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The power of attendants at state mental hospitals to influence policy has often been noted. This paper suggests that the distribution of power in the state mental hospital fails to conform to Michels's "iron law of oligarchy." From an analysis of the ward system, three main characteristics are derived. These are then stated as the formal characteristics of a front-line type of organization in which power tends to be distributed to peripheral units rather than to centralized positions of leadership. It is suggested finally that a front-line type of organization presents special problems of control and hence will tend to develop characteristic structures and processes of control as solutions. [ABSTRACT FROM AUTHOR]

As the liberalizing tendencies of modern reforms change the orientation of mental hospitals from "custodialism" to "humanitarianism," administrators become involved in new kinds of interdependent relationships with the treatment staff. This paper examines an episode of administrative disturbance which was deliberately tolerated within a hospital because of the treatment potential it engendered. Administrative collaboration is seen as not merely necessary in providing a favorable setting for treatment but as an integral part of the treatment itself. [ABSTRACT FROM AUTHOR]

Hospitalized mental patients are increasingly being discharged into the community. Yet, despite the construction of hundreds of community mental health centers, readmission rates continue to rise. This paper analyzes the reasons for this problem and provides suggestions for its solutions. [ABSTRACT FROM AUTHOR]

This article constructs a Terminators-Remainers scale composed of those items of the Social History Questionnaire that best differentiated between Terminators and Remainers. A formidable problem encountered in clinical practice concerns the large number of clients who start psychotherapy but for various reasons terminate treatment prematurely. The initial sample of this study consisted of 95 clients accepted for psychotherapy during a 11-month period at a small mental health clinic. The measure used was the Social History Questionnaire, a 393-item, forced-choice, pencil-and-paper intake interview.

This paper reports selected results of an investigation of staff response to psychiatric innovations in a total institution. A sociometric analysis indicated that staff integration and acceptance were associated whereas staff disintegration was related to resistance. The head nurse of each treatment team investigated proved to be a crucial figure in determining the reaction of nursing personnel. These findings tend to sup port explanations of innovation adoption and diffusion involving the "Gatekeeper" in combination with group integration. [ABSTRACT FROM AUTHOR]

This article focuses on some research programs for or by the U.S. armed forces regarding their personnel. Research in the field of mental adjustment in the armed forces consisted of selection studies which used tests mainly of the paper-and-pencil variety to appraise the emotional stability of servicemen mid studies which attempted to make the same assessment on the basis of psychiatric interviews, situation tests, and other screening procedures. Responses given by well-adjusted soldiers were markedly different in many respects from norms based on well-adjusted civilians. The hypothesis was advanced that personality constriction and regression were produced by military indoctrination. Some discussed a study of the sociological, personality, and adjustment characteristics of hospital patients who supposedly broke under camp life, of veterans in a mental hospital, and of well-adjusted soldiers. A program consisting of an interview in which past history rating was obtained, a standardized life-like construction test which yielded ratings on seven basic traits related to combat leadership ability, a specially devised sensori-motor test, a rapid projection test.

The article presents a discussion related to the use of a hospital volunteer program in the teaching of abnormal psychology. The participation of college students in the volunteer programs of mental hospitals is by now almost commonplace. In 1954, one of the first of such programs sprang up in the Boston, Massachusetts, area as the result of the efforts of a group of Harvard students. At that time and in that locale, students were responding to some serious service needs of one of the nearby state institutions and developed what at first was a somewhat loosely structured program which attracted the involvement, in varying degrees, of over 500 college students from the Boston area. This particular program has continued to thrive, having been expanded in recent years to include a "Halfway House" for mental patients where a group of students live with a group of recently discharged patients who are attempting to readjust to community life. The educational value of such activities has been recognized at Harvard, where a course in Volunteering affording full academic credit has been established in the Department of Social Relations. It is with the educational feature, or, more specifically, usefulness of such a program as an adjunct to an undergraduate course like the traditional one in abnormal psychology, that this paper is concerned.

