Progressive science meets indifferent state? Revisiting mental health care reform in post-war Greece (1950-1980)

摘要

After the Second World War, many Western countries implemented mental health care reforms that included legislative changes, measures to modernise psychiatric hospitals, and policies to deinstitutionalise mental health care, shifting its locus from residential hospitalsto community services. In Greece, psychiatric reform began in the late 1970s and was linked to the fall of the military dictatorship in 1974, the general reorganisation of health care, accession to the European Economic Community and international outcry at the inhuman treatment of the Leros psychiatric hospital inmates. The 1950s, 1960s and most of the 1970s had been an ambivalent period in relation to psychiatric reform. On the one hand, a dynamic group of experts, some long established and some newly emergent, including psychiatrists, hygienists, psychologists and social workers, strove to introduce institutional and legislative changes. On the other hand, the state, while officially inviting expert opinion on mental health care more than once, did not initiate any substantial reform until the late 1970s and the early 1980s. Within this framework, we ask whether the story of psychiatric modernisation in Greece before the late 1970s could be summarised as a futile encounter between progressive scientists and indifferent state authorities. By assessing the early attempts to restructure mental health care in Greece, examining both the expert proposals and the state policies between the end of the civil war in 1949 and the fall of the dictatorship in 1974, this paper proposes a more nuanced view, which brings out the tensions between state and expert discourses as well as the discrepancies between the discourses and the implemented programmes.