Institutionalism in Mental Hospitals

Ratings of mental symptoms, behaviour in the ward, and attitudes to discharge were made on random samples of male schizophrenic patients, aged under sixty, from two London mental hospitals. Those resident less than two years were omitted. There was a concentration of unfavourable attitudes to discharge in the longer‐stay groups which remained significant when age, and mental symptom category, were allowed for. There was no significant association between mental symptom category and length of stay. There was no significant association between ward behaviour and length of stay except for one single item. The results suggested that patients gradually develop an attitude of indifference towards events outside the hospital which is part of a syndrome of ‘institutionalism’. No such long‐term deterioration in mental symptoms or ward behaviour was demonstrated but relatively rapid changes, or deterioration before the two‐year point, could not be excluded.