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Deinstitutionalization and psychiatric reform in Spain
J L Vázquez-Barquero1, J García
1Unidad de Investigación en Psiquiatría Clínica y Social, Hospital Universitario Marqués de Valdecilla, Santander, Spain. vazquezb@humv.es
European Archives of Psychiatry and Clinical Neuroscience
|August 5, 1999
Summary
Spain's Psychiatric Reform since the 1980s improved mental health care organization and community services. However, uneven implementation and insufficient deinstitutionalization highlight challenges in community rehabilitation and resettlement.
Area of Science:
- Psychiatry
- Public Health
- Health Policy
Background:
- The Psychiatric Reform in Spain, initiated in the 1980s, aimed to transform mental health care delivery.
- Key achievements include restructuring care, integrating psychiatric patients into general healthcare, and establishing community mental health centers.
Purpose of the Study:
- To evaluate the outcomes and implementation of Spain's Psychiatric Reform.
- To identify deficiencies and challenges in the deinstitutionalization process and community-based mental health services.
Main Methods:
- Analysis of the implementation of the Psychiatric Reform across Spain's autonomous communities.
- Assessment of deinstitutionalization progress and the role of community mental health services.
Main Results:
- Significant progress in organizational restructuring and community network development.
- Uneven implementation across regions, with notable deficiencies in intermediate community services for rehabilitation and resettlement.
- Insufficient deinstitutionalization, with a continued reliance on traditional psychiatric hospitals.
Conclusions:
- Criticisms of deinstitutionalization often stem from poor implementation rather than conceptual flaws.
- Deinstitutionalization and psychiatric reform are complex processes that should not be solely equated with hospital closures.