Outpatient Psychiatry and Mental Health Care: International Perspectives

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This article is about the main similarities and differences between the twentieth-century history of extramural psychiatry and mental health care in the countries that are central in this volume: France, the Federal Republic of Germany, Italy, the Netherlands, the United Kingdom, and the United States. My comparative analysis not only switches back and forth between relevant general trends and specific national developments. It also has a double focus: the development of outpatient services and other facilities in society, also known as 'community care' in the Anglo-Saxon countries, and 'de-institutionalisation', the demise of the public system of mental institutions, or at least a considerable reduction of its size. First I outline the relevant developments in extramural mental health care during the first half of the twentieth century. Then I will explore the changing constellation of psychiatry and mental health care in the second half of the last century, which some scholars refer to as the third psychiatric revolution: the different ways and degrees in which de-institutionalisation was implemented in the various countries and the accompanying shift towards outpatient or community care. Moreover, special notice will be taken of the tensions between ideals and realities. At the very end I shall again briefly consider the main differences and similarities between the six countries.
Histories of psychiatry largely centre on mental institutions; studies on the history of outpatient psychiatry and mental health care are still thin on the ground and therefore the data at my disposal are incomplete and fragmentary. My comparative analysis relies on some available studies in English, Dutch and German, the preceding articles in this volume, and some papers presented at the Anglo-Dutch-German Workshop on Social psychiatry and Ambulant Care in the Twentieth Century, which took place in London in 2002.
Original languageEnglish
Title of host publicationPsychiatric Cultures Compared
Subtitle of host publicationPsychiatry and Mental Health Care in the Twentieth Century
EditorsM. Gijswijt-Hofstra, H. Oosterhuis, J. Vijselaar, H. Freeman
Place of PublicationAmsterdam
PublisherAmsterdam University Press
Publication statusPublished - 1 Jan 2005
Eventconference; 2005-01-01; 2005-01-01 -
Duration: 1 Jan 20051 Jan 2005


Conferenceconference; 2005-01-01; 2005-01-01

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