Social factors and Recovery: Out of the asylum but still a long way to go

Tom K Jamieson-Craig

doi:10.1921/swssr20252509

Authors

Tom K Jamieson-Craig King’s College London / South London and Maudsley Hospital. https://orcid.org/0000-0003-1442-0391

DOI:

https://doi.org/10.1921/swssr20252509

Keywords:

recovery, resettlement, rehabilitation, person-centred, care teams, social factors

Abstract

Abstract: Mental health interventions matter most where they result in improvements in the social lives of patients. Those resettled from the asylum preferred living in the community and experienced few adverse outcomes. Resettlement was undoubtedly institutional in nature, patients having little or no choice over where, when or with whom they moved. The underlying ‘train then place’ rehabilitation model persists to this day, with step-down towards independence contingent on the (re-)acquisition of daily living skills. Subsequent recognition of the importance of choice and person-centred care has led to interesting questions about this model. Emerging evidence suggests instead a ‘place then train’ approach, involving a rapid move to independent accommodation or to open job placement with support following as necessary. The relationship between service user and the professional providing care is critical for these optimistic person-centred interventions. It is therefore disquieting to observe declining continuity of care and care models that promote fragmentation of the care team.

Author Biography

Tom K Jamieson-Craig, King’s College London / South London and Maudsley Hospital.

Tom K.J. Craig qualified in medicine at the University oi the West Indies, Jamaica. He trained as a psychiatrist in Nottingham, England and after obtaining a PhD in medicine, held several academic posts including the first chair of community psychiatry at King’s College London and the South London and Maudsley Hospital. Now retired, he maintains an active interest in the development of treatments and services for people with severe mental health problems. ORCID: https://orcid.org/0000-0003-1442-0391

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