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- Key words: anti-psychiatry, constructivism, psychiatric hospital, social psychiatry, history of psychiatry
- DOI : 10.1684/ipe.2017.1657
- Page(s) : 457-63
- Published in: 2017
The aims of this article are to re-examine the links between an epistemological model, constructivism, a care model, community care, and a movement specific to psychiatry, and anti-psychiatry. The article recalls the origins of the constructivist movement and shows how sociologists and philosophers have seized this movement to question certain mental health diagnoses which had fueled the anti-psychiatric current of the sixties and seventies. A naturalistic conception of mental illness involves a deterministic causality that leaves no room for patient contingency or freedom. This is the main reason why the constructivist and anti-psychiatry element accuse mental illness in general and schizophrenia in particular as simply a product of psychiatry. An historical reminder is that the psychiatric hospital is not synonymous with the exclusion of madness or a naturalistic conception of madness. It is important to differentiate between an epistemological question (how to define and classify madness) and a social question (where and how to manage it). It is inaccurate to think that a naturalistic conception of mental illness belongs to classical hospital psychiatry and that community care is spared, or to convince people that the construction of psychiatric diagnoses is the cause of the exclusion of these individuals from socially inappropriate discourses or unadapted social behavior.