On the different connotations of social psychiatry
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© Steinkopff Verlag 2002
EDITORIAL
Stefan Priebe · Asmus Finzen
On the different connotations of social psychiatry
Accepted: 20 September 2001
The term social psychiatry is well established and has a long tradition.Almost exactly 100 years after Reil (1803) introduced the word psychiatry into the literature, Ilberg (1904) wrote a paper which – to our knowledge – was the first one carrying the term social psychiatry in the title. Approximately another 100 years later the term is still with us. There are societies, congresses, chairs and journals for social psychiatry, and the term – or its translations respectively – is widely used in various countries. In the last century the connotation of the term inevitably varied. In this short editorial it is impossible to summarise its history or the numerous essays that have been written on it (e. g. see Bebbington 1991; Finzen & Hoffmann-Richter 1995). Whilst nowadays the term has predominantly positive connotations, this has not always been the case. Between the two World Wars the changing political climate in Germany led to negative associations with the term. This era began with, among others, Fischer (1919) who described a programme of social psychiatry that, despite a very different terminology, substantially overlaps with what modern textbooks say on the subject. He emphasised the importance of investigating social causes of mental illness and posited public health interventions as prophylactic measures. In the 1920s, reforms aimed at community based mental health care – the ‘open care’ – were stimulated by such ideas and became associated with social psychiatry (Schmiedebach et al. 2000). However, at the same time, the term was increasingly used by other psychiatrists, who advocated racial hygiene and argued for compulsory sterilisation of mentally ill paProf. S. Priebe () Unit for Social and Community Psychiatry Barts and the London School of Medicine West Smithfield London EC1A 7BE, UK E-Mail: [email protected]
SPPE 508
A. Finzen Psychiatrisches Universitätsklinikum University of Basle, Switzerland
tients, thus brandishing ‘social psychiatry’ with dark implications (e. g. Rüdin 1931). Since World War II, social psychiatry has not been associated with such ideas. What does ‘social psychiatry’ mean today? Any definition is plagued by the ambiguity of the word social.‘Social’ may be used in the sense of communal or public and relate to interpersonal relationships, such as in ‘social’ sciences. On the other hand, ‘social’ may indicate a friendly and humane intention, often of a political nature, and stand for a commitment to equality, such as in ‘social’ political parties. With respect to the latter connotation Von Hayek (1983) stated that “the adjective social is probably the most confusing and misleading term of our whole political vocabulary, . . . a ‘weasel word’. As a weasel is alleged to be able to empty an egg without leaving a visible sign, so can . . . (social) deprive any term to which . . . (it is) prefixed of content, while seemingly leaving them un
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