Critical psychiatry: The implications for community mental health practice

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Critical psychiatry The implications for
community mental health practice

• D B Double

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The origins of community care
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The origins of community care

• Dismay and disgust with the old asylum system

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The origins of community care

• Dismay and disgust with the old asylum system
• Opening the doors of the psychiatric hospital

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The origins of community care

• Dismay and disgust with the old asylum system
• Opening the doors of the psychiatric hospital
• Therapeutic milieu in hospital

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The origins of community care

• Dismay and disgust with the old asylum system
• Opening the doors of the psychiatric hospital
• Therapeutic milieu in hospital
• Institutional neurosis' (Russell Barton)

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The origins of community care

• Dismay and disgust with the old asylum system
• Opening the doors of the psychiatric hospital
• Therapeutic milieu in hospital
• Institutional neurosis' (Russell Barton)
• Total institution' (Erving Goffman)

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Critical psychiatry and community care
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Critical psychiatry and community care

• Thomas Scheff (1999) Being mentally ill

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Critical psychiatry and community care

• Thomas Scheff (1999) Being mentally ill
• Franco Basaglia and law 180 in Italy

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Critical psychiatry and community care

• Thomas Scheff (1999) Being mentally ill
• Franco Basaglia and law 180 in Italy
• Bracken Thomas and home treatment in Bradford

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Nature of critical psychiatry
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Nature of critical psychiatry

• Opposition to the reductionist tendency within
  psychiatry

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Nature of critical psychiatry

• Opposition to the reductionist tendency within
  psychiatry
• More ethical foundation for practice

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Nature of critical psychiatry

• Opposition to the reductionist tendency within
  psychiatry
• More ethical foundation for practice
• The term 'mental illness' may have meaning as a
  psychosocial concept

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Nature of critical psychiatry

• Opposition to the reductionist tendency within
  psychiatry
• More ethical foundation for practice
• The term 'mental illness' may have meaning as a
  psychosocial concept
• Acknowledges the inevitable social dimension of
  psychiatric practice

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Anti-psychiatry and institutionalisation
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Anti-psychiatry and institutionalisation

• A whole new approach without those features of
  psychiatric practice that seemed to belong to the
  sphere of social power and structure rather than
  to medical therapeutics (Laing1985).

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Anti-psychiatry and institutionalisation

• A whole new approach without those features of
  psychiatric practice that seemed to belong to the
  sphere of social power and structure rather than
  to medical therapeutics (Laing 1985).
• An effort to cease interference, to 'lay off'
  other people and give them and oneself a chance
  (David Cooper)

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Anti-psychiatry and institutionalisation

• Villa 21 in Shenley Hospital

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Anti-psychiatry and institutionalisation

• Villa 21 in Shenley Hospital
• Philadelphia Association established Kingsley
  Hall in 1965

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Anti-psychiatry and institutionalisation

• Villa 21 in Shenley Hospital
• Philadelphia Association established Kingsley
  Hall in 1965
• Rumpus room at Gartnavel hospital

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Anti-psychiatry and institutionalisation

• Villa 21 in Shenley Hospital
• Philadelphia Association established Kingsley
  Hall in 1965
• Rumpus room at Gartnavel hospital
• Joseph Berke and Leon Redler both worked with
  Maxwell Jones at Dingleton hospital before moving
  to Kingsley Hall

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Critical psychiatry and other psychosocial
approaches
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Critical psychiatry and other psychosocial
approaches

• Harry Stack Sullivan and Sheppard Pratt Hospital

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Critical psychiatry and other psychosocial
approaches

• Harry Stack Sullivan and Sheppard Pratt Hospital
• Adolf Meyers Psychobiology

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Critical psychiatry and other psychosocial
approaches

• Harry Stack Sullivan and Sheppard Pratt Hospital
• Adolf Meyers Psychobiology
• Clifford Beers and mental hygiene

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Implications
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Implications

• Psychosocial perspectives have a long history in
  psychiatry

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Implications

• Psychosocial perspectives have a long history in
  psychiatry
• Critical psychiatry has an explicitly ethical
  stance

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Implications

• Psychosocial perspectives have a long history in
  psychiatry
• Critical psychiatry has an explicitly ethical
  stance
• The challenge of the user movement

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Implications

• Psychosocial perspectives have a long history in
  psychiatry
• Critical psychiatry has an explicitly ethical
  stance
• The challenge of the user movement
• Meyer diverted Beers critique into the mental
  hygiene movement

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Implications

• Psychosocial perspectives have a long history in
  psychiatry
• Critical psychiatry has an explicitly ethical
  stance
• The challenge of the user movement
• Meyer diverted Beers critique into the mental
  hygiene movement
• Anti-psychiatry had many of the same interests as
  other psychosocial perspectives