Långbro Hospital, Sweden—From Psychiatric Institution to Digital Museum: A Critical Discourse Analysis

Sites of oppression might be remembered in ways that contribute to dialogues about human rights and justice, exemplified by Sites of Conscience. Oppression was commonplace in former psychiatric institutions, yet such institutions are often subject to strategic forgetting and transformed into business parks, hotels, or residential areas. This article concerns Långbro Hospital, a digital museum presenting the former psychiatric institution Långbro, Sweden, now transformed into a residential area. I discuss how the former institution becomes a digital nonplace in which patients tend to be objectified or excluded, and the park and the buildings in which oppression occurred are reduced to representing beauty and functionality. I relate the analysis to digital Sites of Conscience such as British Museum of Colonialism and Pennhurst Memorial and Preservation Alliance and, thereby, show that thoughtful digitization might recognize prior as well as current injustice and oppression and contribute to change.

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

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.

Isolating Madness: Photographs from Seacliff Lunatic Asylum, 1887-1907

<p>Frederic Truby King (1858-1938) is an eminent figure in New Zealand history. His name continues to flourish in contemporary society, due in part to its affiliation with the Royal New Zealand Plunket Society. However, the general populace is still relatively unaware of the time that King spent employed as the medical superintendent of Seacliff Lunatic Asylum, on the remote outskirts of Dunedin. The prevailing image of King during this period is of a single-minded physician, whose career was in a state of acceleration towards the establishment of Plunket. But historians like Barbara Brookes and Catherine Coleborne have rightly started to establish this epoch as significant in its own right. This thesis extends their work by engaging with previously unpublished casebook photographs of patients in King’s care, taken between 1887 and 1907, from the restricted Seacliff Lunatic Asylum archives. Through six case studies, this thesis draws connections between these photographs and the paradigms established by such internationally renowned photographers as Hugh W. Diamond and James Crichton-Browne. It then discusses some distinctive photographs that appear unique to this institutional environment, images that challenge our preconceived notions of psychiatric institutions and their functions. This visual history complicates, and sometimes even challenges, the argument about psychiatric institutions and disciplinary power proposed by Michel Foucault and John Tagg, by demonstrating the diverse forms of photography that can occur within a single institution. This study is part of a growing body of research on the Seacliff Lunatic Asylum archives. In using a largely untapped source of photographic history, this project will contribute to future research on similar topics.</p>

Isolating Madness: Photographs from Seacliff Lunatic Asylum, 1887-1907

<p>Frederic Truby King (1858-1938) is an eminent figure in New Zealand history. His name continues to flourish in contemporary society, due in part to its affiliation with the Royal New Zealand Plunket Society. However, the general populace is still relatively unaware of the time that King spent employed as the medical superintendent of Seacliff Lunatic Asylum, on the remote outskirts of Dunedin. The prevailing image of King during this period is of a single-minded physician, whose career was in a state of acceleration towards the establishment of Plunket. But historians like Barbara Brookes and Catherine Coleborne have rightly started to establish this epoch as significant in its own right. This thesis extends their work by engaging with previously unpublished casebook photographs of patients in King’s care, taken between 1887 and 1907, from the restricted Seacliff Lunatic Asylum archives. Through six case studies, this thesis draws connections between these photographs and the paradigms established by such internationally renowned photographers as Hugh W. Diamond and James Crichton-Browne. It then discusses some distinctive photographs that appear unique to this institutional environment, images that challenge our preconceived notions of psychiatric institutions and their functions. This visual history complicates, and sometimes even challenges, the argument about psychiatric institutions and disciplinary power proposed by Michel Foucault and John Tagg, by demonstrating the diverse forms of photography that can occur within a single institution. This study is part of a growing body of research on the Seacliff Lunatic Asylum archives. In using a largely untapped source of photographic history, this project will contribute to future research on similar topics.</p>

