«Госпитализм» is a rather broad concept that includes adverse primarily mental conditions of a hospital environment and the effects on mental and physical condition of the patient. Госпитализм most often is observed, and because of this and more is designed for infants who he is more pronounced due to their mental and autonomic-somatic immaturity and imbalance. However, he also attacks and adults.
The most common impacts, leading to госпитализму, United under the name of mental deprivation. Лангмайер and Матейчек define it as follows: mental deprivation is a state of developing owing to such a situation, where the subject is not provided with the conditions to meet some basic (vital) mental needs adequately and for quite a long time. The frustrations deprivation differs in that frustration - blockade is already activated on instruments, therefore, in advance satisfied needs, and when deprivation demand was not satisfied. Example: frustration develops in experiments and in fact, if the child taking his favorite toy, but give him the opportunity to play with something else, that he is less like; deprivation is observed then, if the child do not give anything to play.
The centre of gravity of mental deprivation can be in touch, emotional field, for which development госпитализма has the greatest value.
Deprivation can develop under the following conditions:
a) Extreme isolation pilot type, for example, placement of experimental individuals for several days in the cabin, as more and more isolated from the external environment.
b) the Extreme social isolation. Described cases of «wolf children», children raised in a shed without contact with people. This includes a longer stay adults in solitary confinement.
) education in a children's institution, for example, the child's home, in a week a manger long stay in the hospital. Mental deprived children in the house and on its consequences for the us first and most systematically drew attention Дамборская.
the child, so far as his age and state of health must be «conquered» for help during its examination and treatment;
explained by the regime of the day and its place in the life of the Department, that the child was in the right least busy playing, work, movement and rehabilitation to changes occurred and bedridden.
Госпитализм is not limited to only children. It can affect adults, especially patients in old age, are repeatedly and for long periods in the hospital environment in connection with chronic diseases. Is associated with an increased life expectancy and the insufficient number of places in social welfare institutions, which with good guide provide still more emotional and mental stimulation than hospitals. But there is no incentive ordinary life, and that life of old people that brings the noise and the movement of the young generation. If the old or chronically sick person for a long time is in the hospital, his life in the hospital and the disease itself becomes a «lifestyle», he wean from life at home and making significant efforts so that he could once again return to the hospital. With regard to younger patients, greater tendency to госпитализму show neurotics, some psychopaths and especially cured психотоники, which hospital protects against life shocks and bumps. (Final R., Bouchal M Psychology in medicine. - Prague, 1974, C. 290-296)
«Abuse of psychiatry» as defined by the world psychiatric Association is the use of the clinical disciplines, opportunities psychiatrist and capacities of the staff of psychiatric institutions in evil, in harm to the patient or his relatives.
The concept of psychiatric abuse includes:
staging a false psychiatric diagnosis;
involuntary hospitalization, in those cases when its use is not justified and is beyond the scope of the law;
application under the guise of treatment of psychiatric funds for non-medical purposes (healthy people and people with mental disorders to punish etc);
unjustifiable deprivation of the patient or other rights;
abuse psychiatrist their professional position for personal purposes (for example, the use of the labour of the patient, the conclusion with him of property transactions).
Staging a false psychiatric diagnosis and unjustified hospitalization may be due as innocent mistake doctor and conscious use of psychiatry in non-medical purposes. The most notable case of punitive psychiatry are the use of psychiatry not medical political (etc) purposes: as an example, the most frequently cited political persecution of dissidents in the USSR (announcing them mentally ill, the conclusion of the special prison hospital type and application unreasonably cruel medical measures, in particular the typical neuroleptics without proofreaders).
However, significantly more common cases were of a different kind: the use of involuntary psychiatric measures to citizens, отстаивавшим their rights in «local conflicts» with the authorities. A number of publications that appeared in the post-Soviet period, indicating a wide prevalence of such violations and now. So, in the report of «Punitive psychiatry in Russia», published by the International Helsinki Federation for human rights, argues that the causes of illegal hospitalization usually are political (hospitalization human rights defenders alone), criminal (action to seize real estate patient) or household (hospitalization due to domestic conflicts) character. The most well-known instance of the report is the case of Tamara Rakevich. In 2003, won a case against the Russian Federation in connection with unlawful her hospitalization in a psychiatric hospital.
«Classic» view of psychiatric abuse is considered to be the recognition of a person as incapable and / or illegal hospitalization to get his property.
According to the si-bi-si in the canadian province of Quebec in 1940-1960 years under the leadership of provincial Premier Maurice Duplessis (fr: Maurice Duplessis) and the Roman Catholic Church existed long-term practice of forced «treatment» of thousands of those from boarding children adopted for the «mentally retarded», without notice to parents. In addition to treatment with the help of a substance chlorpromazine, children were made to подсобному work. A group of about 3000 survivors, calling themselves orphans Duplessis, tried to bring to justice the government, the Church and the College of doctors of Quebec. Some of the victims found counterfeit copies of their medical records. As of 2001, the government of Quebec refused to conduct a comprehensive investigation into practice.
There may also be cases when it comes to truly sick people, to which, however, there are inadequate measures, for example, hospitalization, in the absence of medical indications or use of a very painful procedures (injections сульфозина, electroconvulsive therapy) as a measure of deterrence. On the other hand, some people seek recognition himself sick, to avoid criminal responsibility, avoid conscription into the army etc.