Psychiatric Experiments with "Community" Under Dictatorship and Authoritarianism: The Case of the Protected Commune Experience, 1980-1989.

Publisher: Kluwer Academic Country of Publication: Netherlands NLM ID: 7707467 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-076X (Electronic) Linking ISSN: 0165005X NLM ISO Abbreviation: Cult Med Psychiatry Subsets: MEDLINE

Publication: Dordrecht : Kluwer Academic
Original Publication: Dordrecht, Boston, Reidel.

Authoritarianism*; Humans ; History, 20th Century ; Chile ; Communism ; Community Mental Health Services ; Deinstitutionalization ; Hospitals, Psychiatric/history ; Psychiatry ; Socialism ; Politics

In Chile, a long and oppressive military regime (1973-1990) dismantled emergent initiatives for the deinstitutionalisation of psychiatric care, imposing a neoliberal constitution that opened public services to market forces and limited the state's role in health and social care. After being associated with communism and socialism, community-based mental health work was banned, and socialist psychiatrists were silenced through torture or exile. However, some therapeutic initiatives persisted, such as the "Protected Commune" (PC) initiative within the El Peral psychiatric asylum. The PC attempted to mimic a real town inside the asylum's gated perimeter. It featured an ecumenical chapel, a school, and various "council" departments like recreation, education, waste, economy, and health. Paths received names, wards became districts, and patients and workers were assigned new, democratic roles, all while the authoritarian regime entirely controlled the "outside" world. The initiative ceased with the return of democracy in 1990. Deemed an eccentric and negligible episode, the PC is often seen as an interruption to the radical community-based experiences of the pre-dictatorial era. Drawing on archival research and oral history interviews with participants, this paper examines how the PC harnessed the notion of community to navigate the complex socio-political landscape of the dictatorship. Differing from established accounts of the political uses of psychiatry under authoritarianism, the study positions the PC as a prism for understanding the contradictory ways in which the idea of 'community' has been able to transcend radically opposed social and political regimes, becoming a core feature in the vocabulary of mental health reform, despite its ambiguities.
Competing Interests: Declarations Conflict of interest No conflict of interest.
(© 2024. The Author(s).)

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United Kingdom WT_ Wellcome Trust

Keywords: Community-based psychiatry; Dictatorship; Mental health reform; Oral history; Psychiatric asylums

Date Created: 20240701 Date Completed: 20241117 Latest Revision: 20241120

20241120

PMC11570558

10.1007/s11013-024-09868-2

38951362