[Psychological and ethical problems in the rehabilitation of mental disorders]

There is a discrepancy between the somatotherapeutic and rehabilitative state of development of institutionalized psychiatry. In addition to objective factors, causes of this discrepancy may be found in the unsatisfactory education and training of middle-level medical personnel. It is above all the behavior and attitudes to patients that indicate remaining traces of authoritarian and hierarchical structures in psychiatry, there being a major difference in this respect between sociopsychiatrically oriented hospitals and district and specialized hospitals, respectively. In rehabilitation, it is necessary to take as a starting point the patient's personality. It is for this reason that the use of psychotherapeutic principles is an essential prerequisite of the rehabilitation of mental patients. On the subjective side of the therapeutic and rehabilitative process it is necessary for patients to be in a position of being able to develop from a submissive object of medical activity into an actively participating (or emancipated) subject.