Leaving the hospital behind? An anthropological study of group homes in two London boroughs.

The thesis examines the impact of leaving a psychiatric hospital, which is due to close, on a group of long-stay patients. Using anthropological method, the study provides a small scale, in-depth analysis of the transition processes involved. It aims to examine the differing perceptions produced from different positions within an institutional setting, focusing particularly on the residents' perspective, and to compare the experience of transition from the clients' viewpoints with the carers' knowledge and assumptions. The first two chapters outline the context of the study, the historical and sociological background to community care policy and the methodological and theoretical approaches taken. Chapter three uses a 'life history' approach, which recounts the experiences of the residents of a particular group home project. These accounts are compared qualitatively with the official summaries of their case histories, suggesting that rehabilitation requires a different method of understanding the patients experiences, abilities, problems and needs. Chapters four and five outline the processes of selection and preparation for leaving the hospital. The experience of leaving hospital is analysed as a 'life crisis' and the professional handling of the move is examined. In chapters six and seven, group home life is described in detail and compared to hospital life, bringing out key features of the environment, routines, and interactions within the home and beyond it. I focus on several areas of change and continuity in the lifestyles of the residents, their use of time and their relations to staff and others. The final section explores the conceptual models of the group home, as an aspect of community care philosophy. I focus particularly on the 'family model' of care, its bases and its implications for the quality of life of the residents, in terms of rehabilitation, social integration and the personal and social identities of the residents