Franz-Werner Kersting,

A Farewell to the "Total Institution"? West German Institutional Psychiatry between National Socialism and the 1970s

The essay illuminates three problems and lines of development of institutional psychiatry: At first, it investigates the significance of the National Socialist health and war policy (compulsory sterilisation/"euthanasia"- murders/"deaths by starvation" in the institutes) for the specific reform bottleneck and reform process of German post-war psychiatry. In the course of this, a small group of psychiatrists from the "sceptical generation" will be introduced, who - in stark contrast to the medical-social mainstream - quite early on combined an orientation towards critical reform with a willingness to talk critically about the past. These psychiatrists demanded the modernisation and humanisation of the treatment of psychologically ill and mentally handicapped people - in part out of a spirit of "historical reparation". Secondly, the essay focuses on the phenomenon of the "reform before the reform". Fundamental reform ideas had already been formulated and discussed since the end of the 1950s (inter alia the "Kennedy-Message" of 1963 or the "Rodewisch Theses" from the former GDR, 1963). Furthermore, many individual practical initiatives for the improvement of institutional and patient conditions were already conducted in the spirit of a fundamental transformation of psychiatric care. Thirdly, the essay analyses the effective and important ways, in which "reforms in the field of psychiatry" and 1968 were interwoven. For the situation of West-German psychiatry only really became a matter of public interest and the subject of a social movement in the course of the social transformations of the late 1960s and early 1970s ("Psychiatry-Enquiry"). Moreover, the emergence of a reform discourse in the narrow sense was accompanied and in part even overlaid by a broad cultural vibrancy, especially of the "anti-psychiatry" movement. This played an important role, both in film and literature, as well as in various circles of the left scene, of which the "Socialist Patient Collective Heidelberg" was to become the most well-known: It is presented here as a pointed example.