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Research evaluation in the treatment of schizophrenia has been largely neglected. The project in research evaluation which is the subject of this book began in 1970 at the National Institutes of Mental Health where it was given the highest priority. The impetus came from the psychotropic drugs which were responsible for a historic rate of discharge of schizophrenic patients from state hospitals in the 1960s, and which made the therapy of schizophrenia appear headed for extinction.
An alarming decline in the prestige of psychoanalytic training and teaching occurred as easier and faster methods promised more for less. A surge of interest in organicity was marked by accelerated research in genetics, brain biochemistry, and by a continuous stream of psychopharmacological remedies. Lithium was hailed as the third revolution in psychiatry. These events accounted for the defection of experienced psychiatrists, disillusioned with intensive psychotherapy.
But these drugs did not prove to be a biochemical solution. The wholesale release of patients was followed by a stampede of readmissions, the “revolving door” phenomenon. Community and family resources were not able to cope with released patients who were leading more impoverished lives than they had in the hospitals. The staunchest supporters realized that drugs did not influence