Miéville C
Schweiz Arch Neurol Neurochir Psychiatr. 1979;124(2):191-5.
The author relates the history of the institutional therapies which have been developed, mainly since 1929, by Hermann Simon. This avant-garde psychiatrist has not only developed the occupational therapies but he has also recommended both the liberalization of the institution and the constant analysis of its problems. The institutional therapies have the tendency, nowadays, to increase infinitely but their choice is not always logically motivated and their use risks being not very useful, if it is not determined by a clear therapeutic plan regarding the patient and by a well defined therapeutic attitude in the institution. The author introduces then the second subject of the discussion: "Psychiatry and penitentiary problems" by recalling the difficulties of the modern psychiatry to abandon its origins and to get rid of the asylum ghetto. This is probably the reason why most of the psychiatrists elude the psychological and psychiatric problems presented in prison and why they avoid every collaboration with the judicial and administrative authorities. Delicate situations, which call the psychiatrists into question by posing them problems of freedom, human rights, justice and social demands.
作者讲述了主要自1929年以来由赫尔曼·西蒙发展起来的机构治疗法的历史。这位先锋派精神病学家不仅发展了职业疗法,还提倡机构的自由化以及对其问题的持续分析。如今,机构治疗法有无限增加的趋势,但其选择并非总是基于合理的逻辑,而且如果不是由针对患者的明确治疗计划以及机构中明确界定的治疗态度所决定,其使用可能毫无用处。然后作者引入了讨论的第二个主题:“精神病学与监狱问题”,回顾了现代精神病学在摆脱其起源和脱离收容所隔离区方面的困难。这可能就是为什么大多数精神病医生回避监狱中出现的心理和精神问题,以及他们避免与司法和行政当局进行任何合作的原因。这些微妙的情况通过提出自由、人权、正义和社会需求等问题,使精神病医生面临质疑。