Asylum in the Community

By Dylan Tomlinson; John Carrier | Go to book overview

Introduction

Dylan Tomlinson and John Carrier

Few would defend the mass-produced care of the large mental hospital, and it is government policy in Europe and America for residential care to be provided on a smaller scale in community care settings. Community care, however, has, of late, been subjected to ever more critical scrutiny. This has led to 'Scull's dilemma' being posed (Jones, 1982). This is the dilemma of those who see institutional neglect being succeeded by community neglect and who thus look in vain for an alternative. Scull suggests in this volume that the dilemma is the dilemma of society at large rather than of mental health care analysts. But whoever it is that faces the dilemma, its existence calls for a reappraisal of the role of the mental hospital in giving asylum, in its truest sense. This book attempts such a reappraisal, from a variety of perspectives, and assesses whether 'true' asylum can be provided in the community.

True asylum as retreat or refuge is a concept that is surprisingly ill-defined. Reparation and even relief from poverty have been argued to lie within its compass. The rather general and often sweeping definitions of true asylum that have been offered in relation to the functions of the mental hospital have tended to lack evidence to support them. To some extent it has been taken as an unquestioned assumption that there has always been, and continues to be, provision of asylum in the psychiatric hospital. A major concern we share with our contributors is therefore to address the lack of evidence to support this claim.

The book begins with an examination of the objectives of asylum for nineteenth-century founders of the 'asylum movement'. It moves on to analysis of case notes and archival material to assess the ways in which the founders' objectives were met, if at all,

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