COERCIVE MEASURESIN PANDEMIC PSYCHIATRIC CARE — RETROSPECTIVE STUDY

Coercion raises serious ethical and legal issues in psychiatric care. Coercive medical measures are applied in psychiatric institutions for protective purposes. Alcoholism is a social and medical problem because it especially affects the behavior of the individual. Alcohol consumption can catalyze exacerbations of mental illness and predispose to behaviors with an increased risk of violence. Aim: The purpose of this study is to illustrate medical and legal issues related to coercive measures in emergency psychiatric care during the pandemic. Methods: The study is retrospective, and the data were taken from the observation sheets of patients in the period between March 1, 2020–March 31, 2021, in acute section II in the Institute of Psychiatry "Socola" Iasi. Results: Of those who required coercive measures during hospitalization, most were restraint for symptoms such as: self-aggression and aggression towards others. Mechanical restraint measures were also necessary in cases with hallucinatory-delusional symptoms, associated with self-aggression and aggression towards others. The share of hospitalized patients for alcohol abuse, who required coercive measures, was significantly higher during the pandemic. Conclusion: Manifestations of violence among patients with major mental disorders are rare. Mechanical restraint was necessary especially in those who had self-aggression and aggression towards others, symptoms secondary to alcohol consumption. Alcohol consumption amplifies the psychological imbalance in the context of the COVID-19 pandemic.

Is Democracy Therapeutic? A Deweyan Reading of the Institutions of Antipsychiatry

This article presents a Deweyan reading of the processes of critique, experimentation, and reform that took hold of a minority of psychiatric institutions in Western Europe during the nineteen-sixties and seventies, under the influence of the so-called Italian and British antipsychiatry movements. Framed within a specific understanding of the sixties, the article examines these complex theoretical and institutional operations against the background of John Dewey’s idea of democracy, which it interprets, above all else, as the constant provision of material, intellectual, and human resources for the people to directly transform their environment and themselves in increasingly complex and creative ways. After acknowledging the historical and conceptual discontinuities that exist between these two autonomous bodies of knowledge, the first section presents a summary of Dewey’s philosophy. Next the article sheds light on Basaglia’s and Laing’s antipsychiatric projects by interpreting them as a sustained effort to distinguish between schizophrenia as a first and a second disease, an epistemological search in the midst of which each of them ended up creating new institutions that necessarily embarked their inmates on a radical process of Deweyan growth. The key role of the sixties counterculture is emphasized at this point, and examples from Gorizia’s and Trieste’s asylums, as well as British community households, are read in terms of Basaglia’s and Laing’s negative and affirmative dialectics, respectively. Finally, in the last two sections, the article argues that antipsychiatry’s analysis of psychotic behavior significantly enlarges Dewey’s understanding of the circuit of growth and experience, and that Dewey’s ideas of growth and experience provided, in turn, a missing criterion for defining mental health and deriving coherent therapeutic and institutional concretions.

Reopening Selves: Phenomenological Considerations on Psychiatric Spaces and the Therapeutic Stance

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 <i>enclosing</i> phenomena such as coercive treatment to then, in contrast, present particular forms of <i>open psychiatric spaces</i> 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 <i>selves</i> 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.

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

The 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.

Shock therapies in Spain (1939–1952) after the Civil War: Santa Isabel National Mental Asylum in Leganés

The first third of the twentieth century changed the therapeutical landscape with the emergence of new treatments for the mentally ill in asylums. However, the historiography of their use in Spanish psychiatric establishments has been scarcely studied. The popularization of barbiturate sleep therapies, insulin shock, cardiazol therapy, electroshock and leucotomy spread from the beginning of the century. However, the Spanish Civil War and Spain’s isolation during Franco’s autarky (1939–52) made their implementation difficult. Through historiographic research using medical records as documentary sources, this work analyses the socio-demographic conditions of the asylum population during the first decade of Franco’s dictatorship. The treatments used in Leganés Mental Asylum are described and are compared with those used in other Spanish psychiatric institutions.