Legal aspects of proxy practices in clinical psychiatry in India.

Proxy procedures in psychiatry include proxy consultations, proxy prescriptions, covert and refill medications. Before Mental Healthcare Act (MHCA) 2017, there was minimal emphasis on the rights of individuals with Severe Mental Illness (SMI), leading family members to use proxy practices. With the new legislation, these practices have to be seen in a new light. Proxy consultations may be allowed for information, advice, etc. but not for giving medications or making a diagnosis. Proxy prescriptions can be given if the patient gives prior authorization or through nominated representative in advanced directive. Psychiatrists may consider covert medications if the patient lacks capacity, but not in emergencies. Medication refills can be given with physicians' recommendation for a specific duration.

ChatGPT in private practice: The opportunities and pitfalls of novel technology.

OBJECTIVE: This article explores the transformative impact of OpenAI and ChatGPT on Australian medical practitioners, particularly psychiatrists in the private practice setting. It delves into the extensive benefits and limitations associated with integrating ChatGPT into medical practice, summarising current policies and scrutinising medicolegal implications. CONCLUSION: A careful assessment is imperative to determine whether the benefits of AI integration outweigh the associated risks. Practitioners are urged to review AI-generated content to ensure its accuracy, recognising that liability likely resides with them rather than with AI platforms, despite the lack of case law specific to negligence and AI in the Australian context at present. It is important to employ measures that ensure patient confidentiality is not breached and practitioners are encouraged to seek counsel from their professional indemnity insurer. There is considerable potential for future development of specialised AI software tailored specifically for the medical profession, making the use of AI more suitable for the medical field in the Australian legal landscape. Moving forward, it is essential to embrace technology and actively address its challenges rather than dismissing AI integration into medical practice. It is becoming increasingly essential that both the psychiatric community, medical community at large and policy makers develop comprehensive guidelines to fill existing policy gaps and adapt to the evolving landscape of AI technologies in healthcare.

[Psychiatry without coercion-Exclude the coercion or the patients?] / Psychiatrie ohne Zwang ­ den Zwang ausschließen oder Patient:innen?

BACKGROUND: With reference to the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD), a fundamental change in psychiatric care in Germany was proposed in 2019 by Zinkler and von Peter, supported by a legal perspective from Kammeier, which has since led to controversial debates. Essentially, the aim is not only to reduce coercion in psychiatry to a minimum, but also to fundamentally exclude it in a psychiatry that only provides care. The function as an agent of social control is to be returned from psychiatry to state institutions. Psychiatric hospitals will only admit patients with their consent; patients who refuse therapy will not be admitted regardless of their capacity for self-determination and will remain untreated or, if they have committed a criminal offence or threaten to commit a criminal offence, they will be taken into custody or imprisoned in accordance with the legal regulations applicable to all people. There they will receive psychiatric care if they so wish. AIM OF THE PAPER: The paper outlines the background of this concept, including international sources, traces the discussion in German specialist literature and takes a critical look at it. RESULTS: The criticism is primarily directed against the fact that responsibility for a relevant proportion of psychiatric patients would be handed over to the police and judiciary and that, as a result, two realities of care would be established that would considerably differ in terms of quality. CONCLUSION: Arguments are put forward in favor of retaining the function of social control and considerations are suggested as to how caring coercion can be largely minimized.

New technology, psychiatry, and the law: Panic, prudence, possibility.

