Paper short abstract:

The aim of this paper is anthropological analysis of moral and emotional aspects of extrainstitutional/family care of severely mentally ill patients in Poland. The intellectual foundation for this practice is self-conscious psychiatric disourse focused on the critique of closed institutions, such as vast psychiatric hospitals. Not only do they create hostile or pathological environment, but also and most importantly – they are a source of unnecessary suffering of the isolated individuals.

Paper long abstract:

Since the end of the 19. century in certain psychiatric hospitals in Poland, as well as in some other European countries, there has been developed a kind of therapy usually called family care for the chronically mentally ill. It involved entrusting patients diagnosed with chronic mental illnesses to the care of chosen families living in the vicinity of the hospital, unrelated to the patient.

This practice has been based on diverse premises, of which economic factors are not the least important, but for which the central reason is a moral one: the perception of the psychiatric hospital as an environment fundamentally harmful for patients. Anthropological analysis of psychiatric discourse (scientific papers, medical diagnoses, opinions of practicing psychiatrists) reveals deeply critical attitudes towards closed institutions and their effects on the health of chronically ill patients, based on the conviction that long-term isolation causes suffering, which is not justified by the requirements of therapy. Family care, as well as community care, is considered a better way to ensure dignity, provide emotional support and ease the suffering of patients.

Psychiatric practice is premised on knowledge gained in the process of family and community care therapy, which includes analyses of social perception of mental illness and its effect on health and wellbeing of patients.

The paper is based on analysis of psychiatric discourse and on ethnographic research in eastern Poland.