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By Dylan Ronald Tomlinson, John Carrier

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With the advent of the twentieth century ASYLUM AND THE COMMUNITY IN SPAIN 35 and the appearance of ‘modern’ socio-cultural values, mainly those underpinning the social and political rights associated with democracy, together with other economic and therapeutic determinants, one of the most radical changes in the care of the mentally ill took place. This was through the movement for mental hygiene, which was concerned with individual learning and developmental processes. This movement, while contributing to the gradual abandonment of the asylum model in Europe, had limited consequences in Spain, as did the movement for community psychiatry.

Rather than a pattern of decline, an extraordinary growth occurred after 1945, with the total admission rate rising by a factor of almost ten (from around 50 to 450 per 100,000) and the first admission rate by a factor of three between 1945 and 1965. DECLINE OF ASYLUM OR POVERTY OF CONCEPT? 3. First, the growth in the total admission was highly specific to the period after 1945. Admission rates in the previous 90 years had shown little change, remaining at around 50 per 100,000 population between 1855 and 1945, with first admissions accounting for the bulk of all admissions.

M. ’, Lancet 335:513–516. , Yates, J. (1993) Survey of English Mental Illness Hospitals, Birmingham: Health Service’s Management Centre. H. (1972) National Income, Expenditure and Output of the UK 1855–1965, Cambridge: Cambridge University Press. Hare, E. ’, British Journal of Psychiatry, 142:439–455. Hirsch, S. (1993) Bed Availability in England and Wales, 1992–3, Department of Health, London: HMSO. Kings Fund (1987) The Need for Asylum in Society for the Mentally Ill or Infirm, The Tliird Kings Fund Forum Consensus Statement, London: Kings Fund.

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