EGENIS seminar: "Madness, dictatorship and utopia. The case of the "protected community" inside the El Peral Psychiatric Asylum, 1983-1999", Dr Cristian Montenegro (University of Exeter)

Madness, dictatorship and utopia. The case of the "protected community" inside the El Peral Psychiatric Asylum, 1983-1999.

Psychiatric deinstitutionalisation started in the USA during WW II, in Great Britain with the creation of the NHS, and in France with the "Psychiatrie de secteur". In Latin America, efforts at reforming psychiatry date back to the 1970s under the influence of the experience led by Franco Basaglia in Trieste. Dictatorial regimes engulfed most of the region in the 1970s, challenging these developments.

In Chile, a long and oppressive military regime (1973-1990) blocked reform attempts, imposing a neoliberal constitution that radically redefined the role of the state in health and other spheres. Community-based work was associated with political activism and banned, radical psychiatrists were tortured and/or exiled, and psychiatric asylums remained overcrowded and abandoned. While dictatorship effectively halted the development of mental health policy -and public mental health more broadly-, several small-scale experiments prefigured some of the values and ambitions that emerged with the recovery of democracy.

The "protected community" was an attempt to create a real "town" inside a psychiatric asylum. This "town" had an ecumenical chapel, a school and various "council" departments, including recreation, education, waste, economy and health, responding to a "mayor". Based on oral history interviews with asylum workers, the talk will trace the initiative's origins, aims, and main characteristics. Beyond its therapeutic value -something that cannot be assessed through available data- the initiative embodied the expectations of psychiatry concerning what a "normal" world of relationships and roles could be, working as an experimental space to test notions of autonomy and normality. At the same time, it prefigured the paradoxes that the idea of "community" introduced to mental health policy after dictatorship when formal "community mental health" became a key normative goal.

Healthcare as protest: Medical and psychological responses to police brutality in the context of large-scale urban protests in Latin America.

2019 saw a string of large-scale protests in South America, affecting fifteen countries. Between October 2019 and May 2020, Ecuador, Chile and Colombia experienced prolonged social unrest directed against inequality, neoliberalism and political corruption. Endorsement by authorities, police and military forces responded with unprecedented brutality. This resulted in at least 6728 wounded persons, including 57 with permanent loss of one or both eyes due to rubber bullets. One hundred and twenty-seven persons died.

These extensive and ambitious protests fostered the development of an army of volunteer organisations that supported the continuity of protest via giving physical and psychological first aid to protestors. These groups included different health brigades composed of medicine, nursing and psychology students and professionals. Centred on the actions of these groups, and based in Santiago, Quito and Bogotá, this project aims to explore how forms of medical and emotional care -linking people, spaces, values and forms of knowledge- emerged and responded to unaccountable police brutality and how each country's social and political specificities influenced the production and the meaning of this response.

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