Worlds That Fail: A Longitudinal Study of Urban Mental Patients


  • Arthur J. Lurigio,

    Corresponding author
    1. Northwestern University
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      ARTHUR J. LURIGIO is a social psychologist who received his doctorate from Loyola University of Chicago. Formerly a faculty member in psychology at Northwestern University, he is currently Assistant Professor of Criminal Justice at Loyola University and Research Associate at the Center for Urban Affairs and Policy Research at Northwestern. His primary research interests include reactions to criminal victimization, victim services, intermediate sanctions, expertise and statistical reasoning, and AIDS and the courts.

  • Dan A. Lewis

    1. Northwestern University
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      DAN A. LEWIS is Associate Director of the Center for Urban Affairs and Policy Research, and Chairman of the Graduate Program in Human Development and Social Policy at the School of Education and Social Policy, both at Northwestern University. His research interests include the sociological analysis of urban problems such as crime, mental illness, and education, and the use of theory in policy development. Currently, he is the principal investigator of the Politics of School Decentralization Project funded by the Spencer Foundation in collaboration with the Chicago Urban League.

Center for Urban Affairs and Policy Research, Northwestern University, Evanston, IL 60208


This longitudinal study of state mental patients in Chicago investigated patient adjustment to everyday living outside state hospitals. Respondents (N = 313) were interviewed in person at the hospital and at two successive waves in the community, and a wide range of variables was measured. Findings showed that mental patients are overwhelmingly poor, unemployed, and on welfare. A substantial number are homeless, and many resort to criminal behavior as a means of support. The state hospital is often viewed as a place for meals, shelter, and companionship. Only about half of the patients receive help before returning to the hospital, and that help is mostly medication. Those who are younger and have a history of prior institutionalizations are most likely to be readmitted. Patients who refuse to sign into the state hospital are frequently persuaded or coerced to admit themselves “voluntarily” in order to circumvent the complicated involuntary commitment process. It is suggested that mental health care focus on helping patients handle everyday problems in living related to housing, jobs, and interpersonal relationships.