Throughout human history, all new technology has been met with surprise, anxiety, panic, and - eventually - prudent adoption of certain aspects of specific technological advances. This pattern is evident in the histories of most technologies, ranging from steam power in the nineteenth century, to television in the twentieth century, and - now - 'artificial intelligence' (AI) in the twenty-first century. Each generation believes that the technological advances of its era are quantitatively and qualitatively different to those of previous generations, but the underlying phenomenon is the same: the shock of the new, followed by more gradual adjustment to (and of) new technology. These concerns are apparent today in relation to AI, which reflects interesting but incremental advances on existing technologies, rather than stand-alone developments. The usual concerns with all technologies (e.g., that they will replace certain aspects of human function) are, perhaps, more concerning in fields such as mental capacity law, which often applies to people with impaired decision-making capacity who might be especially vulnerable to technologies which appear capable of encroaching disproportionately on decision-making or other areas of core human function. This paper approaches this topic from an historical standpoint, noting both previous technological panics in the past and the possibilities offered by AI today, provided it is approached in a proportionate, prudent, and person-centered way, underpinned by appropriate ethical guidance and active ethical awareness in clinical and legal practice.

The Basaglia Law. Returning dignity to psychiatric patients: the historical, political and social factors that led to the closure of psychiatric hospitals in Italy in 1978.

Law no. 180 of 1978, which led to the closure of psychiatric hospitals in Italy, has often been erroneously associated with one man, Franco Basaglia, but the reality is much more complex. Not only were countless people involved in the movement that led to the approval of this law, but we should also take into account the historical, social, and political factors that came into play. The 1970s in Italy were a time of change and political ferment which made this psychiatric revolution possible there and nowhere else in the world.

Discursos e imágenes sobre la desigualdad. Políticas públicas e institucionalización de la locura en el noroeste argentino (1935-1954) / Discourses and images on inequality. Public policy and institutionalization of madness in the argentinean northwest (1935-1954)

En la presente investigación analizaremos la primera institución psiquiátrica del noroeste argentino, específicamente en la provincia de Tucumán, el Hospital de Alienados (HA), desde el evento que impulsó su creación -la negativa de traslados interprovinciales de pacientes a colonias nacionales en 1935- hasta el retorno a dicha práctica por parte del Estado nacional -en 1954-. Hasta la creación del HA, las posibles respuestas para las personas con problemáticas psiquiátricas eran el traslado a instituciones en otras provincias o el encierro en un asilo de la ciudad y en establecimientos policiales. Ante las graves consecuencias de las últimas alternativas, y la cancelación de los traslados, tuvo que ser el propio Estado provincial el que hiciera frente a la problemática. El HA se constituyó como el primero en Argentina en pertenecer a un Estado provincial y no depender de las arcas nacionales. Este trabajo inaugural en los estudios historiográficos de la región nos permitirá analizar algunos procesos institucionales de las políticas en salud mental a nivel provincial y nacional, las concepciones sobre locura y encierro que se sostenían en aquella época, el flagelo de la pobreza como causa para enloquecer y el efecto de todo lo anterior en la opinión pública.(AU)

In the present investigation we will analyze the first psychiatric institution in northwestern Argentina, specifically in the province of Tucumán, the Hospital de Alienados (HA), from the event that prompted its creation -the refusal of interprovincial transfers of patients to national colonies in 1935- until the return to this practice by the national State -in 1954-Until the creation of the HA, the possible responses for people with psychiatric problems were transfer to institutions in other provinces or confinement in a city asylum and in police establishments. Given the serious consequences of the last alternatives, and the cancellation of the transfers, it had to be the provincial State itself that faced the problem. The HA was established as the first in Argentina to belong to a provincial State and not depend on the national coffers. This inaugural work in the historiographical studies of the region will allow us to analyze some institutional processes of mental health policies at the provincial and national level, the conceptions about madness and confinement that were held at that time, the scourge of poverty as a cause of craziness, and the effect of all of the above on public opinion.(AU)

Making Sense of "Insanity": Law, Psychiatry, and the Royal Commission on the Law of Insanity as a Defence in Criminal Cases.

In 1954, the Canadian government established the Royal Commission on the Law of Insanity as a Defence in Criminal Cases. While its final report had little impact at the time, the creation of the commission points to the emergence of insanity as a newly complex problem within the context of postwar Canada. Spurred on by the growing psychiatric profession and the destabilization of capital punishment as a viable sentence, the commission quickly realized that the building blocks of its solution - legal and psychiatric expertise - were largely incompatible. This article explores the commission's problematization of insanity, which, far from providing solutions, highlighted the difficulties surrounding the integration of both psychiatric and legal knowledges of the day. The commission played an important role in upholding the status quo, and it provides an early example of the stasis that would characterize this area of the law until the early 1990s.

