INSTITUTIONALIZATION & MENTALLY ILL PATIENT

 

INSTITUTIONALIZATION

INTRODUCTION

In previous years, the mentally ill patients were cared for in large buildings near hospitals known as asylum. This led to a largest group of patients getting admitted and cared for in mental institutions for a long time. This development led to institutionalization.

 

DEFINITION

Institutionalization is a pattern of passive dependent behavior observed among psychiatric inpatient, which is characterized by hospital attachment and resistance to discharge.

 

OR

It is a deficit of a disability in social and life skills, which develops after a person has long lived or spent a long time in a psychiatric hospital, prison or other remote institution.

 

CAUSES

1.    Extreme poverty: the victim knows where he comes from there is poverty as a result he may prefer to be institutionalized.

2.    Substance abuse by guardian: after parents abuse substances (e.g alcohol) they cause harm to the victim may refuse to go back home hence becoming institutionalized.

3.    Abandonment by the guardian and/or the family: the family and friends tends to reject the patient due to his condition, for example if the patient is frequently violent.

4.    Lack of material and resources: the patient may become institutionalized because of fear to go back in the society and they don’t have capital to establish a living.

5.    Domestic violence: because where the patient comes from he is physically abused. For example the patient is put chains, denied food and beaten.

6.    Lack of guardian and family: The lack of family may also lead to the patient becoming institutionalized as the patient may prefer to say in the hospital where he feels loved and welcomed.

SIGNS AND SYMPTOMS

1.    Low self-esteem: any person may develop a low self esteem if he is in a depressing situation or in an environment where their humanity is denied through being beaten, teased or passing of negative comments.

2.    Passive dependence on staff: the patient seems to depend on everything which the staffs plan for him.

3.    Inability to plan for the future: the patient is used to the daily rigid routines of the environment.

4.    Total submissiveness: the patient follows whatever he is asked to do without questioning and reasoning whether it is good or bad for them both from staff and fellow patients.

5.    Lack of initiative: the patient lacks the ability to begin a process or an activity on their own without the aid of a staff.

6.    Avolition : lack of ambition in life

PREVENTION

Encouraging family support

Adequate support from the family will promote a short hospital stay and care may be continued from home after the patient has recovered. Family support will also enable the recover fast and if they cannot afford to visit on a regular basis, we will encourage them to communicate through the phone as this will help the patient to feel loved and cared for.

Motivating and Encouraging the client to use initiative

Encouraging the patient to be highly involved in planning of his care and also ensuring that he does some activities of daily living without being forced but at his/her own free will. I will also encourage the patient to come up with ideas on how to solve problems or situations given as this will enhance independence and prevent learned helpless behaviors.

Reduction in Dosages

Reduction on the dosages of drugs that make the patient inactive during the day, so that during day time the patient is aware of his environment and is able to participate in productive activities.

Occupational therapy

The focus is on rehabilitating and vocational training of the patient in skill such as basket making, doormat making, carpentry, etc. in which the patient learns to be productive, therapy enhancing self-esteem, ability to plan for the future, initiative and may prevent idleness.

Fighting Stigma and Discrimination

This is important in a way that it may make the patient feel acceptable in the community as a result he would likely spend less time in the hospital, as he will have a feeling of belonging to a community. Fighting stigma can be done through community sensitization about the negative aspects of stigma and its effects on the life of the patient at large.

Assertiveness skills training

This will increase the patient’s self-esteem which will lead to an increase in the ability to develop satisfying interpersonal relationships. It may also improve the communication with others, maintaining honesty in relationship, and enhancing feelings of the patient being in control of his life. This training will also make the patient not to be too submissive as he will be able to stand for his rights and feelings.