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"Institutionalization"
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Változatok a szakmaiság intézményesítésére
This study focuses on how communities of professionals and firms institutionalize. Despite the growing literature on professional associations (private, planned institutions intended to further the interests of business communities), we know little about how they form associational systems at the level of professional communities. Adopting a complementary theories congruence analysis approach, the author compares and combines the descriptive power of the central theories of the logics of membership and influence, and the recently proposed theory of the institutionalization of professional debates. Using document analysis and semi-structured interviews, he studies the associational system of Hungarian logistics, a densely institutionalized professional community which faced substantial regulatory and market challenges. The results highlight that the three theories explain different elements of the professional community’s complex institutionalization. The intellectual orders of professional debates and the transaction-based institutional logics of associations co-evolve, with the shifting regulatory context driving most institutional dynamics.
Journal Article
Shaikh Ali Hossain
At a later stage of his career, he also had to implement new initiatives for \"care in the community,\" enabling the transition of institutionalised patients to either live in smaller units of care or to return to their families in the community.
Journal Article
Understanding psychiatric institutionalization: a conceptual review
Background
Since Goffman’s seminal work on psychiatric institutions, deinstitutionalization has become a leading term in the psychiatric debate. It described the process of closure or downsizing of large psychiatric hospitals and the establishment of alternative services in the community. Yet, there is a lack of clarity on what exactly the concept of institutionalization means in present-day psychiatry. This review aims to identify the meaning of psychiatric institutionalization since the early 1960s to present-day.
Method
A conceptual review of institutionalization in psychiatry was conducted. Thematic analysis was used to synthesize the findings.
Results
Four main themes were identified in conceptualizing institutionalization: bricks and mortar of care institutions; policy and legal frameworks regulating care; clinical responsibility and paternalism in clinician-patient relationships; and patients’ adaptive behavior to institutionalized care.
Conclusions
The concept of institutionalization in psychiatry reflects four distinct themes. All themes have some relevance for the contemporary debate on how psychiatric care should develop and on the role of institutional care in psychiatry.
Journal Article
How has the extent of institutional mental healthcare changed in Western Europe? Analysis of data since 1990
ObjectivesIt has been suggested that since 1990, de-institutionalisation of mental healthcare in Western Europe has been reversed into re-institutionalisation with more forensic beds, places in protected housing services and people with mental disorders in prisons. This study aimed to identify changes in the numbers of places in built institutions providing mental healthcare in Western Europe from 1990 to 2012, and to explore the association between changes in psychiatric bed numbers and changes in other institutions.Settings and dataData were identified from 11 countries on psychiatric hospital beds, forensic beds, protected housing places and prison populations. Fixed effects regression models tested the associations between psychiatric hospital beds with other institutions.ResultsThe number of psychiatric hospital beds decreased, while forensic beds, places in protected housing and prison populations increased. Overall, the number of reduced beds exceeded additional places in other institutions. There was no evidence for an association of changes in bed numbers with changes in forensic beds and protected housing places. Panel data regression analysis showed that changes in psychiatric bed numbers were negatively associated with rising prison populations, but the significant association disappeared once adjusted for gross domestic product as a potential covariate.ConclusionsInstitutional mental healthcare has substantially changed across Western Europe since 1990. There are ongoing overall trends of a decrease in the number of psychiatric hospital beds and an increase in the number of places in other institutions, including prisons. The exact association between these trends and their drivers remains unclear. More reliable data, information on the characteristics of patients in different institutions, long-term pathway analyses and effectiveness studies are required to arrive at evidence-based policies for the provision of institutional mental healthcare.
Journal Article
