Money and Management

Abstract

AbstractTensions between the therapeutic value and the financial benefits of patient work were exacerbated by the difficult financial climate following World War I and during the Great Depression. In France, prefects and asylum directors were keen to maximise the use of patient work to offset institutional running costs, which did not always sit comfortably alongside its therapeutic remit. The transformation of the Asile Clinique into a hospital for acute patients was delayed because it involved losing the asylum’s incurable and chronic patients, who were its best workers. In England, the economic contribution made by patient work was downplayed, in the light of accusations of exploitation, while the curative role of occupation was emphasised. Occupational therapy added to, rather than offset, institutional running costs, but this was justified by its role in active treatment. The budget for entertainment was another contested area; whether expenditure in this area could be justified on the grounds of therapy.