ABSTRACT
Since first publishing the paper on which this chapter is based (Bott, 1976),1 I have changed my view of what its central theme should be. The original research was a study of a typical large British mental hospital carried out somewhat intermittently between 1957 and 1972. Originally the paper had two main themes: the persistence of chronic hospitalization and the presence of endemic conflicts in the hospital. I devoted a great deal of discussion to the first theme because it was assumed in the 1960s that the number of long-stay “chronic” patients was rapidly declining. The big old hospitals in the country were to be closed down and replaced by psychiatric wards in general hospitals for short-stay “acute” patients. The remaining chronically psychotic patients would be housed in a reduced number of the old country hospitals or, better, in some sort of facility provided by local government authorities. “Community care” was a fashionable idea, though little real effort was made either by the National Health Service or by local government authorities to make concrete plans for it.
