Recovery From Schizophrenia: Psychiatry And Political Economy

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ANTIPSYCHOTIC DRUGS: USE, ABUSE AND NON-USE 245• User-friendly medication strategies promote the use of low-doses ofantipsychotic medication in schizophrenia.• The best prognostic measures give a rather crude indication of which patientscan successfully be withdrawn from antipsychotic medication or treatedwithout drugs.• The principles of minimal drug treatment include a non-alienating, humanscaletreatment and living environment, individualized care, and family supportand education.
Chapter 11Work“Of all the modes by which the patients may be induced to restrain themselves,”wrote Samuel Tuke in his Description of the Retreat, “regular employment isperhaps the most generally efficacious.” 1 To the moral treatment advocates, infact, work was not merely a means to occupy and control their charges; it was acentral pillar of the moral-treatment edifice. William Ellis, superintendent of theHanwell Asylum, believed that proper employment “has frequently been themeans of the patient’s complete recovery.” 2 In 1830, Eli Todd wrote to thefamily of a patient about to leave the Hartford Retreat in Connecticut: “I cannottoo strenuously urge the advantage and even the necessity of his being engaged insome regular employment which shall hold out the promise of some moderatebut fair compensation to his industry and prudence.” 3 W.A.F.Browne,superintendent of the Montrose Royal Asylum, had this vision, in 1837, of theperfect asylum of the future:The house and all around appears to be a hive of industry. When you passthe lodge, it is as if you had entered the precincts of some vast emporium ofmanufacture: labour is divided, so that it may be easy and well performed,and so apportioned, that it may suit the tastes and powers of each labourer.You meet the gardener, the common agriculturalist, the mower, theweeder, all intent on their several occupations, and loud their merriment….The curious thing is, that all are anxious to be engaged, toil incessantly, andin general without any recompense other than being kept from disagreeablethoughts and the pains of illness. They literally work in order to pleasethemselves. 4Looking back upon such typically Victorian beliefs and dreams we may beexcused for doubting the extent to which they were grounded upon accurateobservation of the mentally ill and for wondering how far they merely reflectedthe prominent, middle-class work ethic of the day. Scottish philosopher ThomasCarlyle, for example, made the extravagant claim that “Work is the grand cure ofall the maladies and miseries that ever beset mankind.” 5 Nonetheless, we haveseen evidence to support the moral-treatment advocates in their emphasis on theimportance of work (Browne’s fantasies aside). As previous chapters have
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Recovery from SchizophreniaRecovery
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First edition published 1985by Rout
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ContentsAcknowledgments viIntroduct
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devotion to excellence in creating
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ixA NOTE ON THEORYThe materialist t
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Part IBackground
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WHAT IS SCHIZOPHRENIA? 3WHAT IS SCH
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WHAT IS SCHIZOPHRENIA? 5syphilis, n
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WHAT IS SCHIZOPHRENIA? 7Table 1.1-c
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WHAT IS SCHIZOPHRENIA? 9complete sy
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WHAT IS SCHIZOPHRENIA? 11patients w
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WHAT IS SCHIZOPHRENIA? 13publicatio
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WHAT IS SCHIZOPHRENIA? 15Figure 1.1
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WHAT IS SCHIZOPHRENIA? 17intrusiven
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WHAT IS SCHIZOPHRENIA? 19Figure 1.3
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WHAT IS SCHIZOPHRENIA? 21Brain stru
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WHAT IS SCHIZOPHRENIA? 23system. Th
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WHAT IS SCHIZOPHRENIA? 25One thing
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WHAT IS SCHIZOPHRENIA? 27of worth,
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Chapter 2Health, illness and the ec
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HEALTH, ILLNESS AND THE ECONOMY 31a
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HEALTH, ILLNESS AND THE ECONOMY 33i
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HEALTH, ILLNESS AND THE ECONOMY 35B
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HEALTH, ILLNESS AND THE ECONOMY 37s
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HEALTH, ILLNESS AND THE ECONOMY 39d
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HEALTH, ILLNESS AND THE ECONOMY 41F
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HEALTH, ILLNESS AND THE ECONOMY 43o
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HEALTH, ILLNESS AND THE ECONOMY 45T
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HEALTH, ILLNESS AND THE ECONOMY 47b
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HEALTH, ILLNESS AND THE ECONOMY 49F
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HEALTH, ILLNESS AND THE ECONOMY 51A
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Part IIThe political economy of sch
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RECOVERY FROM SCHIZOPHRENIA 55impro
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RECOVERY FROM SCHIZOPHRENIA 57categ
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RECOVERY FROM SCHIZOPHRENIA 59Table
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Table 3.1 -continuedRECOVERY FROM S
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RECOVERY FROM SCHIZOPHRENIA 73Figur
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Table 3.3 Recovery rates in the USA
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RECOVERY FROM SCHIZOPHRENIA 77the l
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THE POLITICAL ECONOMY OF SCHIZOPHRE
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MADNESS AND THE INDUSTRIAL REVOLUTI
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25 patients, and on the more distur
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Chapter 6Labor, poverty and schizop
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THE PERSON WITH SCHIZOPHRENIA IN WE
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Page 206 and 207: Chapter 9The incidence of schizophr
Page 208 and 209: THE POLITICAL ECONOMY OF SCHIZOPHRE
Page 230 and 231: Part IIITreatment
Page 232 and 233: ANTIPSYCHOTIC DRUGS: USE, ABUSE AND
Page 258 and 259: TREATMENT 247indicated, unemploymen
Page 260 and 261: TREATMENT 249success, for the lodge
Page 262 and 263: TREATMENT 251vocational programming
Page 264 and 265: TREATMENT 253the job is permanent.