Résumé. En 1954, le gouvernement du Canada mettait sur pied la Commission royale chargée d'étudier la défense d'aliénation mentale en matière criminelle. Même si son rapport eut peu de répercussions à l'époque, la création de la Commission suggère que le problème de l'aliénation mentale avait acquis une complexité nouvelle dans le contexte de l'après-guerre au Canada. La Commission, aiguillonnée par la profession psychiatrique en expansion et la remise en cause de la peine capitale comme sentence acceptable, a vite réalisé que les éléments de base de la solution à ce problème ­ les expertises juridique et psychiatrique ­ étaient en grande partie incompatibles. Cet article s'intéresse à la manière dont la Commission problématise l'aliénation mentale : loin de fournir des solutions, elle fait plutôt ressortir la difficuté d'arrimer les savoirs psychiatriques et juridiques de l'époque. La Commission a joué un rôle important dans le maintien du statut quo, et constitue un exemple précoce de l'immobilisme qui allait caractériser ce domaine du droit jusqu'au début des années 1990.

Effects of structural features of psychiatric hospital settings on coercive measures

Background and Objectives Involuntary hospital admissions and coercive measures are a long-lasting burden in psychiatry. Many efforts have been undertaken to diminish these wearing circumstances. With the Bochum “track system,” which is structured in mental health teams across inpatient and outpatient clinics without any closed admission wards, we would like to present a new way of facing coercion. To examine the effects of establishing the so-called Bochum “‘track system”’ regarding the presumed reduction of coercive measures within a naturalistic, quantitative pre- and post- comparison.

Hospitais psiquiátricos no Brasil: relatório de inspeção nacional

Este relatório é resultado da Inspeção Nacional, realizada em dezembrode 2018, em 40 Hospitais Psiquiátricos, localizados em dezessete estados,nas cinco regiões do país. O Relatório foi dividido em três partes. A primeira parte faz uma breve introdução apresentando as instituições responsáveis pela organização e coordenação nacional da inspeção. Em sequência, é feita uma contextualização histórica sobre os hospitais psiquiátricos e sua relação com o processo de reordenação do modelo assistencial em saúde mental. Em seguida, a base legal e os principais eixos orientadores da InspeçãoNacional são expostos.

Estrategias de legitimación para un espacio disputado. La inserción del Instituto de Psiquiatría de Rosario en las redes y agenda científica disciplinares (Argentina, 1929-1944) / Legitimation strategies for a contested space. The insertion of the institute of psychiatry of rosario in disciplinary networks and scientific agenda (argentina, 1929-1944)

El trabajo se ocupa del proceso de profesionalización y autonomización disciplinar de la Psiquiatría en la Argentina de entreguerras estudiando una de sus ángulos, referida a la legitimación académica, inserción y posicionamiento en un campo internacional de debates. Para ello toma el caso de la ciudad de Rosario, con la creación del Instituto de Psiquiatría de la Universidad Nacional del Litoral. Éste emergió como resultado de una disputa disciplinar entre neurología y psiquiatría - en su vertiente de higiene mental-, suscitada con la creación de la Facultad de Ciencias Médicas local en 1920. Partiendo de los estudios sociales de la ciencia y la historia psi, se reconstruyen y analizan las estrategias desplegadas por los miembros del Instituto para legitimar y consolidar su disciplina tanto al interior del campo médico rosarino como del campo psiquiátrico en conformación a nivel nacional, regional e internacional, que oscilaron entre la participación en distintos eventos científicos, el sostenimiento de sociabilidades científicas de alcance nacional y latinoamericano y la generación de redes a partir del canje de revistas con distintas latitudes

