Wing J K
Research Unit, Royal College of Psychiatrists, London.
Br J Psychiatry. 1990 Dec;157:822-7. doi: 10.1192/bjp.157.6.822.
Many of the functions of large psychiatric hospitals were those of asylum. As the structure of services has changed and the role of the large hospital has diminished, the necessity to continue to cover their functions has tended to be forgotten, partly because it has been thought that, even at best, they were purely protective. Such a point of view cannot be sustained. The functions of asylum have always been both refuge and recuperation. 'Community care' will come to deserve the odium now attached to the worst practices of former times if the tradition of asylum practised in the best of the large hospitals is not (with appropriate modification) acknowledged, properly placed in the psychiatric curriculum, and given high priority in service planning.
大型精神病医院的许多功能都属于收容所的功能。随着服务结构的变化以及大型医院作用的减弱,继续承担其功能的必要性往往被遗忘了,部分原因是人们认为,即使在最好的情况下,这些功能也纯粹是保护性的。这种观点是站不住脚的。收容所的功能一直都是庇护和康复。如果大型医院中最佳实践所体现的收容传统得不到(适当调整后)认可、没有恰当地纳入精神病学课程,并且在服务规划中没有得到高度重视,那么“社区护理”将会像过去最恶劣的做法一样遭人唾弃。