Wiersma Durk
Department of Psychiatry, Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Int Rev Psychiatry. 2008 Dec;20(6):540-5. doi: 10.1080/09540260802565513.
Social psychiatry as an academic discipline and field of clinical practice seems to have lost its prominence and is being incorporated in regular clinical services of mental healthcare and also in various branches of social, genetic, psychiatric or clinical epidemiology. However, the central debate in social psychiatry from its very beginning on how to care best for patients with severe mental illness (SMI) in the community, what to do with mental hospitals as potentially harmful pernicious institutions or with the hospitalization process, has never lost its momentum even in scientific meetings today. Social psychiatry and rehabilitation share a common focus on these issues, e.g. on independent living and working, on participation in society, and on prevention of hospitalization. Rehabilitation as an ideological and somewhat revolutionary movement of users and professionals in wanting to produce a fundamental change of mental healthcare (e.g. no compulsory treatment) and of society (e.g. elimination of stigma) developed its methods away from medicine and psychiatry and also away from testing these methods. Nowadays we observe growing scientific evidence for various psychosocial rehabilitative interventions which could substantiate the original mission of social psychiatry.
社会精神病学作为一门学术学科和临床实践领域,似乎已失去其突出地位,并正被纳入精神卫生保健的常规临床服务以及社会、遗传、精神病学或临床流行病学的各个分支。然而,社会精神病学从一开始就围绕如何在社区中为重症精神疾病(SMI)患者提供最佳护理、如何处理作为潜在有害机构的精神病院或住院治疗过程展开的核心辩论,即使在如今的科学会议上也从未失去其势头。社会精神病学和康复在这些问题上有着共同的关注点,例如独立生活和工作、参与社会以及预防住院。康复作为使用者和专业人员发起的一场意识形态上且颇具革命性的运动,旨在从根本上改变精神卫生保健(例如取消强制治疗)和社会(例如消除污名),其方法的发展脱离了医学和精神病学,也不再对这些方法进行检验。如今,我们观察到越来越多的科学证据支持各种心理社会康复干预措施,这可以证实社会精神病学的最初使命。