The paper deals with the professionalisation and disciplinary autonomy process of Psychiatry in Argentina between the interwar period, studying one of its angles, referred to the academic legitimacy, its entrance and positioning in an international field of debates. For this, it takes the case of the city of Rosario, with the creation of the Institute of Psychiatry of the National Coastal University. It emerged as a result of a disciplinary dispute between neurology and psychiatry -in the orientation of mental hygiene- aroused with the creation of the local Faculty of Medical Sciences in 1920. Located in the field of social studies of science and psy history, we reconstruct and analyze the strategies deployed by members of the Institute to legitimize and consolidate their discipline, both within the Rosario’s medical field and the psychiatric field in formation at a national, regional and international level, wich range from participation in different scientific events, the sustentance of scientific sociabilities of national and Latin American scope, and the network generation from the journals exchange with different latitudes

Desinstitucionalizar o cuidado e institucionalizar parcerias: desafios dos profissionais de Educação Física dos CAPS de Goiânia em intervenções no território / Deinstitutionalizing the care and institutionalizing partnerships: challenges of Physical Education professionals at CAPS in Goiânia, Brazil, for interventions in its territory

Resumo Este artigo analisa os desafios dos CAPS para a consolidação de intervenções de cuidado que utilizam recursos do território. A pesquisa foi realizada em oito CAPS do município de Goiânia com o objetivo de compreender as dificuldades encontradas pelos profissionais de educação física para o desenvolvimento de atividades no território. Para tanto, realizamos entrevistas com 18 profissionais que foram analisadas por meio da técnica de análise de conteúdo. Os resultados indicam que os principais desafios podem ser sintetizados em duas categorias inter-relacionadas: (1) desinstitucionalizar o cuidado; e (2) institucionalizar parcerias. Concluímos que a desinstitucionalização do cuidado requer superação de dificuldades relacionadas a estigmas, preconceitos e inseguranças, presentes na sociedade e que ainda reverberam entre os profissionais de saúde mental investigados. A institucionalização de parcerias aponta para a necessidade de enfrentamento das precárias condições de trabalho e da fragilidade das políticas de gestão que dificultam a formalização de parcerias interinstitucionais e comprometem a consolidação da Rede de Atenção Psicossocial. Portanto, concluímos que o processo de desinstitucionalização do cuidado ainda encontra-se como grande desafio para o movimento de Reforma Psiquiátrica em Goiânia, especialmente na construção do cuidado ao usuário com utilização de recursos do território.

Abstract This article analyzes the challenges of CAPS to consolidate patient care interventions using the resources of its own territory. The survey was conducted in eight CAPS in the city of Goiânia, Brazil, in order to understand the difficulties encountered by physical education professionals for the development of activities in its territory. In order to do so, we conducted interviews with eighteen professionals and we analyzed them, using content analysis technique. The results indicate that the main challenges can be summarized and split into two interrelated categories: (1) Deinstitutionalize the care and; (2) Institutionalize partnerships. We conclude that, deinstitutionalization of patient care requires surpassing the difficulties related to stigmas, prejudices and insecurities, which are not only present in society in general, but also found among mental health professionals investigated. On the other hand, we found that the institutionalization of partnerships indicates the necessity to overcome the precarious working conditions and the fragility of management policies that hinder the formalization of inter-institutional partnerships and undertake the consolidation of Psychosocial Care Network. Therefore, we conclude that the process of deinstitutionalization of patient care is still a great challenge for the Brazilian psychiatric reform movement in Goiânia, Brazil, especially regarding development of human care, using resources of its own territory.

