Everyday life following long term psychiatric hospitalisation.(Case study)

ABSTRACT

Although the immediate benefits of deinstitutionalisation are well documented, few studies have focused on the long term effects of lengthy psychiatric hospitalisation on everyday living. This narrative inquiry involved eight people who had spent more than four years in a New Zealand psychiatric institution. At the time of interview, they were living in unsupported accommodation in the community. Key findings reported here are that participants had few social contacts, and most reported not having enough to do. However, their belief that others know best and their acceptance of 'taking one day at a time' precluded expressing the need or desire for change or taking action to improve their situation. The provision of long-term support is recommended, along with further research to confirm the findings, investigate causative factors, and explore whether people deinstitutionalised from psychiatric hospitals and now resident in supported accommodation face similar issues.

KEY WORDS

narrative inquiry; mental illness; deinstitutionalisation; friends; family; activity

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In New Zealand, as in most western countries, the 1980s and 1990s saw many people deinstitutionalised after spending years as patients in psychiatric hospitals. This article concerns the experiences of eight individuals who now live in unsupported accommodation in the community, but who continue to have some involvement with publicly funded mental health agencies. Drawing on a qualitative study of expatients' experiences of life outside the institution, we explore the nature of their everyday activities, and how these individuals view living in the community and their dealings with mental health agencies. This research contributes to a small body of literature that utilises narrative analysis to interpret the experiences of individuals with mental illness.

The discussion opens with a brief history of deinstitutionalisation, and proceeds to the research question and methodology. Gergen and Gergen's (1986) model of narrative forms and Frank's (1995) typology of illness narratives are utilised in developing a theoretical frame for this study, and to guide the interpretation of participants' stories. In the next section, the participants are introduced, the specific ethical issues addressed within this study are identified, and an overview of the interview and analytical procedures is given. Finally, findings are presented, followed by discussion of concerns raised by the study and research directions it suggests.