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and should there not be a family or home available to provide
the care needed for a particular person then it is reasonable to
suppose that there is lacking a good home and residential care
may be necessary. This may not mean that the home is unsuitable
in the normal sense but that it is unable to provide the care
necessary for a particular individual. Mentally disordered persons
who lack a suitable home may require residential care for a
variety of reasons. There may be no family available because of
death, disappearance or refusal to take any further responsibility
for their family member. There may be a family but it could still
be unsuitable for the person because although willing to have their
family member they are totally unable to provide the type of care
and environment for the person's needs. This is particularly
so where emotional relationship between a mentally disordered
person and his family may be disturbed and living in close
proximity seems to make the illness worse. There are also situations
where the family is willing to have its member but is
already over-burdened and this extra problem leads to inter
familial stress. People are, therefore, admitted to hostel care
for a variety of reasons and are, likewise, discharged for a
similar variety of reasons. Many different things happen to them
and their families whilst they are in hostel care. It is, therefore,
the aim of hostel care to provide a stable and helpful environment
for mentally ill persons who need this and who, for the reasons
already stated, cannot find this within their own social circles.
Therefore, each person is seen as an individual needing his own
particular kind of training, assistance and support, directed
towards whatever goals seem appropriate for him as an
individual.
Selection of Residents
It may well be that the patients that would benefit most from
transitional care are not referred as they prefer either to return
to their home environment or to seek accommodation directly
within the community although neither of these might be most suitable.
When selecting residents referred for hostel care we look
for people who seem already motivated towards work and getting
back to the community. Patients who are motivated and who
are already working from hospital or who attend regularly at an
industrial unit and will be ready to seek employment at an early
date are offered hostel placement as soon as possible. It is
difficult to assess how well a patient might improve and move on
and one can only look at past records of achievement and how
they seem in the "here and now". Unfortunately, some residents
are unable to sustain their level of functioning and lose their jobs
or are only able to function at Day Centre level. This then
presents more problems of management and movement within
the hostel as patients tend to become more long-stay.