公共慈善、私营机构和国家干预:英格兰疯人的制度化护理(1600-1815)

Institutional Care of the Insane in England,1600-1815:Public Charity,Private Enterprise and State Intervention

1600年至1815年是英国政治、经济和社会发生重大变革的时期之一。为社会伤病人员提供服务的范畴越来越广,其中包括那些患有精神疾病的人。1676年在伦敦重新开业的伯利恒医院规模宏大,成为公共慈善事业的典范。18世纪,其他精神病院在伦敦等城市相继建立。此类机构主要为贫民提供服务。然而,社会中上层人群中日益严重的精神错乱问题也刺激了私营事业的发展。从1650年起,“私立疯人院”在伦敦乃至整个英国逐渐兴起,截至1800年至少已有60家机构成立。它们提供给病人的服务条件差异悬殊,这引起了公众关注度的与日俱增,并使政府在1774年予以立法管控。来自改革者的压力导致1808年立法的实现,国家开始资助疯人院的筹建工作。1815年,政府主导的一次重大调查,旨在将针对服务精神失常群体的公立和私立机构在实践过程中的优缺点公之于众。

The period between 1600 and 1815 was one of great political,economic and social change in England.The range of provision for society's casualties became increasingly sophisticated,including those people suffering frommental disorders.Public charitable endeavour was exemplified by the grand newBethlem Hospital,opened in London in 1676.During the eighteenth century,itwas followed by other lunatic hospitals,in London and several other cities.These institutions provided mainly for the poorer classes.However,thegrowing problem of insanity among the middle and higher classes also stimulatedprivate enterprise.From 1650 onwards,a growing number of private‘madhouses'were established in London and throughout the country,and by 1800 therewere at least sixty of these houses.They varied greatly in the conditions providedfor patients,which aroused rising public concerns and government regulation in1774.Further pressure from reformers led to legislation in 1808,initiating theprovision of state-sponsored lunatic asylums.A major government enquiry in1815 exposed the many shortcomings,as well as some good practices,in bothpublic and private institutions for mentally disordered people.