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A total institution is defined by Goffman as a place of residence and work where a large number of like-situated, individuals, cut off from the wider society for an appreciable period of time, together lead an enclosed, formally administered round of life. Prisons serve as a clear example, providing we appreciate that what is prison-like about prisons is found in institutions whose members have broken no laws. This volume deals with total institutions in general and, mental hospitals, in particular. The main focus is, on the world of the inmate, not the world of the staff. A chief concern is to develop a sociological version of the structure of the self. Each of the essays in this book were intended to focus on the same issue--the inmate's situation in an institutional context. Each chapter approaches the central issue from a different vantage point, each introduction drawing upon a different source in sociology and having little direct relation to the other chapters. This method of presenting material may be irksome, but it allows the reader to pursue the main theme of each paper analytically and comparatively past the point that would be allowable in chapters of an integrated book. If sociological concepts are to be treated with affection, each must be traced back to where it best applies, followed from there wherever it seems to lead, and pressed to disclose the rest of its family.
Mental Institutions in America: Social Policy to 1875 examines how American society responded to complex problems arising out of mental illness in the nineteenth century. All societies have had to confront sickness, disease, and dependency, and have developed their own ways of dealing with these phenomena. The mental hospital became the characteristic institution charged with the responsibility of providing care and treatment for individuals seemingly incapable of caring for themselves during protracted periods of incapacitation. The services rendered by the hospital were of benefit not merely to the afflicted individual but to the community. Such an institution embodied a series of moral imperatives by providing humane and scientific treatment of disabled individuals, many of whose families were unable to care for them at home or to pay the high costs of private institutional care. Yet the mental hospital has always been more than simply an institution that offered care and treatment for the sick and disabled. Its structure and functions have usually been linked with a variety of external economic, political, social, and intellectual forces, if only because the way in which a society handled problems of disease and dependency was partly governed by its social structure and values. The definition of disease, the criteria for institutionalization, the financial and administrative structures governing hospitals, the nature of the decision-making process, differential care and treatment of various socio-economic groups were issues that transcended strictly medical and scientific considerations. Mental Institutions in America attempts to interpret the mental hospital as a social as well as a medical institution and to illuminate the evolution of policy toward dependent groups such as the mentally ill. This classic text brilliantly studies the past in depth and on its own terms.
“Mikita Brottman is one of today’s finest practitioners of nonfiction.” —The New York Times Book Review Critically acclaimed author and psychoanalyst Mikita Brottman offers literary true crime writing at its best, taking us into the life of a murderer after his conviction—when most stories end but the defendant's life goes on. On February 21, 1992, 22-year-old Brian Bechtold walked into a police station in Port St. Joe, Florida and confessed that he’d shot and killed his parents in their family home in Silver Spring, Maryland. He said he’d been possessed by the devil. He was eventually diagnosed with schizophrenia and ruled “not criminally responsible” for the murders on grounds of insanity. But after the trial, where do the "criminally insane" go? Brottman reveals Brian's inner life leading up to the murder, as well as his complicated afterlife in a maximum security psychiatric hospital, where he is neither imprisoned nor free. During his 27 years at the hospital, Brian has tried to escape and been shot by police, and has witnessed three patient-on-patient murders. He’s experienced the drugging of patients beyond recognition, a sadistic system of rewards and punishments, and the short-lived reign of a crazed psychiatrist-turned-stalker. In the tradition of One Flew Over The Cuckoo’s Nest, Couple Found Slain is an insider’s account of life in the underworld of forensic psych wards in America and the forgotten lives of those held there, often indefinitely.
30th ANNIVERSARY EDITION • NATIONAL BESTSELLER • In 1967, after a session with a psychiatrist she'd never seen before, eighteen-year-old Susanna Kaysen was put in a taxi and sent to McLean Hospital. Her memoir of the next two years is a "poignant, honest ... triumphantly funny ... and heartbreaking story" (The New York Times Book Review). WITH A NEW INTRODUCTION BY THE AUTHOR The ward for teenage girls in the McLean psychiatric hospital was as renowned for its famous clientele—Sylvia Plath, Robert Lowell, James Taylor, and Ray Charles—as for its progressive methods of treating those who could afford its sanctuary. Kaysen's memoir encompasses horror and razor-edged perception while providing vivid portraits of her fellow patients and their keepers. It is a brilliant evocation of a "parallel universe" set within the kaleidoscopically shifting landscape of the late sixties. Girl, Interrupted is a clear-sighted, unflinching document that gives lasting and specific dimension to our definitions of sane and insane, mental illness and recovery.
Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane, by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and doctors: the Ralph Waldo Emerson prot'g' whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age. This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.
Gerald N. Grob's Mental Institutions in America: Social Policy to 1875 has become a classic of American social history. Here the author continues his investigations by a study of the complex interrelationships of patients, psychiatrists, mental hospitals, and government between 1875 and World War II. Challenging the now prevalent notion that mental hospitals in this period functioned as jails, he finds that, despite their shortcomings, they provided care for people unable to survive by themselves. From a rich variety of previously unexploited sources, he shows how professional and political concerns, rather than patient needs, changed American attitudes toward mental hospitals from support to antipathy. Toward the end of the 1800s psychiatrists shifted their attention toward therapy and the mental hygiene movement and away from patient care. Concurrently, the patient population began to include more aged people and people with severe somatic disorders, whose condition recluded their caring for themselves. In probing these changes, this work clarifies a central issue of decent and humane health care. Gerald N. Grob is Professor of History at Rutgers University. Among his works are Mental Institutions in America: Social Policy to 1875 (Free Press), Edward Jarvis and the Medical World of Nineteenth-Century America (Tennessee), and The State and the Mentality III (North Carolina). Originally published in 1983. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.
Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.
An urgent exposéf the mental health crisis in our courts, jails, and prisons America has made mental illness a crime. Jails in New York, Los Angeles, and Chicago each house more people with mental illnesses than any hospital. As many as half of all people in America's jails and prisons have a psychiatric disorder. One in four fatal police shootings involves a person with such disorders. In this revelatory book, journalist Alisa Roth goes deep inside the criminal justice system to show how and why it has become a warehouse where inmates are denied proper treatment, abused, and punished in ways that make them sicker. Through intimate stories of people in the system and those trying to fix it, Roth reveals the hidden forces behind this crisis and suggests how a fairer and more humane approach might look. Insane is a galvanizing wake-up call for criminal justice reformers and anyone concerned about the plight of our most vulnerable.