Francois Ferrero: The Geneva 1980's psychiatry crisis: Psychiatry an Antipsychiatry
Foreword by Norman Sartorius
It is important that psychiatrists, social scientists, public health experts, managers of health institutions and mental health workers read Professor Ferrero’s new book. It describes the extraordinary events which followed the death of a patient in the psychiatric hospital of Geneva in 1980 and uses the incident to introduce the reader to the correspondence between himself and a pleiad of leaders of psychiatry in various countries reciting facts and describing their experiences related to the antipsychiatry movement and its consequences. The correspondence is organized in a manner that makes readers see personal experience and data about the time of antipsychiatry merging into a story – a story with morals which are particularly relevant now when psychiatry is experiencing another examination of its goals, methods of work and achievements.
The current challenge to psychiatry is to demonstrate that the paradigms which it developed in the second half of the past century and which it still promotes remain valid. Is it still possible to expect that people with serious mental illness will be provided care by their families and communities? Rapid urbanization led to the disappearance of communities sharing living space and supporting their members. Families became smaller and less stable and the sense and limits of the families’ responsibility for its members has changed. Many of the roles previously played by the family have been transferred to governmental or insurance agencies. The classical pattern of engaging the family in care and involving the community in helping those who had experienced an illness or other misfortune are no longer universally applicable realistic options. Will this lead to the development of a new system of care catering to the needs to an increasing number of people with impairments and disabilities who will not be able to rely on care offered by family and community members? And who should therefore be relying on institutions which provide care? Are we entering a new era, an era of re-institutionalization? Perhaps, using different types of institutions but still institutions with features and effects which we declared obsolete and harmful? Will it be possible to ensure that the new institutions are structured in a manner that will ensure the protection of human rights of people with mental illness and provide them with personalized effective care? And even if so, will this bring about a new era of antipsychiatry?
Is it still possible to see psychiatry and psychology as being different and see psychology as a scientific discipline exploring psychological functioning and psychiatry a branch of medicine providing treatment to people with mental illness? A significant proportion of psychologists are engaged in the provision of care to people with mental illness and an equally significant proportion of psychiatrists see research as their main goal and occupation. The change of roles which are defining professions and the consequent need to re-assign responsibilities may also help to reawaken developments similar to those which marked psychiatry in the times which are so vividly described in Professor Ferrero’s book.
Will the current osmosis of cultures brought about by migration and digitalization make most psychiatrists obliged to treat people whose cultural background they neither share nor understand? And will this lead to an even stronger role of alternative medicine and a reliance on various types of healers who have never seen eye to eye with psychiatrists whom they see (and the feeling is mutual) as rivals at best and as enemies at worst to become the new leaders of antipsychiatry?
We should be grateful to Professor Ferrero for providing us with the fascinating information that he assembled and for the stimulus for reflection that it represents. We should thank him for reminding us of the difficulties which psychiatry had faced and managed to overcome and for reviving the memories about some of the challenges which faced psychiatry in the second part of the 20th century. And we should not forget to thank him for this presentation of a cameo of history of psychiatry in Switzerland – the land which has given world psychiatry an extraordinary number of leaders and makers of the best of the discipline – ranging from Abraham Joly and Auguste Forel to Carl Gustav Jung, Ludwig Binswanger and Hermann Rorschach to Eugen Bleuler and many others since then.
December 2, 2021