The future of the psychiatric center
The predictions made in 1972 by D. Jacobs, md, then director of Psychiatric Hospital Zon & Schild, Amersfoort, The Netherlands, concerning the development of Dutch psychiatry and its management are reviewed. A number of developments were foreseen correctly, e.g. the increased demand for scientific underpinning of the practice of psychiatry, and the increase in the role of modern management techniques in the administration of psychiatric hospitals. Unforeseen in 1972 were the malignant growth of bureaucratic and legal demands that threaten psychiatry today and the secularisation of the institutional roots in Roman Catholic and Protestant hospitals. Extending present lines of development, the author also predicts the end of psychiatric hospitals in The Netherlands by the incorporation in the regional medical conglomerates, resulting in loss of autonomy and impoverishment of the diversity and quality of care.