Milieu therapy with chronic mental patients.

The article describes a program in milieu therapy that the authors designed and operated between September 1970 and January 1972. It was carried out in the Kalamazoo State Hospital, Kalamazoo, Michigan, which had approximately 2,000 patients in 1970. The program aimed to reduce constraints and barriers within the hospital that discouraged discharge, and overcome external or community barriers to discharge. The overarching goal was to create a social structure involving patients and staff that would strengthen patients' motivation and increase their opportunities for leaving the hospital. No program of social intervention can be self-justifying. It was not possible to obtain adequate baseline data prior to intervention so that there might be a simple before-and-after evaluation. As is often the case in such situations, those with authority-the hospital administrators in this instance-were not willing to devote the time, energy, and money that rigorous evaluative research requires. Nevertheless, the soft data available indicate that the program has been successful in attaining the goals set forth for the patient population.