Future of the chronic schizophrenic patient: prediction and recommendations.

A glimpse into the future for the schizophrenic patient requires a grasp of the history of American psychiatry and the many factors which led to the deinstitutionalization process and its negative effects. The paper reviews this material in some depth. It covers in detail the past forty years of legislation which saw psychiatry rise to heights of good care and then slowly decline to its present state. Some predictions are made about the continuing fate of the state system, how schizophrenic patients are likely to be viewed and treated, and where they will tend to live. Long-term psychotherapy increasingly will fall into disrepute, hospital care will be increasingly brief, biologic in its emphasis and the numbers of chronically ill schizophrenics will grow out of control. It is predicted that there will not be a breakthrough in either the biologic or social fields, and pessimism will reign.