Pastoral care in psychiatric hospitals: an approach based on some of the insights and methods of liberation theology

Abstract

In this work some of the insights and methods of a particular form of political theology, liberation theology, are used as a basis for constructing a critique of a specific type of pastoral care, that undertaken in English and Welsh psychiatric hospitals.In the first part of the thesis the background, character and method of liberation theology are described. A 'methodological spiral' based on, and integrating, some of the insights and methods of liberation theology is outlined. This determines the rest of the work. It requires that the socio-political factors surrounding pastoral care should be thoroughly explored using the insights of the social sciences, and that particular attention should be paid throughout to matters of injustice, inequality and impotence before pastoral care and its political significance is assessed and suggestions are made for its re-orientation.The psychiatric hospital and socio-political factors affecting its contemporary functioning and the lives of those living or working within it is the focus of the next part. The evolution of the psychiatric hospital is considered and its contemporary goals and organisations are described. A staff/patient divide is identified and patient and staff groups and relevant socio-political factors affecting them and their mutual interaction are surveyed. An examination of some models of mental disorder and modes of treatment and their socio¬ political implications is undertaken. Finally, some of the problems of the contemporary psychiatric hospital are outlined and the future of this institution is discussed. It is concluded that socio-political factors play a large part in the functioning of the psychiatric hospital and that the inequalities and injustices revealed in the foregoing analysis can contribute to human suffering.Eileen Witts has worked long and very hard to transform my original manuscript into a legible document. Thanks are hardly adequate as a tribute to her industry and perseverance.In the light of these findings, the final part is concerned with an examination of the practice and ideology of pastoral care in the psychiatric hospital. The role of the chaplain in the hospital is described. Socio-political awareness among chaplains is assessed and found to be minimal. A Marxist analysis of the role of the chaplain reveals a mainly conservative function. Turning to the wider pastoral care tradition of the Church, it is argued that the socio¬ political dimension is not incompatible with the essential nature of pastoral care and that it should on occasion stand at the centre of this activity. In conclusion, some principles orientating pastoral care in psychiatric hospitals towards socio-political awareness and commitment are outlined