The Mental Hospital in the 21st Century

Cynthia R. Comacchio is an assistant professor of History at Wilfrid
Laurier University in Waterloo.

This collection provides expert discussion and analysis of various
aspects—historical, current, and prospective—of the role and
function of the mental hospital in Canada, with some comparative
reference to the United States and the United Kingdom. The 20 studies
were first presented at the October 1990 conference sponsored by the
London Psychiatric Hospital (Ontario) on the theme “The Role of the
Mental Hospital in the 21st Century.” The purpose of the conference
was to provide a forum for a panel of international experts to engage in
critical examination of the role of the psychiatric hospital. As the
editors explain in their preface, “the intent was to obtain both a
longitudinal or historical perspective [and] ... a cross-sectional or
international perspective.”

The collection is divided into three sections. The first discusses the
mental hospital largely in its historical, functional, and
administrative contexts. Particular attention is given to the process,
history, and impact of deinstitutionalization in the United States, the
United Kingdom, and Canada. Part 2 details treatment, practice, and
efficacy, and includes discussion of psychosocial rehabilitation,
working with families, psycho-geriatric patients, organizational and
security concerns and the medication and management of schizophrenia.
Part 3 focuses on administrative, educational, and research issues,
ending with a thought-provoking essay by Leona L. Bachrach entitled “A
Proposal: That There Is a Role for the Mental Hospital in the 21st
Century.”

The contributions to this volume are timely, specialized studies that
will be of particular value and interest to community mental-health
workers, to those involved in social policy formation, to institutional
administrators, and to anyone interested in a serious analysis of the
deinstitutionalization issue.