This paper attempts to integrate theoretically the Bales-Parsons model of small groups and a theory of complex organizations. The organizational positions of the instrumental and expressive leaders are seen as critical variables, affecting both the fulfillment of the functional needs of participant groups and the groups' commitment to organizational goals. Complex organizations are distinguished according to the nature of their goals, power employed. and the level of lower-echelon commitment they require. The relations between the small group and the complex organization are reviewed for each kind. These theoretical consideration are applied to the study and administration of prisons, the "Human Relations" approach in industry, therapeutic mental hospitals, and schools. [ABSTRACT FROM AUTHOR]

This has been suggested that when a patient on a mental hospital ward becomes the object of covert disagreement among staff members, he will respond by an intensification of behavioral disturbance, and that this will subside only when the disagreement is exposed and resolved. This paper reports on an empirical investigation of this hypothesis, utilizing standard measures of disturbance and consensus. It was found that no significant relation could be demonstrated, for individual patients, between direction of change in staff consensus concerning patients and direction of change in their level of disturbance. [ABSTRACT FROM AUTHOR]

This paper attempts to examine the decision-making process in a small, institute type of psychiatric hospital in terms of the differences in real, perceived, and ideal influence patterns of 53 mental health specialists. It was hypothesized that these decision-making patterns would reflect the influence of a dual criteria system with respect to the organization and functioning of the hospital. These criteria are, first, the traditional medical bureaucracy and, second, the currently emphasized "team" or equalitarian approach regarding the care and treatment of patients. Under investigation were the nature and implications of this organizational dualism for both the involvement of staff members in the on going decision-making process and their evaluations of this process. [ABSTRACT FROM AUTHOR]

This paper will deal with the transition from adjustment in the mental hospital to readjustment in the family and community. The problems of the mental hospital which are of interest for the sociologist fall into three main groups. The first includes those processes which take place before the patient is committed, the second, those which take place in the hospital; the third, those which function to release the patient from the hospital and rehabilitate him to his family and community. The mental hospital is designed as a temporary place of treatment and cure. The hospital and community environments differ in their demands upon the individual, adjustment in the hospital does not assure adjustment in the community. Convalescents are released to the community where they must assume responsibilities, where good readjustment demands assuming a good many responsibilities, and considerable initiative. Hospital facilities extend only partially into the community and are limited by the commitment of the patient.

This paper evaluates the cost-effectiveness of a specialized geriatric program in a California mental hospital by analyzing the movement of patients into, through, and out of the program. The procedure for modelling the patients' movements between states with a Markov chain is detailed and the results analyzed. First passage times, long-term trends, and stay times until death are derived as well as the associated costs the hospital must endure. Lastly, ways to simulate the effect of possible program modifications are illustrated. [ABSTRACT FROM AUTHOR]

An account is given of the creation and management of an in-patient therapeutic programme for male alcoholics at Bellsdyke Hospital, Larbert, Stirlingshire, commencing with a selected group within a psychoneurotic unit which it was found necessary to convert into an unstaffed alcoholic unit with often admission procedure. Statistics over a two-year period are provided and discussed. In the discussion which followed an attempt was made to answer a series of questions posed by the experience involved. For their advice and support in the preparation of this Paper, I would like to thank Dr. A. P. Russell, Physician Superintendent, Bellsdyke Hospital, Larbert; Dr. D. A. Pemberton, Consultant Psychiatrist, Bellsdyke Hospital, Larbert; Dr. A. B. Sclare, Consultant Psychiatrist, Eastern District Hospital, Glasgow; Professor Ferguson Rodger. Chair of Psychiatry. Glasgow University; and Dr. R. J. Simpson, Registrar in Psychiatry, Bellsdyke HospitaL Larbert. [ABSTRACT FROM AUTHOR]

On the basis of a community need seen during the years it operated an Information and referral service, Mental Health Association of Westchester County moved, with the help of the psychiatric division of a voluntary hospital and a private psychiatric hospital, to establish and operate a suicide prevention center. This paper presents the staff's experience during the first year of the service's operation-Including problems with community and professional resistance-and offers suggestions as to essential ingredients of an effective service. [ABSTRACT FROM AUTHOR]

The article informs that clinical psychologists are so well aware of the place they have won in mental hospitals that it may be a source of either surprise or scorn to learn that some mental hospitals are still unprovided with such service. No propaganda is needed except that where a hospital lacks such service one may well point out to its director or governing board that other mental hospitals not far away think very highly of psychological service. In contrast with the isolationist attitudes discussed above are powerful movements tending to work for greater cooperation and integration of all scientific specialties. Particularly in modern medicine are there active trends toward inter-group coordination.

