Maybe that’s progress

Working in the community also helped practitioners to rethink the meanings of success and failure. While some of my interviewees were harshly critical of the new hospital psychiatric wards, they acknowledged that in the old asylums, too, success was often measured by patient compliance with therapeutic regimens and the nurses’ ability to maintain order, cleanliness and discipline. Community care meant rethinking the concept of “achievement” in cases where a patient remained socially and economically marginal or failed to maintain sanctioned standards of hygiene or comportment.

Even the ones on the street, when you saw them [on the wards] they were so doped up there was no future for them. But now you see them, they’re walking the streets,… [but] they’re talking to people…. Maybe that’s progress in some way.