer and been organized for his care, custody, and treatment. Being thus oriented inwards, the hospital tends to develop a special subculture’ and to see many of its problems as emanating from and revolving about the patient. The indirect consumers then assume less importance. At times a disjunction of family and patient has been promoted. Currently the trend is to bring about a closer, co-operative relationship between family and hospital. The assumption is that this may be brought about simply because the mental hospital organization considers it to be desirable. This assumption is, we think, a product of the hospital’s inward orientation, and is not in accord with the realities of the complex process of practices that occurs when one family member is transferred to the care of a bureaucratic organization.