This paper reports results of an attempt to specify one of the circumstances in which suicide among patients in a mental hospital is most likely to occur, without having to use data which depend on retrospective evaluations of the psychological or motivational adequacy of individuals involved in caring for the patient at the time of his death. Stated simply, the relative size and turnover rates of mental hospital personnel and patient populations are shown to bear a significant relationship to the time at which the suicide occurred. [ABSTRACT FROM AUTHOR]

The article attempts to ascertain whether there are measurable differences in the symmetrical accuracy of Human figure drawings (HFD) of schizophrenics and nonpatients. The schizophrenic patients used in the present article were all recent admissions to a psychiatric hospital, while the nonpatients had no known psychiatric hospitalization. The HFD of the two groups were compared, and all five of the symmetry variables along with the total width of the drawing were related to the level of adjustment of the drawer.

Previous theory and research in role conflict provided empirical tools and hypotheses regarding conflict resolution. A pencil-and-paper conflict situation was administered to workers in a mental hospital, a setting previously described as conflict- ridden. A positive association was found between mode of conflict resolution, ideology and worker's effectiveness as a hospital employee. [ABSTRACT FROM AUTHOR]

The increasing concern with social structural factors affecting the treatment process of the hospitalized mental patient has led to a reconsideration of the organization of services provided for patients in these settings. A new format-the unit system-has been designed to enhance the therapeutic potentiality of the large mental hospital by decentralizing the treatment activities of both patients and staff members. This paper examines the unit system in terms of organizational theory, indicating some of the more problematic issues and concerns activated by a decentralization move. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to demonstrate that "total institutions," specifically state operated mental hospitals, contain two cultures: (1) that brought by the inmates and (2) that found in the "institution." Attempts to develop a therapeutic milieu in mental hospitals have been largely directed to `modification of the social structure and have largely ignored cultural norms. There appears to be an implicit assumption that a therapeutic community may be achieved through a social structure with certain universal characteristics. A study of selected background norms of patients in one such "therapeutic milieu" revealed significant differences from the norms of behavior maintained on the ward. [ABSTRACT FROM AUTHOR]

90 functionally psychotic Ss and 90 nonhospitalized Ss were given varying amounts of failure and nonfailure experiences on a puzzle task. These experiences were temporally associated with a neutral paper-and-pencil task. Tests were made for any differential effect upon preference for the neutral task after this association. A 3-dimensional analysis of variance design yielded significant results (beyond the .01 level) only in the groups of psychotics subjected to failure. These Ss lowered their preference for the formerly neutral task. The results may indicate a loss in the psychotic's ability to respond differentially and appropriately to individual experiences. [ABSTRACT FROM AUTHOR]

In the research reported here, the authors look at the state mental hospital system in its more traditional, chronic, or custodial institutional form. Particular attention has been paid to understanding the perspectives of state hospital workers, the basic institutional conditions of their work, and the relationships between these elements. The aides and practical nurses who run the wards are people of lower class origins, who operate with common sense, relatively non-abstract notions. While they work within the concrete province of psychiatry, they think and talk outside of the psychiatric universe of discourse. The problems of state hospital workers center upon providing a modicum of decent care for large masses of patients with a minimum of resources at hand. The ward workers are confronted with a number of responsibilities with respect to this mass of patients. In this research paper, the author has viewed the state hospital social system as a consequence of a number of conjunctive phenomena which have also been noted by other investigators: the social, political, and administrative requirements, social class and other extrapsychiatric characteristics of the personnel, patient-personnel ratio, and the routines of the hospital.

A different type of psychiatric emergency program is described and preliminary data concerning its operation are presented. The program provides emergency service ranging from outpatient visits to twenty-four hour care. Further reports are anticipated. [ABSTRACT FROM AUTHOR]

Tsukisoi are sub-professional nurses who, in private psychiatric hospitals in Japan, are assigned on a one-to-one basis to patients. The tsukisoi cares for the patient continuously throughout his hospitalization. The work of this role group and its place in the social structure of the hospital are described. Correspondences are drawn between the behavior of the tsukisoi in her technical role and the behavior exhibited in more general roles, such as that of mother, in Japanese culture. The position of the tsukisoi in the power structure of the hospital is seen in relation to the structure of power groupings in organizations such as the Japanese company or factory. Some of the wider sociological and psychodynamic implications of the role of the tsukisoi are discussed. [ABSTRACT FROM AUTHOR]

