ABSTRACT
The Medical Research Council Social Psychiatry Unit was set up under Sir Aubrey Lewis’s directorship in 1948. When George Brown joined the unit in 1956, the mental hospital was still at the centre of psychiatric services, although some pioneering superintendents had begun to discharge longstay patients who were stable and not conspicuously disabled. This change in policy at local level was of great interest to the members of the research unit since it antedated the introduction of the antipsychotic drug chlorpromazine, and hence represented a social innovation. The enthusiasm of the pioneers was somewhat dampened when it became evident that some of the patients discharged with such hopes had to be readmitted, but this setback represented a challenging question for the research team. What could it be in the lives of the patients resettled in the community that unbalanced their mental equilibrium? A study was mounted of 229 men discharged from psychiatric hospitals, 156 of them with a diagnosis of schizophrenia. Measurements were made of a large number of variables that might explain the readmission rate (Brown, Carstairs and Topping, 1958). In the event, the strongest link with readmission was the type of home to which patients were discharged. Unexpectedly, patients who left hospital to live with their parents or wives were more likely to need readmission than those who resided in lodgings or with brothers or sisters. It was also discovered that patients living with their mother had less chance of returning to hospital if they and/or their mother went out to work (Brown, 1959). While this result could readily be explained as a consequence of the degree of the patient’s disability, it also hinted at the possibility of a deleterious effect of prolonged contact between patient and relative (Brown, 1985).
