Josep M. Comelles

The Dilemmas of Chronicity: the Transition of Care Policies From the Authoritarian State to the Welfare State in Spain

In this article, the constitution of the population of chronic mental patients is examined for the period 1885 to 1975 as well as its influence on the design of reform programmes in the crisis of the Franco-ist state. Then follows an assess ment of state reforms and regional policies with effect from 1980. Reference is made to the theoretical models utilised in this last period and to the tension and contradictions between professionals of bio-medical orientation and sectors sympathetic to community models sustained from the perspective of social psychiatry.

Psychiatric care in relation to the development of the contemporary state: The case of Catalonia

Over the past two centuries, extensive mental health care systems have come to be a feature of all Western societies. However, the theoretical model generally invoked to account for this process has only limited applicability to Spain, where the growth of capitalism and the liberal state followed an atypical and uneven course. Political power and economic power, usually coterminous, were divided in Spain between center and periphery, so that, until the 1960s, Spains economic center of gravity was localized in Catalonia, the most culturally and linguistically distinct region. Here we are dealing with a paradox: on the one hand, the failure of the incompletely centralized and economically underdeveloped Spanish state to develop a system of psychiatric care comparable to those of other European states; and on the other hand, the success of the Catalan bourgeoisie, though lacking a state of its own, in creating such a system through private initiative.

Schools and health education in Spain during the dictatorship of General Franco (1939-1975)

Purpose The purpose of this paper is to analyse the evolution and characteristics of health education in schools in Spain during the dictatorship of General Franco (1939-1975). Design/methodology/approach The analysis of two kinds of sources has been performed. First, the reports from international organizations on health education in schools published in the 1950s and 1960s. Second, journals, books and official documents published by public health and education organizations in Franco’s Spain. Findings Health education in schools evolved in three stages under Franco’s dictatorship. In the first stage (1939-1953), Spanish schools maintained an outdated “school health” approach in the teaching programmes. In the second stage (1953-1965), the agreements with the USA in 1953 ended Spanish isolation, and the regime sought to follow the recommendations of international organizations. Efforts were made to “import” the WHO/UNESCO version of health education in schools but it failed to materialize. A programme that sought to enhance citizen participation and to acknowledge their idiosyncrasies was unlikely to prosper in a dictatorship. However, the less threatening food and nutrition education programme, encouraged by the FAO/UNICEF, did succeed. In the last stage (1965-1975), the Spanish education system entered a period of modernization in which the contents and methods of health education in schools were reformed in order to introduce the less conflictive aspects of the international recommendations. Originality/value The paper highlights the tensions between the aspirations to follow international programmes and the recommendations on health education in schools and the difficulties of implementing such schemes under a dictatorship.

Forgotten paths: culture and ethnicity in Catalan mental health policies (1900-39)

Between 1900 and 1939 the regional government in Catalonia discussed a complete reform of the psychiatric institutions inherited from the nineteenth century. The debate was centred on the Spanish government’s lack of interest in mental health policies and the growing demand for services. The projects developed between 1900 and 1939 opened a wide-ranging discussion on the role of ethnic and cultural factors in shaping mental illness, and the need to adapt the new facilities to the ethnic features of Catalonia. This study explores the production of Catalan psychiatric discourses and their ideological roots, and the development of public policies up to the end of the Spanish Civil War (1936—39). The paper concludes with a discussion of the influence of pre-war Catalan mental health policies on the wartime practice of psychiatry and, later, on the development of the French psychothérapie institutionnelle after World War II.