First Step to Independence

The step out of mental hospital back into the community can he a major ordeal for many patients. To provide a halfway stage between hospital and full independence, the Birmingham and District Association for Mental Health recently opened a special short-stay hostel for ex-patients, which is described here by Julian Smithells. In many mental hospitals today there are patients who are ready to take their first steps into a more normal life again but who, nevertheless, are more or less forced to stay in hospital because there is nowhere suitable for them to go. They may already be going out to work each day and earning a living, but they are not ready for full independence and still need some kind of support. For some patients the alternatives to continuing to live i'i the hospital are either a return to families which may have helped to bring on the illness that originally led to hospital, or a lonely existence in a bedsitter. In both cases there would be a considerable likelihood of a return to hospital in a few months, with the necessity of a further period of treatment. Back in an old and trying family situation, the Patient's tenuous hold on the progress he has made in hospital will be severely tested, and due to the familiarity of the situation he may well be driven again towards the illness that first brought him to hospital. Alternatively, living alone in a bedsitter , Perhaps without friends, with a limited ability to Niake contacts outside his work and limited interests, lhe patient is only too likely to find his life appears empty and meaningless. Most people find a lonely existence trying, and for one who has special psychiatric difficulties and is, anyway, accustomed to the c?mpany and supportive environment aimed at In a hospital the sudden transition is more than likely to cause a relapse into illness. ^hat missing halfway stage Such patients clearly need a period, perhaps a few Months or even a few years, in which to consolidate 'he progress they have made and to gradually find their ^eet in normal community life. While they may be ^hle to hold down a job and get on with their work-mates, they may still require the kind of kindness ar>d understanding that is not always available in the outside world, and a situation in which they can receive help if it …