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The Social Conditions of Destitution: The Situation of Men with Schizophrenia or Personality Disorder*

Published online by Cambridge University Press:  20 January 2009

Susanne MacGregor Wood
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Abstract

This article discusses the particular characteristics of men with schizophrenia or personality disorder and it compares these two categories with one another and with the destitute population as a whole. On a number of variables, no significant differences are discerned, the category as a whole sharing a background of considerable material and social deprivation. However, with reference to place of birth, loss of mother, and father's occupation, significant differences do appear. The two categories also show distinctly different patterns in the process of becoming destitute and they use existing agencies differently. Finally, the type of service most suitable for these men is discussed together with other issues raised by the question, ‘How can we improve the lot of the homeless single person?’

Type
Articles
Information
Journal of Social Policy , Volume 8 , Issue 2 , April 1979 , pp. 207 - 226
Copyright
Copyright © Cambridge University Press 1979

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References

1 See for example Edwards, G., Williamson, V., Hawker, A., Hensman, C. and Postoyan, S., ‘Census of a Reception Centre’, British Journal of Psychiatry, 114 (1968), 1,031–9.CrossRefGoogle ScholarPubMed

2 See for example Bogue, Donald J., Skid Row in American Cities, Community and Family Study Center, University of Chicago, 1963.Google Scholar

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4 See Becker, Howard S., Outsiders: Studies in the Sociology of Deviance, The Free Press, New York, 1963.Google Scholar

5 National Assistance Board, Homeless Single Persons, HMSO, London, 1966.Google Scholar

6 see Tidmarsh, D., Wood, S. and Wing, J. K., Report on Research at Camberwell Reception Centre, Institute of Psychiatry, London, 1972Google Scholar. Where the term ‘mental illness’ is used in the present article it refers to the existence of present or past symptoms of mental illness sufficient to warrant referral to a psychiatrist. Psychiatric diagnosis rested on the clinical judgements of my colleague, David Tidmarsh, supplemented by the use of the PSE (present state examination), where time allowed. see Wing, J. K., Birley, J. L. T., Cooper, J. E., Graham, P. and Isaacs, A. D., ‘Reliability of a Procedure for Measuring and Classifying “Present Psychiatric State”’, British Journal of Psychiatry, 113 (1967), 499–515CrossRefGoogle Scholar. Diagnoses were based on the eighth revision of World Health Organization, International Classification of Diseases, ‘Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death’, Geneva, 1967Google Scholar; and General Register Office, British Glossary, ‘Studies on Medical and Population Subjects No. 22: A Glossary of Mental Disorders’, HMSO, London, 1967Google Scholar. The term ‘personality disorder’ used here refers to the presence of a persistent inability to form or maintain normal personal relationships, or persistent inability to work steadily despite the availability of a range of apparently suitable jobs.

7 See Wood, Susanne MacGregor, ‘Camberwell Reception Centre: A Consideration of the Need for Health and Social Services of Homeless, Single Men’, Journal of Social Policy, 5:4 (1976), 389–99.CrossRefGoogle Scholar

8 Nissel, Muriel (ed.). Social Trends, no. 5, Government Statistical Service, HMSO, London, 1974Google Scholar, Table 9, Families by Size and Age of Head, 1971Google Scholar; and Table 16, Children in One-Parent Families, 1971.Google Scholar

9 Ibid. Table 6. This refers to England and Wales only.

10 The Housing Index (as defined in census of population reports for Great Britain) gives a measure of the density of occupation defined in terms of the number of persons per room; over 1 1/2 persons per room is considered as overcrowded, fewer than 1/2 a person per room as under-occupied.

11 Halsey, A. H. (ed.), Trends in British Society Since 1900, Macmillan, London, 1972CrossRefGoogle Scholar, Table 5:1 (based on surveys carried out between 1949 and 1963).

12 There is considerable literature on the social drift hypothesis. The most relevant publications to which readers may refer are Faris, R. E. L. and Dunham, H. W., Mental Disorders in Urban Areas, Hasner, Chicago, 1939Google Scholar; Hare, E. G., Journal of Mental Science, 102 (1956), 349–57CrossRefGoogle Scholar; Bogue, op. cit. especially ch. 14; Goldberg, E. M. and Morrison, F. L., British Journal of Psychology, 122 (1963), 15–30Google Scholar; and Dunham, H. W., Community and Schizophrenia: An Epidemiological Analysis, Wayne State University Press, Detroit, 1965.Google Scholar

13 The ‘rate of skid’ is defined from a cluster of factors. It refers basically to the speed at which men move from a family setting to homelessness, without passing through a stage of digs, living-in jobs, working-men's hostels and so on. Thus the commonly used analogy of a ladder connecting the world of the homeless and the destitute with the world of the ‘settled population’ (that is, those with relatively secure accommodation, income, employment and social contacts with relatives and neighbours) could in this instance be used to denote the presence of intermediary rungs or steps between the social levels. Thus, where the rate of skid is relatively slow, it will have taken more years for a man to proceed downwards through the stages; where the rate of skid is relatively fast, a man has slipped, missed out a few rungs and fallen more quickly and heavily to the bottom of the ladder. The factors considered as indices of the rate of skid were the length of time since the last permanent accommodation; the length of time since the last accommodation in a family setting; the type of the last permanent accommodation; and the pattern of use of accommodation – here accommodation was ranked in order of security of tenure and amenities: with family or relatives; in a rented flat, room or lodgings; in a living-in job; in a working-men's hostel; in a Salvation Army or similar hostel; at a reception centre or in similar accommodation; and sleeping rough. Other factors also considered were the length of time since the last employment; the type of the last employment; the length of time since the last contact with relatives; the nature of the contact with relatives; the interviewer's assessment of the man's ability to manage; the man's stated attitude with regard to confidence in the future; and the total number of years of ‘unsettlement’ – defined by reference to the pattern of use of accommodation; the duration of the present episode of ‘unsettlement’; and the pattern of ‘unsettlement’ – that is, with reference to the present episode only (usually less than three months); to one previous episode and a period of stability; to spasmodic episodes; and to chronic ‘unsettlement’.

14 Bishop, D., ‘Survey of Men Seen at Medical Clinic, Camberwell Reception Centre’, unpublished report, Institute of Psychiatry, University of London, 1972.Google Scholar

15 see Tidmarsh, D. and Wood, S., ‘Psychiatric Aspects of Destitution’, in Wing, J. K. and Hailey, A. M. (eds), Evaluating a Community Psychiatric Service, Oxford University Press, London, 1972.Google Scholar

16 see Leach, J. and Wing, J. K., Helping Destitute Men, report of an action research project designed to evaluate the effectiveness of services provided by the St Mungo Community Trust, Institute of Psychiatry, University of London, 1976.Google Scholar

17. Ibid.

18 Wedderburn, Dorothy, ‘Facts and Theories of the Welfare State’, in Miliband, R. and Saville, J. (eds), The Socialist Register, The Merlin Press, London, 1965.Google Scholar