Psychiatric Institutions and the Emerging Institutional Scene in Nigeria

Classical and contemporary phenomenological approaches in psychiatry describe schizophrenia as a disorder of common sense and self-affection. Although taking into account intersubjectivity, this conceptualization still puts forward an individualistic view of the disorder, that is, the intersubjective deficit resides within the person. To overcome such individualism, in this article, we first propose that schizophrenic experience might be understood as arising from a dialectic relation between the self’s loss of openness to the world and the world’s loss of openness to the self. To show the relevance of social factors at the onset of schizophrenic experience, we propose a phenomenological analysis of trigger situations. In the second and main part of this article, we then focus on the implications of these phenomenological insights for the clinical practice: we argue that if schizophrenia is understood as a loss of openness between self and social world, psychiatric institutions should be transformed into spaces that enable a reopening of selves. We first describe enclosing phenomena such as coercive treatment to then, in contrast, present particular forms of open psychiatric spaces such as open door approaches and open dialogue. Besides the institutional-structural level, we also highlight aspects of openness at the intersubjective level of the individual agents, thus particularly emphasizing the role of an open therapeutic stance. We thus speak of (re)opening selves as we believe that the reopening of the patients’ self cannot but be related to and fostered by a reopening of the professionals’ self and stance. We thus argue that openness in the therapeutic stance is key to initiating the further process of recovery, which we describe as a reattunement of selves both at the bodily and narrative level. Last but not least, we sketch out possibilities for future phenomenological research on the question of psychiatric space and draw some broader societal implications.

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Between Punishment and Care: Autonomous Offenders Who Commit Crimes Under the Influence of Mental Disorder

Criminal Law and Philosophy ◽

10.1007/s11572-021-09595-4 ◽

2021 ◽

Author(s):

Thomas Hartvigsson

Keyword(s):

Criminal Justice ◽

Mental Disorders ◽

Mental Disorder ◽

Criminal Responsibility ◽

Psychiatric Patients ◽

Involuntary Treatment ◽

Psychiatric Condition ◽

Psychiatric Institutions

AbstractThe aim of this paper is to present a solution to a problem that arises from the fact that people who commit crimes under the influence of serious mental disorders may still have a capacity to refuse treatment. Several ethicists have argued that the present legislation concerning involuntary treatment of people with mental disorder is discriminatory and should change to the effect that psychiatric patients can refuse care on the same grounds as patients in somatic care. However, people with mental disorders who have committed crimes and been exempted from criminal responsibility would then fall outside the scope of criminal justice as well as that of the psychiatric institutions if they were to refuse care. In this paper, I present and develop a solution to how society should deal with this group of people, called Advance criminal responsibility. The basic idea being that if a person with a potentially responsibility exempting psychiatric condition refuses care, that person is responsible for any future criminal acts which are due to the mental disorder.

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‘Psychosis of civilization’: a colonial-situated diagnosis

History of Psychiatry ◽

10.1177/0957154x20968063 ◽

2020 ◽

pp. 0957154X2096806

Author(s):

Marianna Scarfone

Keyword(s):

Clinical Case ◽

Inner Life ◽

Differential Approach ◽

Psychiatric Institutions ◽

New Material

In the late 1930s, when colonial psychiatry was well established in the Maghreb, the diagnosis ‘psychosis of civilization’ appeared in some psychiatrists’ writings. Through the clinical case of a Libyan woman treated by the Italian psychiatrist Angelo Bravi in Tripoli, this article explores its emergence and its specificity in a differential approach, and highlights its main characteristics. The term applied to subjects poised between two worlds: incapable of becoming ‘like’ Europeans – a goal to which they seem to aspire – but too far from their ‘ancestral habits’ to revert for a quiet life. The visits of these subjects to colonial psychiatric institutions, provided valuable new material for psychiatrists: to see how colonization impacted inner life and to raise awareness of the long-term socio-political dangers.

