Community mental health care in Europe--an overview

Europe shares some historical roots of modern psychiatry. Even before the 19th century, there had been institutions for the mentally ill, such as the Bethlem in London which was founded more than 750 years ago, and organised forms of care in the community for people with mental illness, such as the tradition of family care in Geel in Belgium. Modern psychiatry, however, was initiated through the spirit of enlightenment and began around 1800. This beginning was marked by the symbolic cutting of the chains of mentally ill patients in Paris, the first publication of the term 'psychiatry' ("Psychiatric") in Germany in 1803, and the establishment of the retreat in York, England. The rise of modern psychiatry as a speciality of medicine was closely linked to the development of new institutions in both health care and academia. In the 19th century, various universities established chairs and academic departments of psychiatry, and large asylums for the mentally ill were built across Europe. The asylums were meant to replace the family as carriers for the material needs of patients--since many families could not fulfill that function in an industrialising society anymore--remove the mentally ill from the public scenes of urban life and provide a therapeutic environment.