World experience in the last century passed way of de-institutionalization of the psychiatric service. The fact is that there are two main strategies for the development of psychiatric care.
First strategy is the institutionalization of a service with predominantly inpatient forms of care, it has an isolated biological approach to treatment, a quarantine restrictive function of psychiatry. This is the remoteness of care and the regime of “closed doors”, this is hospitalization and isolation of the mentally ill, this is a restriction of the patient’s freedom as an alleged guarantee of public safety.
he topic around psychiatry evoked either horror or black humor. As a result, stigmatization and often discrimination of mentally ill people in society. The second strategy is the de-institutionalization of the service with predominantly non-stationary forms of care, a biopsychosocial approach to treatment that includes, in addition to biological, psycho-psychotherapeutic, also rehabilitation approaches to treatment, resulting in the resocialization of the function of psychiatry and partnership with the patient.
This is the maximum availability of care in the least cramped conditions. This is the rehabilitation of patients for their return to the community, this is humanization and the provision of freedom as a guarantee of personal security, this tolerant attitude to “other people” as the main social buffer providing tolerance in society in general.
Many developed countries have already passed the path of de-institutionalization and are in a position to retrospectively evaluate the results and mistakes made, so as not to repeat them. The sequence of transformations should ensure the continuity and continuity of the provision of psychiatric care. Decrease in hospital-beds capacity should not outstrip the development of the outpatient network and introduction of stationary substitution technologies is impossible without the formation of training programs for specialists of multidisciplinary teams.
About the Author
Dmitriy Polyakov is currently a practicing lawyer in the health care industry. He obtained an additional Paralegal Studies Associate Degree and has wide experience in litigation and protection of the interests of citizens at obtaining medical services. He is convinced of the need for comprehensive access to health care and education for all segments of the society.