Page 266 and 267: TREATMENT 255Social enterprises in
Page 268 and 269: TREATMENT 257pharmacy technicians a
Page 270 and 271: TREATMENT 259The situation seems to
Page 272 and 273: TREATMENT 261Though these results a
Page 274 and 275: TREATMENT 263• raise the minimum
Page 276 and 277: TREATMENT 265• Social policy inno
Page 278 and 279: TREATMENT 267Table 12.1 Living situ
Page 280 and 281: TREATMENT 269A JAIL DIVERSION PROGR
Page 282 and 283: TREATMENT 271the office work and th
Page 284 and 285: TREATMENT 273One might imagine that
Page 286 and 287: TREATMENT 275studies may be the res
Page 288 and 289: TREATMENT 277established for some o
Page 290 and 291: TREATMENT 279Another residential pr
Page 292 and 293: TREATMENT 281interest loans and gra
Page 294 and 295: TREATMENT 283individual’s goals s
Page 296 and 297: TREATMENT 285Cognitive therapy, it
Page 298 and 299: TREATMENT 287Table 12.2 Facts about
Page 300 and 301: TREATMENT 289consumers and professi
Page 302 and 303: TREATMENT 291definitively not part
Page 304 and 305: FIGHTING STIGMAAlthough the mentall
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TREATMENT 295The National Alliance
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TREATMENT 297other medical disorder
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TREATMENT 299when a psychiatrist an
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NotesINTRODUCTION1 Harris, M., Cult
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NOTES 30333 Heston, L.L., “Psychi
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NOTES 30557 Sham, P.C., O’Callagh
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87 Dohrenwend, B. and Egri, G., “
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NOTES 30929 Srole, L., Langner, R.S
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NOTES 311unemployment cause the dea
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NOTES 313107 Warr, P., “Studies o
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138 Dear, M., Clark, G. and Clark,
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NOTES 3178 Epstein, L.J., Morgan, R
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NOTES 31943 Quirk, A. and Lelliott,
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NOTES 32349 Walton, “Pauper lunat
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105 Bockoven, J.S., Moral Treatment
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NOTES 32729 For positive evaluation
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66 Barker, D., “Moscow mayor has
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NOTES 33133 World Health Organizati
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NOTES 33380 Eliade, M., Shamanism:
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NOTES 335homelessness a mental heal
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NOTES 337Academic Press, 1978; Faul
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NOTES 339Washington, DC: House of R
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NOTES 34194 Read, J. and Baker, S.,
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132 Robinson, J.R and Shaver, P.R.,
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NOTES 345“Schizophrenia is not di
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NOTES 34748 Bagley, C., “The soci
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NOTES 34979 ni Nuallain, M., O’Ha
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NOTES 3514 Kapur, S. and Seeman, P.
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NOTES 35327 Pasamanick, B., Scarpet
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NOTES 355Archives of General Psychi
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NOTES 357“Prognostic factors in r
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NOTES 359Chandler, D., Meisel, J.,
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30, 1978; Moffit, R., “The econom
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NOTES 36312 Stein, L.I. and Test, M
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NOTES 36547 Personal communication,
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NOTES 367European Psychiatry, 15:26
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BibliographySTUDIES OF THE OUTCOME
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BIBLIOGRAPHY 371Horowitz, W.A. and
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BIBLIOGRAPHY 373Salokangas, R.K.R.,
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AUTHOR INDEX 375Dunham, Warren 31Du
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AUTHOR INDEX 377Urquhart, M.C. 129n
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SUBJECT INDEX 379atypical 20;compan
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SUBJECT INDEX 381CESP see Carer Edu
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SUBJECT INDEX 383disability pension
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SUBJECT INDEX 385diagnosis of 148;d
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SUBJECT INDEX 387Isle of Wight 33is
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SUBJECT INDEX 389Middlesex, Hanwell
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SUBJECT INDEX 391PACE see Personal
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SUBJECT INDEX 393economic condition
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SUBJECT INDEX 395self-employment 15
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SUBJECT INDEX 397symbolic thinking
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SUBJECT INDEX 399volition disturban
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