ABSTRACT
This chapter discusses the history of psychiatric care and confinement. It describes a fuller awareness of the interplay between confinement, therapy, politics and morality. The chapter explains the concept of community care as an extension of psychological confinement. It addresses the roles of gender, class and economics in the political construction of institutional centres of care. Opposition can arise when the means and content of mental health promotion and health services, in their construction, codification and delivery, are not informed and structured from inclusive service user/survivor perspectives. Trauma-informed research methodologies and social discourse theory methods re-position the subject, whom medical research often treats as an experimental repository of data, rather than as an individual person. The history of psychiatric care is weighted heavily by the dichotomy – to the extent that there is one – between custodialism and the delivery of therapy.
