Research Article
Understanding psychiatric institutionalization: a conceptual review
Winnie S Chow, Stefan Priebe
Published:
DOI:
10.1186/1471-244X-13-169
License:
Copyright © 2013 Chow and Priebe; licensee BioMed Central Ltd.2013Chow and Priebe; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
BackgroundSince Goffman’s seminal work on psychiatric institutions, deinstitutionalization has become a leading term in the psychiatric debate. It described the process of closure or downsizing of large psychiatric hospitals and the establishment of alternative services in the community. Yet, there is a lack of clarity on what exactly the concept of institutionalization means in present-day psychiatry. This review aims to identify the meaning of psychiatric institutionalization since the early 1960s to present-day.MethodA conceptual review of institutionalization in psychiatry was conducted. Thematic analysis was used to synthesize the findings.ResultsFour main themes were identified in conceptualizing institutionalization: bricks and mortar of care institutions; policy and legal frameworks regulating care; clinical responsibility and paternalism in clinician-patient relationships; and patients’ adaptive behavior to institutionalized care.ConclusionsThe concept of institutionalization in psychiatry reflects four distinct themes. All themes have some relevance for the contemporary debate on how psychiatric care should develop and on the role of institutional care in psychiatry.