(Received 1 December 1975; accepted 27 April 1976)
Published Online: 1977
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The subtle changes of the early 1960s in the practice of institutional psychiatry were suddenly accelerated by the desire for freedom that swept the world later in that decade. The growing interest in the therapeutic community approach, the shift from custodial care to community placement, and the new respect for patients' rights substantially altered the life and the fate of mental patients in civil institutions. However, only in the last few years have public opinion and legislation focused on two other groups of institutionalized persons: the “mentally retarded” and the “criminally insane.” In the wake of the Willowbrook scandal and the von Wolfersdord case , official policy backed by legislation resulted ‘in the placement in civil institutions of persons with a history of criminal conduct. More often than not the court decisions first affected individuals, then groups of individuals. This paper studies what happened when a group of 19 mentally retarded individuals were transferred to a newly created unit in a civil institution as the result of a New York State Court of Appeals ruling in 1973. We recorded the events following the transfer, the staff-patient interactions, the difficulties encountered, and their resolution. We also monitored the patients’ patterns of behavior to evaluate the therapeutic efficacy of the new treatment approach to which they were exposed.
Counselor, Psychiatric Epidemiology Unit, Poughkeepsie, N.Y.
Associate professor, University of Louisville, Ky.
Stock #: JFS10391J