A number of recent studies of the structure and functioning of the mental hospital have attempted to focus attention upon the nature of and the operational consequences of status differences among participating professional clinical personnel. These investigations have to a large extent been guided, implicitly or explicitly, by a major assumption concerning the effects of status differentiation upon the care and treatment of patients. The study reported in this paper attempts to specify some of the conditions and circumstances which influence staff perceptions of accorded and desired status. The findings indicated that professionals tend to perceive their actual and preferred status through the eyes of their profession or specialty. All specialists agreed on the status hierarchy as presently constituted but disagreed on the ideal status and prestige gradations. Those occupying the upper rungs of the status ladder underestimated their own status when compared to the amount ascribed to them by the other professions. Similarly, the ancillary professional specialists overestimated their own status.

This paper presents a study of the perceptions and beliefs, the cognitive structures, found among staff members of a psychiatric ward in a British Psychiatric Hospital. It is based on the analysis of data from a cognitive grid test, which was devised during field research. The evidence suggests that members of small groups do not share a single, common structure of perceptions and beliefs, rather that a complex relationship exists between the social structure of the group and the beliefs its members hold. Cognitive structure or organization here refers to the degree of rigidity or flexibility that characterizes an individual's perceptions. It is suggested that a person who is highly structured perceives in a more global way than a person who is less structured. The data from the cognitive grid test offer a partial insight into whatever cognitive structures might exist with a group. The guiding hypothesis of the present study is that, contrary to previous assumptions, especially by those working in componential analysis, there are no grounds for assuming that people who are similar in position or social status necessarily possess a similar cognitive structure. Indeed, relationships between cognition and social structure may be very complex. [ABSTRACT FROM AUTHOR]

The article presents the paper that discusses about Hollymoor Hospital, an urban mental hospital located at the southwest of Birmingham, England. An analysis was done on the data related to the build-up of the long-stay patients resident for two years or more in the hospital, the reception area, the staff, as well as the total patient population. The patients who stayed long in the hospital starting December 31, 1964, and details of the patients admitted during the period 1953-62 were examined. There was a prediction in the hospital's future long-stay bed need. The causes of prolonged institutionalization were emphasized. The remedies and the provision of specialized facilities for treatment and research were suggested as the proper function of this urban mental hospital in the future.

The article decribes the types of group work to be adopted in mental hospitals in Great Britain for pyschiatric treatment. This papers tried to expressed that it is impossible to consider group treatment in psychiatric hospitals without referring to the social structure of the hospital as a whole. Psychoanalytic group is for out-patient groups of selected patients with psychoneurotic problems and familiar with conceptual thinking. Ward meetings involve 60 patients with a staff who comes in contact with them. Family group is a case for every patient seen in relation to his family, in which the family should be involved at the initial interview. In activity groups, five patients are formed into a group and activity program are developed within their competence.

The article examines the psychiatric practice and profession in Kuwait. Neuropsychiatric patients were usually taken to a mullah or teacher who will blow on him in a prescribed ritualistic manner or write certain words on paper which will be wrapped in cloth and suspended on a string from the patient's neck or arms. By 1945, the first mental hospital was established with from the conversion of an old prison with staff consisting of eight psychiatrists. The economic and general medical situation of the country

The article demonstrates how psychological instruments can be utilized in the understanding and study of organizational processes in the mental hospital. The instruments consist of two attitudinal or ideology scales and a measure of role-conception. The attitude scales are the Custodial Mental Illness Ideology Scale (CMI) and the Opinions About Mental Illness questionnaire (OMI). The following four occupational groups were administered the three instruments: the New Psychiatric Aides, Older Aides, Business Maintenance, Clinical Group.

The article cites a study that aims to investigate whether a relationship exists between psychiatric patients' hospital adjustment and their attitudes toward hospitals, to observe patients' feelings about mental hospitals, and to see whether a difference exists in attitude scores of patients on different wards. The Hospital Adjustment Scale provides an estimate of hospital adjustment for use with adult patients of either sex hospitalized in any type of psychiatric institution. The Southern Attitude Scale is a Thurstone-type attitude scale consisting of 72 statements about mental hospitals with which the subject either agrees or disagrees.