Responsabilidad profesional médica en Psiquiatría / Professional liability in Psychiatry

Introducción. La seguridad del paciente y el riesgo de reclamación por defecto de praxis son preocupaciones de primer orden en Medicina y en Psiquiatría. Material y métodos. Se analizaron descriptivamente las reclamaciones por presunta mala praxis en Psiquiatría gestionadas en el Consejo de Colegios de Médicos de Cataluña entre 1986 y 2009 evaluando sus características clínicas y legales. Resultados. Se hallaron 94 casos en 23 años, predominando las alegaciones relacionadas con el diagnóstico (63,83%, incluida la valoración de riesgo autolítico) y el supuesto legal de delito de homicidio por imprudencia profesional grave (46,8%). La mayoría de reclamaciones correspondieron a asistencia en atención hospitalaria (62,77%), urgente (52,5%) y prestada en equipo (53,75%). El eventual perjudicado tipo fue un varón (51,58%) con 36,6 años de edad media. En la mitad de los casos, la secuela alegada fue la muerte. Implicaron a 139 facultativos, predominantemente varones (69,57%) con una edad media de 41 años y de nacionalidad española (91,4%). El tiempo entre el acto médico reclamado y la reclamación fue de 1,28 años y el de resolución de 2,68 años. La mayoría de expedientes (77,66%) se tramitaron por vía judicial. Entre estos, se registraron un 95,77% de archivos o sobreseimientos, 2 condenas (2,81%) y 1 acuerdo (1,41%). Correspondencia: Carles Martin-Fumadó Institut de Medicina Legal de Catalunya (IMLC) Ciutat de la Justícia de Barcelona i L’Hospitalet Gran Via de les Corts Catalanes, 111 - Edifici G - 6a planta 08014 Barcelona (España) Tel.: 935548278 Fax 935548259 Correo electrónico: carles.martin@xij.gencat.cat Conclusiones. La incidencia acumulada de 0,013 (1,35%) en 23 años sugiere que la Psiquiatría tiene un riesgo muy bajo de reclamación, con una tasa de responsabilidad profesional médica y cuantía en las indemnizaciones igualmente baja. Existen actuaciones específicas susceptibles de mejora en seguridad clínica resultando clave la valoración del riesgo autolítico

Introduction. Patient safety and malpractice litigation risks are major concerns in Medicine, in Psychiatry as well. Material and Methods. Descriptive analysis of clinical and legal characteristics of claims related to psychiatry, opened between 1986 and 2009 at the Council of Physicians Colleges in Catalonia. Results. We identified 94 cases in 23 years, major allegations were related to diagnosis (63.83%, including suicide risk assessment) and the legal concept of homicide by professional imprudence (46.8%). Claims most frequently related to hospital care (62.77%), happened at the hospital floor (30.85%), during urgent care (52.3%) and related to team work (53.75%). The patient was most frequently male (51.58%) with mean age of 36.6 years. Half of the cases involved the patient’s death. 139 physicians were sued, predominantly males (69.57%) with a mean age of 41 years and Spanish (91.4%). Mean time elapsed between the physicians’ act and the claim was 1.28 years, and it took 2.68 years to solve the procedure. Most claims were solved at court (77.66%) and among those 95.77% were closed without consequences, 2 ended up with a sentence (2.81%) and 1 with an economical transaction (1.41%). Conclusions. The cumulative incidence of 0.013 (1.35%) in 23 years reflects a low risk of malpractice claims in Psychiatry, with a low rate of cases solved in favor of the plaintiff and low payouts. However, there are specific clinical safety issues that should be taken into account, such as suicide risk assessment

Los trastornos bipolares en las nuevas clasificaciones: DSM-5 y CIE-11 / Bipolar disorders in the new DSM-5 and ICD-11 classifications

