By Dylan Ronald Tomlinson, John Carrier
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Certification involved an extreme removal of citizens’ normal legal rights (Unsworth, 1987). Once certified and admitted, patients had no right to discharge themselves. Since admission involved legal processes, discharge also tended to be cumbersome. The term ‘inmates’ which also applies to prisons, seems more appropriate than patients. The abolition of certification after 1959 may have had more influence on patients’ abilities to discharge themselves than has generally been noted. It is curious that nostalgia for Asylum 1 ignores the extreme degree of paternalism involved.
ASYLUM AND THE COMMUNITY IN SPAIN 51 Community attitudes While we have referred to the family, we cannot overlook the community itself that has, in an overall sense, to take in or reject the patient in its midst, and that has the gift of asylum in this sense. Writers such as Baca (1992) point to the risk of trusting too much in the capacity of the population for collaborating with the community model of assistance, and of underestimating the existence of stereotypes of the majority of mental patients, such as their dangerousness, their incurability and their unpredictable behaviour.
This first period, which has come to be called the Golden Age of Spanish psychiatry, saw the introduction of rational methods in the treatment of madness, with the mad being considered ill rather than possessed, as was predominantly the case in the West. The Spanish case is therefore instructive in relation to asylum being provided out of pious and charitable motives from the beginning, with protection of the insane from abuse and from lack of rudimentary care being the chief objective. Just as Christian piety had played a role in the development of these early forms of asylum, however, so Christian zealotry, as much as the need for the governors of Spain to confine those threatening the social order, was to play a role in the deterioration of care and protection afforded within the hospitals.
Asylum in the Community by Dylan Ronald Tomlinson, John Carrier