Eikelmann B
Klinik für Psychiatrie und Psychotherapie, Städtisches Klinikum Karlsruhe.
Psychiatr Prax. 2000 Sep;27 Suppl 2:S53-8.
Deinstitutionalization is a complex process that in the past was often misunderstood solely as a run down or even closure of psychiatric hospitals. Although chronically mentally ill patients were prevented from long term hospitalisation some fundamental mistakes were repeated often: patients were simply discharged without any preparations and outpatient care was badly organised. In some cases this led to therapeutic neglect, social disintegration, homelessness, incarceration or other forms of dramatic loss of quality of life. These findings are internationally confirmed although there are remarkable differences between various health care systems. Especially when primarily determined by purely economic interests deinstitutionalization constitutes a severe danger for the whole psychiatric system of care and in particular for chronic patients. Intensive research is required to avoid severe disadvantages for the further development of psychiatry.
非机构化是一个复杂的过程，在过去它常常被简单地误解为精神病医院的衰败甚至关闭。尽管长期住院的精神疾病患者被避免了长期住院，但一些基本错误却经常反复出现：患者未经任何准备就被直接出院，门诊护理组织得很差。在某些情况下，这导致了治疗疏忽、社会解体、无家可归、被监禁或其他形式的生活质量严重下降。尽管不同的医疗保健系统之间存在显著差异，但这些发现已得到国际上的证实。特别是当主要由纯粹的经济利益决定时，非机构化对整个精神科护理系统，尤其是对慢性病患者构成了严重威胁。需要进行深入研究，以避免给精神病学的进一步发展带来严重不利影响。
