Originally published in 1978, with the reform of the 1959 Mental
Health Act under consideration, it was time to re-examine the
recent policy of desegregating the mentally ill and treating them
within general hospital psychiatric units rather than in mental
hospitals. This shift in policy reflected a number of significant
trends in contemporary British psychiatry. It signified the
acceptance of the idea that mental disorder is like a physical
illness and should be treated as such, within the same buildings.
It had also brought the psychiatric profession closer to the
mainstream of medicine and had conferred on it a status similar to
that enjoyed by other branches of the medical profession. In this
study, however, the authors question much of British psychiatric
practice at the time. Part of the book is devoted to explaining how
the psychiatric profession had been able to establish a hegemony
over the mental health field, and consequently subordinate the
other mental health professions to minor roles. The main emphasis
of the book is on the controversial policy of desegregation of the
mentally ill. The historical development of general psychiatric
units is discussed, then a case study documenting the 'careers' of
three patients who passed through one such unit is presented,
providing a fascinating insight into the way in which the unit
operated as a diagnostic and therapeutic centre. Finally, an
analysis is made of some of the issues raised by the study. In
particular, the staff structure of psychiatric centres and the
processes of assessment and treatment are considered in detail.
General
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