The material presented in this chapter extends and replicates the results of a previous study (Wing, 1961) in which it was shown that attitudes to discharge became more unfavourable, the longer the patient had been in hospital, independently of age and clinical condition. This gradual acquiescence in a state of life which precludes participation in the community outside hospital lies at the very heart of institutionalism.

In terms of the three interlocking theories presented in Chapter 1, it was expected that negative aspects of the clinical condition and social environment would be highly intercorrelated. Florid symptoms should be less in evidence if the environment were socially unstimulating and certainly not positively related to social poverty. The association between attitude to discharge and length of stay, independently of social and clinical condition (institutionalism), should be confirmed.

In order to examine the relationships between social, clinical and other relevant variables, two matrices of correlations were constructed, using fifteen of the main variables measured in 1960 and in 1964. Definitions of the variables have been given in Chapter 2. The matrices are presented in Tables 4.1 and 4.2 (pp. 199 and 200). It is evident from inspection that these are closely similar to each other although the measurements were made at an interval of four years and, in the case of the nurses’ ratings and the inventories of personal possessions, by different people. Most of the subsequent discussion will be based on Table 4.1.