chapter  III
98 Pages


The various psychiatric units in general hospitals, which had been established over the years, seemed to work very satisfactorily and had indeed become an integral part of the mental health services of the Manchester Region. Their work was not only known from the general statistical returns submitted to the Regional Hospital Board as a matter ofroutine, but a number of consultants had also written surveys of their own units, which gave a descriptive account of them (Leyberg, 1959; Freeman, 1960; Silverman, 196 I ). These descriptions drew a vivid picture of the work as it presented itself to those who were occupied in it. This, however, was not necessarily the complete picture. It only reported on those patients who actually came to the units or returned there when they fell ill again. It could not throw much light on those who failed to return. Did they seek treatment elsewhere? Nor could assessments be made as to how large a number of patients living in the community engaged other services. Did they swell the work of the general practitioners or strain the existing social services? These questions were difficult to answer and in fact require special planned investigation. Most of all there was a nagging doubt as to what this new kind of management of psychiatric patients might mean for their families. So far no systematic investigations had been made into what kind of burden was devolving on the patients' households, or to what extent their position might have been eased by this new type of management, as compared with what occurs in the more conventional kind of service.