In Holland there is a tradition called social psychiatry - -not so well known in England—which is the study and practice of the relationship of mental health problems in relationship with the context in which people live their lives.
Social psychiatry is not clinical psychiatry in the community but an approach that observes and treats mental health problems as the result of social emotional problems related to the daily life reality of the patients That is his family interactions his social activities his dependency on societal structures and his social development. It is rooted in the work of Querido in the thirties when as a consequence of the economic crisis. Querido started a service in which patients were visited at their homes in order to find a different solution from being hospitalized. It started with an economic purpose to prevent psychiatric admissions, because when admitted many patients stayed in the hospital for long episodes which was a costly affair for the community at that time responsible to pay the stay.
This experience led to a lot of knowledge about the influence of poverty on the development of interaction problems in the family and in the neighborhood resulting in emotional problems and deviant behavior as a result for which admission to a psychiatric hospital was easily required. Hospital treatment didn’t solve the social problems. From this early experience over the years a lot of knowledge was acquired about the relationship between mental health problems and the context in which people have or choose to live
Being trained and educated in this system it is not strange that many years later I had an open mind for the relationship between what are called psychotic symptoms in clinical psychiatry, like hearing voices paranoia and unusual believes and the problems experienced in the life of persons with mental health problems. Also in social psychiatry exploring the experience of psychotic symptoms in relation to their social emotional background has taken much longer than necessary, if we look back at the history of psychiatry. One of the main handicaps might be the clinical concept of schizophrenia and the development of biological psychiatry since the sixties, closing the doors of the search for meaning. It is also the idea of management of psychiatric symptoms (see Lindemann) which brings clinical psychiatry into society in a very reduced way. This possibly combined by the denial of social problems in relation to illness at all governments reduces mental health treatment into a control system instead of an approach that focus on the development of people with mental health problems. Outside Holland social psychiatry has been called Psychiatric Rehabilitation, which much more starts from the illness concept then from the concept of social emotional and societal problems as the roots of mental health problems. There have always been exceptions with psychiatrist developing social psychiatric concepts in their country but they never became main stream.