Politics and mental health I.

The origins and evolution of psychiatry as a medical discipline since the end of the 18th century have been influenced by society's beliefs about the 'nature of man', the dominant forms of social organisation, and the level of technology which could be mobilised to modify human behaviour. These are also the themes from which politics develop. Throughout the past two centuries and up to the present day, two distinct streams can be traced in the political history of psychiatry: first, psychiatry as social control of deviance; and secondly, psychiatry as advocacy of the 'right to be different'. The 'third psychiatric revolution' which is now in progress in many parts of the world has been inspired by the second set of beliefs. It has already produced positive effects on the quality of life of many patients but is also experiencing certain setbacks. The extent to which the new approach to mental health care delivery will benefit patients and society depends not so much on psychiatry as a discipline as on the perceptions and actions of politicians.