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Here the institution is the subject of the case study. Institutions that are theoretically orientated to psychoanalysis were chosen and examined, taking into account their various approaches to the treatment. A number of institutional models that are informed by psychoanalysis offer a guide to the treatment and present a version of institutional practice that is different from the prevailing models in psychiatry. This has implications for health services in the current climate of mental health reform.
Psychoanalysis has its greatest efficacy in long-term treatments and has shown its suitability for patients diagnosed with psychosis when the method is adapted to the uniqueness of each person and is conducted by an experienced clinician. The treatment of psychosis cannot usually be conceived without considering some form of institutional care, although this does depend on the level of the individual’s psychopathology. This is because the majority of people with a psychotic illness, especially those with schizophrenia, will be exposed to inpatient, community or outpatient treatment, in one form or other, during the course of their lives.