Las clasificaciones DSM-5 y CIE-11, esta última en elaboración, pretenden armonizar los diagnósticos de los trastornos mentales. En este artículo hacemos una revisión crítica de los puntos que pueden aproximar y aquellos que pueden dificultar la convergencia de los trastornos bipolares, así como de aquellas condiciones clínicas single bondincluidas dentro de los trastornos depresivossingle bond con especial relevancia para los trastornos bipolares (p. ej., episodio depresivo mayor). Las principales novedades agregadas comprenden la incorporación de parámetros dimensionales para la evaluación de los síntomas, la posibilidad de diagnosticar cuadros subumbrales del espectro bipolar, la consideración de nuevos especificadores de curso como los síntomas mixtos, la desaparición del diagnóstico de episodio mixto, y el aumento del umbral para el diagnóstico de hipo/manía. Las convergencias destacables son la inclusión del trastorno bipolar ii en la CIE-11 y la exigencia adicional, además de la euforia o la irritabilidad, de un aumento de la energía o de la actividad para el diagnóstico de hipo/manía en ambas clasificaciones. El mantenimiento del diagnóstico de trastorno mixto ansioso-depresivo, del duelo como criterio de exclusión de depresión mayor, o el diagnóstico de episodio mixto en el trastorno bipolar, son algunas de las principales divergencias en la versión beta de la CIE-11 respecto al ya editado DSM-5. Conclusión. Dado que el DSM-5 ya ha sido publicado, serán necesarios cambios en el borrador de la CIE-11 o modificaciones del DSM-5.1 para armonizar los diagnósticos psiquiátricos (AU)

The DSM-5 and ICD-11 classifications, the latter still under development, are aimed at harmonizing the diagnoses of mental disorders. A critical review is presented of the issues that can converge or separate both classifications regarding bipolar disorders, and those conditions - included in depressive disorders - with special relevance for bipolar (e.g. major depressive episode). The main novelties include the incorporation of dimensional parameters to assess the symptoms, as well as the sub-threshold states in the bipolar spectrum, the consideration of new course specifiers such as the mixed symptoms, the elimination of mixed episodes, and a more restrictive threshold for the diagnosis of hypo/mania. The most noticeable points of convergence are the inclusion of bipolar ii disorder in ICD-11 and the additional requirement of an increase in activity, besides mood elation or irritability, for the diagnosis of hypo/mania in both classifications. The main differences are, most likely keeping the mixed depression and anxiety disorder diagnostic category, maintaining bereavement as exclusion criterion for the depressive episode, and maintaining the mixed episode diagnosis in bipolar disorder in the forthcoming ICD-11. Conclusion. Since DSM-5 has already been published, changes in the draft of ICD-11, or ongoing changes in DSM-5.1 will be necessary to improve the harmonization of psychiatric diagnoses (AU)

La legitimización de la semiología psiquiátrica y su conjunción con los conceptos de "normal" y "patológico": una visión en la Era de la revolución (siglos XVIII-XIX) / The legitimization of psychiatric semeiology and its conjunction with the concepts of "normal" and "pathological": a vision during the Age of Revolution (18th-19th centuries)

Este artículo tratará una pregunta esencial: ¿Qué es lo que le va dar validez y legitimidad dentro del ámbito psiquiátrico a la semiología? Para responder, inicialmente se analizan las características,las reglas y algunas de las problemáticas para la configuración de signos como elementos semiológicos y clínicos; enseguida se da una mirada a lo que se entiende por normalidad desde la perspectiva de Georges Canguilehm. Se examinará entonces la historia y los orígenes filosóficos y médico-psiquiátricos de la semiología en lo que se llamó la Era de la revolución. Se sale de la esfera psiquiátrica para tocarel ámbito de la retórica y la oratoria, y su función normalizadora y categorizadora de ciertos signos clínicos relativos al lenguaje, para regresar a la psiquiatría y analizar cómo Michel Foucault de una manera original concibió la sintomatología y la semiología a partir del concepto de "instinto", el eje voluntario involuntario, y la influencia de la neurología en la mitad del siglo XIX. Finalmente, se ve como la estadística y la eugenesia jugarán un papel igualmente importante en la conceptualización de la norma y por ende del discurso científico detrás de los signos clínicos establecidos (AU)

