Abstract

This chapter explores two themes that illustrate the close relations between psychiatry and society. The first one is the mental hospital as a small society, as an organized community in which madness was contained. This theme is examined in order to reveal how this principal institution of mental health care functioned as a mini-society that was separate from, and yet in close interaction with, the larger social organization. The main function of mental asylums was twofold: first, to protect society from the disruptions caused by the mentally ill and second, to help mental patients adjust to the norms and rules of larger society as well as to the norms and rules of the mental hospital. The second theme, “race” and marginality, draws on the experience of African Americans to explore the ways in which minorities have been treated and discussed by mainstream psychiatry in the United States. This theme delves into the role of psychiatric expertise enforcing social norms on the one hand, and conversely into psychiatry as a reflexive science that adapts itself to the changing norms and rules of society on the other. Psychiatric terms and theories have been incorporated into social and political ideas and practices, while racialist thinking has influenced the ways in which nonwhite minorities were treated as patients, clinical material, and subjects of medical experiments. Intrinsic to the discussion of both themes are the issues of social class, inequality, and marginality as exclusion.