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During the 1950s, mentally disordered people who were harmful to society and

themselves could be treated with medications and were able to return safely to their

communities. During the 1980s, the cost of health care increased more than any other

cost in our national economy. As a result, strategic planning has been made to reduce

costs. "The political decision made to deinstitutionalize chronic mental patients started

with the appearance of phenothiazine medications. Dramatically reducing the instability

influenced by psychosis, these medications were of great significance to many

individuals with serious mental disorders. At both the state and federal levels,

legislators looked at the high cost of long-term psychiatric hospitalization. Social

scientists guaranteed them that community-based care would be in the best interests of

all concerned: the mentally ill and the general, tax-paying public." It was

believed that a social breakdown syndrome would develop in chronically mentally ill

persons who were institutionalized. The characteristics of this syndrome were

submission to authority, withdrawal, lack of initiative, and excessive dependence on the

institution (Seeds).

Schizophrenia is the most common psychoses in the United States affecting

around one percent of the United States population. It is characterized by a deep

withdrawal from interpersonal relationships and a retreat into a world of fantasy. This

plunge into fantasy results in a loss of contact from reality that can vary from mild to

severe. Psychosis has more than one acceptable definition. The psychoses are

different from other groups of psychiatric disorders in their degree of severity,

withdrawal, alteration in affect, impairment of intellect, and regression (Insight).

In psychotic disorders, the intellect is involved in the actual psychotic process,

resulting in derangement of language, thought, and judgment. Schizophrenia is called

a formal thought disorder. Thinking and understanding of reality are usually severely

impaired. The most severe and prolonged regressions are seen in the psychoses,

regression. There is a falling back to earlier behavioral levels. In schizophrenia this

may include returning to primitive forms of behavior, such as curling up into a fetal

position, eating with one's hands, and so forth. The symptoms of schizophrenia usually

occur during adolescence or early adulthood, except for paranoid schizophrenia, which

usually has a later onset. The process of schizophrenia is often slow, with the

exception of catatonia, which may have an abrupt onset. As an adolescent, a person

who later develops schizophrenia is often antisocial with others, lonely, and depressed.

Plans for the future may appear to others as vague or unrealistic (Seeds).

It is possible that there may be a preschizophrenic phase a year or two before

the disorder is diagnosed. This phase may include neurotic symptoms such as acute or

chronic anxiety, phobias, obsessions, and compulsions or may reveal dissociative

features. As anxiety mounts, indications of a thought disorder may appear. An

adolescent may complain of difficulty with concentration and with the ability to complete

school work or job-related work. Over time there is severe deterioration of work along

with the deterioration of the ability to cope with the environment. Complains such as

mind wandering and needing to devote more time to maintaining one's thoughts are

heard. Finally, the ability to keep out unwanted intrusions into one's thoughts becomes

impossible. As a result, the person finds that his or her mind becomes so confused and

thoughts so distracted, that the ability to have ordinary conversations with others is lost (Insight).

The person may initially feel that something strange or wrong is going on.

He or she misinterprets things going on in the environment and may give mystical or

symbolic meanings to ordinary events. The schizophrenic may think that certain colors

hold special powers or a thunderstorm is a message from God. The person often

mistakes other people's actions or words as signs of hostility or evidence of harmful

intent. As the disease progresses, the person suffers from strong feelings of rejection,

lack of self-respect, loneliness, and feelings of worthlessness. Emotional and physical

withdrawal increase feelings of isolation, as does an inability to trust or sociate with

others. The withdrawal may become severe, and withdrawal from reality may be

noticeable from hallucinations, delusions, and odd mannerisms. Some schizophrenics

think their thoughts are being controlled by others or that their thoughts are being

broadcast to the world. Others think that people are out to harm them or are spreading

rumors about them. Voices



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