Proposal for a social psychiatry theory based on experiences from a programme for the homeless mentally ill

Abstract

What are the paradigm, the theory and the methods of social psychiatry? This theme is discussed on the background of the evaluation of a social and psychiatric project, going out into the streets looking up and offering support and treatment to psychotic persons living on the streets. All activities in the project during one year, i.e. 120 out-reach activities and 37 different persons, were registered in a diary. The contacts resulted in interventions and treatment, even involuntary hospitalization. One out of three seems to have improved life quality due to the project. The main question is whether it is acceptable to go out into the streets and seek out persons with the purpose of intervening in their existence. The answer is that it must be a part of psychiatric work - as an ethical claim - to seek out psychiatric patients living under miserable social conditions. The project resulted in a programme dealing with this kind of psychiatric work. It is suggested that the field of interest for social psychiatry is the life of the mentally ill person as it comes out in the dialogue and contact between individual persons and between the individual and the surrounding society. Social psychiatry must deal with the question of “what is the good life”, and must be an analysing, critical and active partner in the public debate. The paradigm of social psychiatry is suggested to be found within the European humanistic tradition. Social psychiatry could then be a “humanistic psychiatry” or an “existential psychiatry”, not an alternative but a supplement to other psychiatric work.

Key Words:

• Ethics
• Homelessness
• Social psychiatry
• Street-level psychiatry