Psychiatric care in relation to the development of the contemporary state: the case of Catalonia.

Over the past two centuries, extensive mental health care systems have come to be a feature of all Western societies. However, the theoretical model generally invoked to account for this process has only limited applicability to Spain, where the growth of capitalism and the liberal state followed an atypical and uneven course. Political power and economic power, usually coterminous, were divided in Spain between center and periphery, so that, until the 1960s, Spain's economic center of gravity was localized in Catalonia, the most culturally and linguistically distinct region. Here we are dealing with a paradox: on the one hand, the failure of the incompletely centralized and economically underdeveloped Spanish state to develop a system of psychiatric care comparable to those of other European states; and on the other hand, the success of the Catalan bourgeoise, though lacking a state of its own, in creating such a system through private initiative.