The New Asylums in the Community

One-hundred and one residents of a board-and-care home housing psychiatric patients were studied. Of these, 92% were diagnosed as psychotic; 42% have lived there five years or more; and 32% have overt major psychopathologic characteristics. Nine of ten have never lived alone or failed in their last attempt. A relationship was found between use of a community social rehabilitation program and its distance and provision of transportation. Sixty-one percent have had contact with community vocational rehabilitation but only 12% are still involved. Half of them have no goals for changing anything in their lives; 95% use community facilities, mostly eating places and supermarkets. Board-and-care homes offer an asylum from life's pressures, a degree of structure, and some treatment, especially medication supervision. For many long-term patients they have taken over the functions of the state hospital.