(Re)ordering disorder? : analysis of a rehabilitative psychiatric halfway-house

Abstract

The particular topic I am looking at is people with mental health problems in a rehabilitative halfway house. This setting is specific to Malta in that its explicit philosophy is to deinstitutionalize mental health care; it is specific in terms of general community-based models in that it actually aspires to place individuals back into society (ideally). The home is partly successful, partly unsuccessful. This dissertation aims not so much to explain why this is the case, or even less to make policy recommendations. It is, rather, to apply certain anthropological insights and techniques to understand the culture of what is not a total institution. In so doing, I hope to tease out the particular tensions in the way the structure influences 'localized' culture, but simultaneously to show how the culture emerging out of interaction between staff and clients, and between clients themselves, is a very specific one which merits particular attention. For analytical purposes, I have divided the dissertation into six chapters. In this chapter I shall give a brief description of the history of psychiatric care in Malta, introduce the institution as my field of research, and present a reflexive approach to fieldwork. In the second chapter I shall define basic pathological and therapeutic ideologies which form the framework of the home. In the third chapter I shall discuss more practical explanations of illness and methodologies for cure. The following chapter will consider the ways in which power is distributed throughout the organization of space and rank in the home. In the fifth chapter I shall consider different meanings attributed to time and money within the home. I lastly will be the concluding chapter, which aims at linking together all the topics discussed throughout this dissertation.