https://www.tandfonline.com/doi/abs/10.1080/00332747.1954.11022958?

journalCode=upsy20

The Formal Social Structure of a Psychiatric Hospital

by
Jules Henry
This paper is an attempt to communicate some of the conceptualizations and hypotheses
regarding formal organizational structure which the author arrived at as the result of intensive
study of a psychiatric unit of a general hospital. I present these in the hope that some of the
conceptualizations of the way that stress is created by organizational structure, which I have
formalized in two equations, can be further tested by other workers.

On the basis of my observations, I feel that when people fail to function adequately in an
organization, the areas of stress in the formal organization itself must be examined. In other
words, before one identifies certain people as operating inappropriately within the
organization, some attention should be focused on the difficulties inherent in the organization
itself. On the basis of my data, I have constructed certain typical situations that arise in
hospital administration, involving, for example, the charge nurse, or the administrators of
different wings of a hospital. Some of these situations will be recognized by people working
in other hospitals as typical of their own organizations, too.

The emotional relations among the many of the important pioneering

workers in any task-performing
organization are important; but in a
psychiatric hospital they are especially so
because of the direct effect of workers on
patients. It has long been one of the
guiding principles of sociology' and
anthropology that the specific quality of
emotional relations between people is in
large part a function of the over-all formal
social matrix in which they live, and this
paper will be devoted to the development
of hypotheses regarding the relationship
between the formal structure of a
psychiatric hospital as a task-performing
organization and the attitudes of the
workers toward each other.
1
Perhaps Dr. Kirkbride should be given credit
for having first stressed the Importance of the
forma] structure of a mental hospital to the
welfare of patients. Sec Karl D. Bond. Dr.
Kirkbride and His Mental Hospital: New York,
Lippincott. 1947: pp. 153*154. William C.
In speaking of a psychiatric hospital, has I
felt that it is legitimate at this time to stress
formal organization, for the reason that so
sociological studies of psychiatric
hospitals have analysed
Menninger. said that “above all, it must be a
highly organized, efficient Institution."
See his “Therapeutic Methods in a Psychiatric
Hospital." J. Amer. Med. Assn. (1932) 99:533-
542.
See also: Chester I. Barnard, The Functions of
the Executive: Cambridge. Harvard Univ.
Press, 1938. Burleigh B. Gardner. “The
Factory as a Social System”; In Industry and
Society, edited by William Foote Whyte: New
York. McGraw-Hill. 1946. There Is no reason
why the hypotheses developed hr re need be
thought of as applying to psychiatric
hospitals only, even though they were
developed in the course of the study of one.
*J. Fremont Bateman and H. Warren
Dunham, “The State Mental Hospital as a
Specialized Community.” Amer. J. psychiatry
(1948) 105:445-448. William Caudill,
Fredrick C. Redlich, Helen R. Gilmore. and
Eugene B. Brody, “Social Structure and
Interaction Processes on a Psychiatric Ward.”
Amer.
J. Orthopsychiatry (1952) 22:314-333.
Howard Row land. “Interaction Processes in
the State Mental Hospital.” PSYCHIATRY
(1938) 1:323-337. Rowland. “Friendship
Patterns in the State Mental Hospital”
PSYCHIATRY (1939) 2:363-373. Charlotte
Green Schwartz. Morris S. Schwartz, and
Alfred H. Stanton. “A Study of Need-
Fulfilment on a Mental Hospital
Ward,” PSYCHIATRY (1951) 14:223-242. A. H.
Stanton and M. S. Schwartz: “The
Management of a Typo of Institutional
Participation in Mental Illness,”
PSYCHIATRY (1949) 12:13-20. "Medical
Opinion and the Social Context in the Mental
Hospital,” PSYCHIATRY (1919) 12:243249.
“Observations on
Dissociation as Social Participation,"
PSYCHIATRY (1949) 12: 339-354. “A Social
Psychological Study of Incontinence”
PSYCHIATRY (1950) 13:399-410.

• B.S. College of the City of New York 28: Ph.D. Columbia 35: Asst. Anthropology, Columbia 34-
36,38-39; Prof. Anthropology. Institute Polytechnic National. Mexico. D.F. 40-41: Honorary Prof.
Sociology, Univ. of Mtchoacan. Mexico; Linguist. Dept. Asuntos Indlgenas Mexico. D.F. 40; U. S.
Dept, of Agriculture, OWI. OIAA 42-45: USSBS 45-46; U. S. Dept, of Labour 46-47: Assoc. Prof.
Anthropology, Washington Univ.47- Rsc Assoc, and Visiting Assoc. Prof. Anthropology. University of
Chicago 53

The author wishes to accept full responsibility for the opinions expressed in this paper.
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