This paper will address an essential question: What is it that will give validity and legitimacy to the psychiatric semeiology? To answer this, initially we analyze the characteristics, rules and some of the issues for configuring semiological signs and clinical elements; next we take a look to what is understood by "normality" from the perspectiveof Georges Canguilehm. We then examinethe history, and the philosophical and medical psychiatric origins of semeiology during what is called the Age of Revolution. To continue, we leave the psychiatric field in order to take a glance of the field of rhetoric and oratory, and the categorizing and normalizing function of certain clinical signs related to language; then we come back to psychiatry and discuss how Michel Foucault conceivedin an original way symptomatology and semeiology as a result of the concept of "instinct", the voluntary-involuntary axis and the influence of neurology in the mid 19 th century. Finally, we analyze how the statistics and the eugenics played also an important role in the conceptualization of the norm and therefore the scientific discourse behind the established clinical signs (AU)

O "morar" em hospital psiquiátrico: histórias contadas por familiares de ex-"moradores" / The "residence" in psychiatric hospital: stories told by families of ex-"residents" / El "vivir" en hospital psiquiátrico: historias contadas por familiares de ex-"habitantes"

Este estudo teve como objetivo conhecer as histórias de ex-"moradores" de hospital psiquiátrico na visão de seus familiares. Por meio de uma pesquisa de campo de caráter exploratório entrevistamos alguns familiares de ex-"moradores" de hospital psiquiátrico, os quais descreveram o trajeto percorrido. As histórias possibilitaram delinear os caminhos que levaram essas pessoas a se tornarem "moradoras" de hospital psiquiátrico, o que esse fato lhes acarretou e o que lhes possibilitou retornar ao lar. A recorrência e longevidade da internação psiquiátrica dos "moradores" provocaram perda de papéis sociais e de laços afetivos, além de sinais de cronificação do transtorno mental, reforçando que o modelo manicomial acarreta agravos que poderiam ser evitados com o tratamento em consonância com os preceitos da atenção psicossocial. Neste modelo não há lugar para o "morar" em um hospital psiquiátrico tradicional, mas leitos em hospital geral para permanência pelo menor tempo possível, como determinam a Lei 10.216, de 06 de abril de 2001, e a Portaria 3.088, de 23 de dezembro de 2011.(AU)

This study aimed at getting to know stories of the ex-"residents" of psychiatric hospital in their families'view. Through a field research of exploratory character, families of ex-"residents" of psychiatric hospital were interviewed and they described the route taken by them. The stories allowed to trace the path that led these people to become "residents" of psychiatric hospital, what this fact caused to them and what allowed them to return home. The recurrence and longevity of psychiatric hospital admission of "residents" caused loss of social roles and of affective bonds, and also cronicity signs of mental disorders, reinforcing that the asylum model entails in aggravations that could be avoided with treatment in accordance with the precepts of psychosocial care. In this model, there is no place to "reside" in traditional psychiatric hospital, but in general hospital beds and in the shortest time possible, as determined by Law 10216 of April 6, 2001 and by Decree 3088 of 23 December 2011.(AU)

Esta investigación tuvo como objetivo conocer las historias de ex "habitantes" de hospital psiquiátrico según la visión de sus familiares. Por medio de una investigación de campo de carácter exploratorio, entrevistamos tales familiares cuyos relatos permitieron delinear los caminos que hicieron que estas personas se convirtieran en "habitantes" de hospital psiquiátrico, las consecuencias de este hecho y lo que les posibilitó el retorno a sus casas. La recurrencia y la longevidad de la internación psiquiátrica generaron la pérdida de papeles sociales y de lazos afectivos, además de señales de cronificación del trastorno mental, reforzando que el modelo manicomial conduce a agravantes que podrían evitarse con el tratamiento de acuerdo con los principios de atención psicosocial. En este modelo no hay lugar para el "vivir" en hospital psiquiátrico tradicional, pero en los lechos de los hospitales generales y en el menor tiempo posible, según lo determinado por la Ley 10.216 de 6 de abril de 2001 y el Decreto 3088 de 23 de diciembre de 2011.(AU)