"Despite the Asylum, Not Instead of It": Community Psychiatry in West Germany (1960-1980)

Histories of the German psychiatric reform usually identify the origin of this process with the so-called Psychiatrie-Enquete. The Enquete, published in 1975, consisted of a comprehensive report of the status quo and concrete recommendations for a structural reorganization of the West German psychiatric care system: community orientation; patient-centred care; coordination of all service institutions and providers; equal treatment and opportunities for the mentally and physically ill. The scholarship seems unanimous in highlighting the importance of some contemporaneous international developments as an intellectual and institutional blueprint for the German reform, especially the Italian initiative led by Franco Basaglia. Some points of the 1975 reform program, however, had already been actualised in the 1960s, most notably some elements of community care. For example, the considered fruitful relationship between psychiatry and anthropology was to be tested on the grounds of community care. This paper considers two of these early instances, later taken as models: the Zentralinstitut für seelische Gesundheit (Central Institute for Mental Health) in Mannheim and the community psychiatry set in place in Mönchengladbach (NRW). The focus will be on their epistemological setting and their concrete solutions, such as day- and night-clinics, sheltered housings and patient clubs. Finally, we will discuss how far at the time and at the direct aftermath of the Enquete the international developments were mobilised as models for the national reform, or if the Germans tired of affirming their own tradition. This paper as been written by Chantal Marazia and Heiner Fangeru, Heinrich Heine Universität Düsseldorf