A medical model vs. a normative approach: the place of values in community psychiatry.

Based on a series of consultations with the staff in a mental hospital, which followed staff-patient meetings, the point of view taken derives from Scheff's 'social system' model, according to which psychiatric symptoms are considered as labelled violations of social norms, and mental illness is considered as a social role. It was found that in a somewhat cyclical succession, patient deviance was followed by the staff's spontaneous moral indignation. But thanks to the intervention of a medical idelogy, this was channelled and transformed into an impersonal, value free, non-judgemental reaction. It seems that as a first step towards humanizing their relationships with patients, the staff must be prepared to engage in a clarification and definition of their moral convictions. A major therapeutic goal should be to help de-moralized people, called mental patients, to acquire a new sense of morality and self-responsibility.