Thompson J W
Department of psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201.
Hosp Community Psychiatry. 1994 Oct;45(10):987-92. doi: 10.1176/ps.45.10.987.
Over the past 150 years, support for providing appropriate services for mentally ill persons has waxed and waned. In colonial America, mentally ill persons were institutionalized in jails or almshouses. In the 18th and 19th centuries, asylums constituted the primary psychiatric service. Only in the late 19th and early 20th centuries did alternatives to long-term hospitalization appear. The mental hygiene movement of the early 20th century and the community mental health centers movement of the 1960s and 1970s both increased the number of services and introduced new types of services. Today, however, despite hopeful signs of reduced public prejudice against mentally ill persons, a new "dark age" for support of psychiatric services may be dawning, as negative attitudes about mental illness continue to drive public policy.
在过去的150年里，为精神疾病患者提供适当服务的支持力度一直起伏不定。在殖民时期的美国，精神疾病患者被收容在监狱或救济院。在18世纪和19世纪，精神病院是主要的精神科服务机构。直到19世纪末20世纪初，长期住院治疗的替代方案才出现。20世纪初的精神卫生运动以及20世纪60年代和70年代的社区精神卫生中心运动，都增加了服务的数量并引入了新的服务类型。然而如今，尽管有迹象表明公众对精神疾病患者的偏见有所减少，但由于对精神疾病的负面态度继续影响公共政策，支持精神科服务的新“黑暗时代”可能正在来临。
