Community Care--A Study of the Psychiatric Morbidity of a Salvation Army Hostel

Abstract

The decrease in the number of patients in mental hospitals since 1955 has been due in part to the introduction of the phenothiazine drugs and derivatives, and in part to the change in attitude of the community towards mental illness. The Mental Health Act 1959 stressed this change of attitude and amongst other measures empowered local authorities to provide hostel accommodation for patients who, though felt not to require medical or nursing care, are still in need of a sympathetic and sheltered environment. This run-down in mental hospital beds was expected by some authorities to continue. For example, Mr. Enoch Powell, when Minister of Health, stated in his inaugural speech to the Annual Conference of the National Association of Mental Health in March, i961, that he expected 'the acute population in mental hospitals to drop by half in the next 15 years, and the long stay population ultimately to dwindle to zero'. Many workers in the fields of psychiatry and sociology have disagreed with these views and have thought that patients are being discharged from mental hospitals without adequate after-care facilities and suitable accommodation. We thought it would be of interest to study the residents of a local Salvation Army Hostel to assess the psychiatric morbidity. The Salvation Army in its booklet Tragedies of Affluence states they provide 8,141 beds per night in 57 hostels in Britain. They believe that they only provide for some 25 per cent of the need, as they estimate that every night probably there are about 35,ooo men looking for lodgings. The Salvation Army analyses the men in their