Erving Goffman’s “Asylums” is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and (...) mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines. (shrink)

We draw on ancient Greek philosophy and contemporary psychosocial theorists to analyse the ethical implications of social policies implemented through the welfare state with the espoused objective of achieving social inclusion. We argue that many such policies establish a boundary between domains of inclusion and exclusion that perversely maintains the very problem such policies are designed to solve. They then also provide ?rationalisations? for social exclusion which imply that such states can be explained?that they are ethical, and so legitimate. We (...) illustrate our argument with reference to a specific area of social policy?Improving Access to Psychological Therapies?and discuss how it impacts on our own area of practice as state employed psychotherapists. We analyse how this policy frames aspects of social exclusion (un(der)employment?) as a ?psychological? problem: a move that grants the excluded a specific kind of identity and then locates the problem of exclusion in this identity. We invoke Plato's Republic to show how this offer of psychological ?help? subliminally suggests that these mental disorders result from individuals' failures to ?know their place? and to ?mind their own business?, rather than as a consequence of complex networks of social (dis)orders, exclusions and injustices within which we are all embedded. (shrink)