Abstract

on the need for asylum. Although theme is no doubt that many patients have benefited by being removed from long-term hospitals, it is equally true that not all patients will benefit from such deinstitutionalization. I have seen patients who have been hospitalized for 25 or more years and whose community was the community of the hospital. They were the educators of nurses and psychiatnic residents, and they knew the grounds and the mules and the gossip ofthc institution. For them to be torn from their community and deposited in the cruel outer world was a dissemvice. Once more, it is a matter of trying to fit the patient to the procrustean bed by stretching him or lopping offhis feet. The essence of good care is to be able to individualize-to see the patient as he or she is and not as some reflection ofa figment ofone’s imagination. There arc patients who need the asylum, a place of shelter. If it is a dehumanizing institution, the task is to make it more humane and not simply to discard it without giving thought to what is being lost in the process. LEO H. BERMAN, M.D.provide it for a long period