Mental health care and the politics of inclusion: A social systems account of psychiatric deinstitutionalization
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Theoretical Medicine and Bioethics 31 (6):411-427 (2010)
This paper provides an interpretation, based on the social systems theory of German sociologist Niklas Luhmann, of the recent paradigmatic shift of mental health care from an asylum-based model to a community-oriented network of services. The observed shift is described as the development of psychiatry as a function system of modern society and whose operative goal has moved from the medical and social management of a lower and marginalized group to the specialized medical and psychological care of the whole population. From this theoretical viewpoint, the wider deployment of the modern social order as a functionally differentiated system may be considered to be a consistent driving force for this process; it has made asylum psychiatry overly incompatible with prevailing social values (particularly with the normative and regulative principle of inclusion of all individuals in the different functional spheres of society and with the common patterns of participation in modern function systems) and has, in turn, required the availability of psychiatric care for a growing number of individuals. After presenting this account, some major challenges for the future of mental health care provision, such as the overburdening of services or the overt exclusion of a significant group of potential users, are identified and briefly discussed
|Keywords||Mental health services Deinstitutionalization Psychiatric reform Social inclusion Social systems theory Niklas Luhmann|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
Enric J. Novella (2010). Mental Health Care in the Aftermath of Deinstitutionalization: A Retrospective and Prospective View. [REVIEW] Health Care Analysis 18 (3):222-238.
Enric J. Novella (2008). Theoretical Accounts on Deinstitutionalization and the Reform of Mental Health Services: A Critical Review. [REVIEW] Medicine, Health Care and Philosophy 11 (3):303-314.
Citations of this work BETA
No citations found.
Similar books and articles
John Z. Sadler (2005). Values and Psychiatric Diagnosis. Oxford University Press.
David A. Pollack, Bentson H. McFarland, Robert A. George & Richard H. Angell (1993). Ethics and Value Strategies Used in Prioritizing Mental Health Services in Oregon. HEC Forum 5 (5):322-339.
Antoon Braeckman (2006). Niklas Luhmann's Systems Theoretical Redescription of the Inclusion/Exclusion Debate. Philosophy and Social Criticism 32 (1):65-88.
Dan W. Brock (2001). Children's Rights to Health Care. Journal of Medicine and Philosophy 26 (2):163 – 177.
Elin Palm (2013). Who Cares? Moral Obligations in Formal and Informal Care Provision in the Light of ICT-Based Home Care. Health Care Analysis 21 (2):171-188.
Elliot N. Dorff (1997). Paying for Medical Care: A Jewish View. Kennedy Institute of Ethics Journal 7 (1):15-30.
Laurence R. Tancredi (1977). Ethical Policy in Mental Health Care: The Goals of Psychiatric Intervention. Prodist.
John C. Moskop (1983). Rawlsian Justice and a Human Right to Health Care. Journal of Medicine and Philosophy 8 (4):329-338.
Engelbert Theurl (1999). Some Aspects of the Reform of the Health Care Systems in Austria, Germany and Switzerland. Health Care Analysis 7 (4):331-354.
Lorian E. Hardcastle, Katherine L. Record, Peter D. Jacobson & Lawrence O. Gostin (2011). Improving the Population's Health: The Affordable Care Act and the Importance of Integration. Journal of Law, Medicine & Ethics 39 (3):317-327.
K. W. M. Fulford (2006). Oxford Textbook of Philosophy and Psychiatry. Oxford University Press.
J. Warren Salmon (1987). The Medical Profession and the Corporatization of the Health Sector. Theoretical Medicine and Bioethics 8 (1).
Added to index2010-11-17
Total downloads39 ( #61,739 of 1,696,507 )
Recent downloads (6 months)12 ( #47,511 of 1,696,507 )
How can I increase my downloads?