The Psychiatric Society

392 Pages·1982·53.41 MB·English

by  Françoise Castel, Robert Castel, Anne Lovell

PSYCHIATRIC
SOCIETY
CASTEL,CASTEL,& LOVELL
THE
PSYCHIATRIC
SOCIETY
Robert Castel,
Frangoise Castel,
and
Anne Lovell
Arthur Goldhammer, Translator
The first asylums were established in
America in the 1820s. The mental hospitals
which gradually replaced them saw a
dramatic drop in the number of resident
patients after 1955. Was this due to a so-
called "unlocking of hospital gates"?
"Collective care" was the label given the new
service offered by community mental health
centers—but in whose interest was such
"social medicine" really conceived?
As the mental health establishment evolved
in the United States, powerful groups of
professionals and politicians stood to lose or
gain prestige and economic well-being.
Although there were fewer patients in mental
hospitals by the mid-fifties, increasing
numbers of Americans were seeking
psychiatric care. The reorganization of
mental health services—dictated by
economic and bureaucratic reasons as much
as by medical or philanthropic ones-
resulted in an enlarged role of psychiatric
treatment in society. Behind the guise of
"social medicine," social and political forces
were effecting a change in the definition of
mental health, and subtly encouraging
conformity to the norm.
The Psychiatric Society traces the
complicated interplay of medicine with
politics, the public with the private sector,
and the impulses toward decentralization
with those of social control. Robert Castel,
Frangoise Castel, and Anne Lovell explain
how an institution originally intended to
provide medical services for a small segment
of American society evolved into a system
ready to absorb any new technique directed
{continuedon back flap)
^^
Digitized by the Internet Archive
2010
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The Psychiatric Society
European Perspectives: A Series ofthe Columbia University Press

THE PSYCHIATRIC SOCIETY
^m^
Robert Castel, Fran^oise Castel,
and Anne Lovell
Translated by Arthur Goldhammer
COLUMBIA UNIVERSITY PRESS
New York 1982
—
First published in French as La Societepsychiatrique avancee,
© Editions Grasset et Fasquelle, 1979
Columbia University Press
New York Guildford, Surrey
Copyright © 1982 Columbia University Press
All rights reserved
Printed in the United States ofAmerica
Library ofCongress Cataloging in Publication Data
Castel, Fran(;oise.
The psychiatric society.
(European perspectives)
Translation of: La societe psychiatrique
avancee / Franqoise Castel, Robert Castel,
Anne Lovell.
Includes bibliographical references and
index.
—
1. Mental hea—lth services United States.
2. Psychiatry United States. I. Castel,
Robert. 11. Lovell, Anne. III. Title.
IV. Series—. [DNLM: 1. Mental health—services
History United States. 2. Psychiatry Histo-
WM
ry—United States. 11 AAl C4s]
RA790.6.C3713 362.2'0973 81-15504
ISBN 0-231-05244-8 AACR2
Clothhoundeditions ofColumbia University Press books are
Sntyth-sewn andprinted onpermanent anddurable acid-freepaper.
Contents
Translator's Note vii
Preface to the English Edition ix
Preface xv
A
Part One: Resistible Rise
CHAPTER one: The Success ofthe Worst 3
CHAPTER two: The Progressive Era 24
CHAPTER three: The Third Psychiatric Revolution 54
Part Two: An American Dream
chapter four: Psychiatric Hospitals: The New
Order 83
CHAPTER five: The Illusions ofCommunity 124
Part Three: Psychamerica
CHAPTER six: The Psychiatrization ofDifference 175
CHAPTER seven: Alternatives to Psychiatry and
Psychiatrization ofthe Alternatives 214
CHAPTER eight: Psy Services and Their New
Consumers 256
Conclusion: The Psy World 291
Notes 321
Index 353