Los avatares de una ilusión: la reforma psiquiátrica en España

Abstract

The article examines the question of the development of psychiatric reform after three decades of implementation in Spain. The circumstances and principles that originally characterized psychiatric reform and the situation of the community model upon which it was based are reviewed, within the framework of changes produced in society and in the health system. The article explores the shortcomings (chronic care, preventive programs and community programs) and, especially, the threats to its sustainability. Some primary threats seen are trends towards privatization in the Health System, inadequate collective consciousness of the importance of Public Health, and the difficulties of a different clinic, rooted in psychopathology able to understand mental illness in its multiple determinations: historical, social, organic and psychological.