独裁和专制下的 "社区 "精神病学实验:1980-1989 年受保护公社的经验。

IF 1.5 4区 医学 Q2 ANTHROPOLOGY Culture Medicine and Psychiatry Pub Date : 2024-12-01 Epub Date: 2024-07-01 DOI:10.1007/s11013-024-09868-2
Cristian Montenegro
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引用次数: 0

摘要

在智利,长期压迫性的军事政权(1973-1990 年)瓦解了新出现的精神病治疗非机构化的倡议,强制推行新自由主义宪法,将公共服务向市场力量开放,限制国家在医疗和社会关怀中的作用。在与共产主义和社会主义联系在一起之后,以社区为基础的心理健康工作被禁止,社会主义精神病学家也因酷刑或流放而沉默。然而,一些治疗措施仍在继续,例如埃尔佩拉尔精神病院内的 "受保护公社"(PC)计划。该公社试图在精神病院的大门内模仿一个真实的小镇。它有一个普世教堂、一所学校和各种 "理事会 "部门,如娱乐、教育、废物处理、经济和卫生部门。在专制政权完全控制 "外部 "世界的同时,小路有了名字,病房变成了地区,病人和工人被赋予了新的民主角色。随着 1990 年民主制度的恢复,这一举措也随之终止。PC 被认为是一个古怪的、可忽略不计的插曲,常常被视为独裁统治前激进社区经验的中断。本文通过档案研究和对参与者的口述历史访谈,探讨了独裁者大会如何利用社区概念来驾驭独裁时期复杂的社会政治格局。有别于既有的关于专制统治下精神病学政治用途的论述,本研究将PC定位为一个多棱镜,用于理解 "社区 "这一概念以何种矛盾的方式超越了截然对立的社会和政治体制,成为心理健康改革词汇中的一个核心特征,尽管其含义模糊不清。
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Psychiatric Experiments with "Community" Under Dictatorship and Authoritarianism: The Case of the Protected Commune Experience, 1980-1989.

In Chile, a long and oppressive military regime (1973-1990) dismantled emergent initiatives for the deinstitutionalisation of psychiatric care, imposing a neoliberal constitution that opened public services to market forces and limited the state's role in health and social care. After being associated with communism and socialism, community-based mental health work was banned, and socialist psychiatrists were silenced through torture or exile. However, some therapeutic initiatives persisted, such as the "Protected Commune" (PC) initiative within the El Peral psychiatric asylum. The PC attempted to mimic a real town inside the asylum's gated perimeter. It featured an ecumenical chapel, a school, and various "council" departments like recreation, education, waste, economy, and health. Paths received names, wards became districts, and patients and workers were assigned new, democratic roles, all while the authoritarian regime entirely controlled the "outside" world. The initiative ceased with the return of democracy in 1990. Deemed an eccentric and negligible episode, the PC is often seen as an interruption to the radical community-based experiences of the pre-dictatorial era. Drawing on archival research and oral history interviews with participants, this paper examines how the PC harnessed the notion of community to navigate the complex socio-political landscape of the dictatorship. Differing from established accounts of the political uses of psychiatry under authoritarianism, the study positions the PC as a prism for understanding the contradictory ways in which the idea of 'community' has been able to transcend radically opposed social and political regimes, becoming a core feature in the vocabulary of mental health reform, despite its ambiguities.

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来源期刊
CiteScore
3.70
自引率
5.90%
发文量
49
期刊介绍: Culture, Medicine, and Psychiatry is an international and interdisciplinary forum for the publication of work in three interrelated fields: medical and psychiatric anthropology, cross-cultural psychiatry, and related cross-societal and clinical epidemiological studies. The journal publishes original research, and theoretical papers based on original research, on all subjects in each of these fields. Interdisciplinary work which bridges anthropological and medical perspectives and methods which are clinically relevant are particularly welcome, as is research on the cultural context of normative and deviant behavior, including the anthropological, epidemiological and clinical aspects of the subject. Culture, Medicine, and Psychiatry also fosters systematic and wide-ranging examinations of the significance of culture in health care, including comparisons of how the concept of culture is operationalized in anthropological and medical disciplines. With the increasing emphasis on the cultural diversity of society, which finds its reflection in many facets of our day to day life, including health care, Culture, Medicine, and Psychiatry is required reading in anthropology, psychiatry and general health care libraries.
期刊最新文献
Psychiatric Experiments with "Community" Under Dictatorship and Authoritarianism: The Case of the Protected Commune Experience, 1980-1989. Training in Cultural Competence for Mental Health Care: A Mixed-Methods Study of Students, Faculty, and Practitioners from India and USA. Medical Returnees: Somali Canadians Seeking Psychosocial and Spiritual Care in East Africa. The Evolution of Symbolic Thought: At the Intersection of Schizophrenia Psychopathology, Ethnoarchaeology, and Neuroscience. Infertility as Trauma: Understanding the Lived Experience of Involuntary Childlessness.
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