Rosenbaum M
Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque.
Gen Hosp Psychiatry. 1991 Mar;13(2):115-21. doi: 10.1016/0163-8343(91)90022-o.
In recent years there has been a marked increase in interest and publications dealing with violence in psychiatric facilities. There is general agreement that the increase in violent behavior is real despite underreporting prior to the late 1970s. The author proposes that the changes in structure and functioning of psychiatric facilities following the Community Mental Health Act of 1963 may be one of the factors responsible for the increase of violent behavior. To test this proposal, Index Medicus was searched for articles on violence in psychiatric facilities from 1935 through 1988. The first articles appeared in 1968. A review of leading textbooks of psychiatry during the same period revealed similar findings. The role of the lax milieu is discussed. It is proposed that the "medical model" as described in this paper be reinstituted in short-stay psychiatric facilities.
近年来，有关精神病院暴力行为的关注度和相关出版物显著增加。尽管在20世纪70年代末之前存在报告不足的情况，但人们普遍认为暴力行为的增加是真实存在的。作者提出，1963年《社区精神卫生法》颁布后精神病院结构和功能的变化可能是暴力行为增加的因素之一。为了验证这一观点，检索了《医学索引》中1935年至1988年有关精神病院暴力行为的文章。最早的文章出现在1968年。对同一时期主要精神病学教科书的回顾也得出了类似的结论。文中讨论了宽松环境的作用。建议在短期精神病院中重新采用本文所述的“医学模式”。
