Recovery From Schizophrenia: Psychiatry And Political Economy

TREATMENT 267Table 12.1 Living situation of the 720 people (age 18 and over) with a psychoticdisorder who were clients of the Mental Health Center of Boulder County on January1, 2002Figures are derived from a 42 per cent sample.* Group homes with varying levels of staffing.** All nursing home patients suffer from physical illness that requires nursing care, thelarge majority being over age 65.• aggressively pursue the client’s interests—ensuring that other social agenciesfulfill their obligations, for example, or actively searching for those who dropout of treatment;• provide a range of supportive services that can be tailored to fit each person’sneeds and that will continue as long as they are needed;• educate the person to live and work in the community; and• offer support to family, friends and community members. 2Community support, then, comprises everything the old, long-stay institutionsused to furnish and a host of additional services besides, which are essential forcommunity tenure. By these means, if they are all supplied, we may virtuallyeliminate the revolving-door phenomenon.Keeping the patient in the community, however, does not necessarily meanthat he or she, in any real sense, is recovered. Required in addition, as the earlierchapters have argued, are efforts to raise the degraded social status of the person withschizophrenia, to offer him or her a meaningful role in life leading to a sense ofworth and a reduction of alienation. Notably absent from the community supportsystem requirements established in the 1970s were:• place the person in a job, wherever possible;• help the person establish real community ties; and• work to reduce the stigma of schizophrenia.