I changed my opinion about psychosis. I now think that number of psychotics indulge in psychosis, and become chronic because they have nothing better to do, socially speaking. Psychiatric addiction participates in this movement, but is not the cause of chronicity. The first cause of chronicity is ostracism and institutionalization. One must not deprive the psychotic of his responsibility (without excluding that of the family and the institution) by saying to him: “it is the fault of the neuroleptic, it is the fault of the syndrome of weaning”. Of course, the neuroleptic does not help, but the main factor of chronicity is social.
Although the number of hospitalizations by force increases alarmingly in France, the majority of hospitalizations are voluntary. The majority of chronic psychotics are volunteers. They do not want to recover. Chronic psychosis, for lack of anything better, suits them perfectly: they do not have to work, they are excused for all their quirks, they are irresponsible, and they have all the drugs they want. They like this institutionalized position because they have nothing else.
This opinion is developed by Lawrence Kelmenson: Institutionalization: An Unacknowledged Cause of Psychiatric Outpatients’ Deterioration