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A 5-year retrospective investigation of all first admitted schizophrenics to Danish psychiatric institutions in the fiscal year from April 1st, 1970, to April 1st, 1971

Acta Psychiatrica Scandinavica ◽

10.1111/j.1600-0447.1980.tb07708.x ◽

1980 ◽

Vol 62 (S285) ◽

pp. 332-336 ◽

Cited By ~ 4

Author(s):

J. Gam

Keyword(s):

Fiscal Year ◽

Psychiatric Institutions ◽

Retrospective Investigation

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Mental illness, personhood, and transcendence: Spiritual and religious assistance in Catholic psychiatric contexts

Transcultural Psychiatry ◽

10.1177/13634615211059698 ◽

2021 ◽

pp. 136346152110596

Author(s):

Tiago Pires Marques

Keyword(s):

Mental Health ◽

Integrative Approach ◽

Spiritual Needs ◽

Global Dynamics ◽

Central Concept ◽

Psychiatric Institutions ◽

Whole Person ◽

Spiritual Tradition ◽

Catholic Hospital ◽

Fragmentation Of Care

In recent decades, there have been many calls for the inclusion of spirituality and religion (S/R) in therapeutic contexts. In some contexts, this has been an institutionalized form of spiritual and religious assistance (SRA). This article examines the concepts and practices involved in SRA services at three psychiatric institutions in Portugal, a country with strong Catholic roots but increasing efforts at secularity and recognition of religious diversity. The case of a user who contacted the SRA service allows us to better grasp this new practice in action. Although some SRA practices have similarities with mindfulness, a systematic comparison allows us to explore the links between SRA and the global dynamics related to S/R in mental health and the particularities of Catholic spirituality. In the contexts observed, the transition from the Catholic hospital chaplaincy system to the SRA model is developing through the integration of features of the Catholic spiritual tradition with concepts and practices drawn from the psychology of religious experience. The accompaniment of the ‘whole person’ emerges as the central concept of this form of SRA. Spirituality gains significance as an integrative approach to the subjectivity fragmented by the illness and the fragmentation of care across multiple clinical specialties. Furthermore, the prioritization of the spiritual needs expressed by users suggests that SRA combines well with the individualistic rationales and the technification of care in the field of mental health.

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Implementation of the national register of suicide attempts as a preliminary strategy for the prevention of suicides in Poland

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1816 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s892-s893

Author(s):

A. Gmitrowicz ◽

R. Szmajda ◽

A. Baran ◽

I. Makowska ◽

P. Kropiwnicki

Keyword(s):

Suicide Attempts ◽

Independent Predictor ◽

Population Based ◽

Death Certificates ◽

Psychiatric Institutions ◽

Central Register ◽

Central Statistical ◽

Central Statistical Office ◽

Competing Interest ◽

Reported Data

Studies show that suicide attempts are a major independent predictor of suicide. Only in some countries of the world, there are national registers of these behaviors. Poland is among the countries where suicide prevention is at the stage of implementation of these strategies. One is the initial diagnosis of the prevalence of suicidal behavior (SB) in selected populations. The aim of the study was to assess the prevalence of SB in Poland on the basis of available databases, including data such as age, sex and mental disorders and the analysis of differentiation of selected indicators of SB.Material and methodsWe analyzed available registers of completed suicides (CS) and suicide attempts (SA), carried out under reporting of the central statistical office (CSO, in the general population, based on death certificates), Police Headquarters (PH, the number of reported SB in the country) and the Institute of Psychiatry and Neurology in Warsaw (IPiN, the number of SB in all psychiatric institutions) and the department of adolescent psychiatry in Łódź (SB among hospitalized youth).Results and conclusionsReported data on dissemination of SB in Poland are incomplete, which may affect the reliability of the assessment of the effectiveness of implemented strategies for the prevention of suicides. The aim should be to create a central register of SB, which will not only gather a well-defined data but also monitor how it is obtained.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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