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Reviewed by:
  • Madness in Buenos Aires: Patients, Psychiatrists, and the Argentine State, 1880-1983
  • Julia Rodrirguez
Madness in Buenos Aires: Patients, Psychiatrists, and the Argentine State, 1880-1983. By Jonathan D. Ablard (Athens, OH: Ohio University Press, 2008. iv plus 319 pp. $32.00).

Jonathan D. Ablard has written a detailed analysis of Argentina's mental institutions from the late 1880s to the late twentieth century. Based on previously unexamined mental hospital records, government archives, and a range of other sources, Ablard's account weaves together psychiatric institutional changes, legal issues around confinement, medical and psychological ideas, patients' conditions, and doctors' professional experiences. Moreover, he uses this case study to make a valuable contribution to the literature on the Argentine state. The book is primarily and centrally concerned with Argentina, and yet Ablard is also in conversation with the literature beyond Latin America, especially in terms of histories of psychiatric institutions in Europe, North America, and Africa. (Since the late nineteenth century, Argentina has been internationally recognized by specialists as a hotbed of psychiatry and psychology.)

Madness in Buenos Aires is organized chronologically into seven chapters, each accompanied by haunting photos of asylum patients, who flitter like ghosts throughout the text. Ablard also provides extensive statistics on confinement and movement of mental patients in the Appendices. Chapter 1, an introduction, establishes the importance of the history of mental institutions in Argentina to our understanding of Argentine social developments, both past and present. Chapter 2 takes on the early figures in psychiatric reform in Argentina. Ablard demonstrates the gap between rhetoric and reality among early psychiatrists and asylum administrators, whose enthusiasm, hard work, and innovation were not enough to convince the state to truly invest in modern asylums (aside from a few model institutions that were themselves overrun with problems within a few years). State investment was so low that a major source of funding for the treatment of mental illness continued to come from the national charity, the Society of Beneficience.

Chapter 3 documents the myriad problems facing Argentina's mental institutions in the early twentieth century and doctors' often-frustrated attempts to innovate to improve the treatment of mental patients as well as the nation's mental health infrastructure (along with significant victories in mental health reform in some selected facilities). In the twentieth century, Argentina was reaping both [End Page 292] the benefits and the social challenges brought by mass immigration in the late-nineteenth century. By 1920, almost half of Argentina's inhabitants were first or second-generation immigrants (the vast majority came from Italy and Spain), and the nation's population had palpably ballooned within a generation. Overcrowding, a perception of increased crime and chaos, and new political threats to authority were accompanied by an unprecedented uptick in the number of mental cases. Psychiatrists sought to increase the number of confinements, but inadequate institutional infrastructure made this impossible. In addition, because of overcrowding and poor conditions, mental hospitals in Argentina acquired among the general populace a bad reputation that persists to this day. In Chapter 4, Ablard looks at the "ambiguous spaces" experienced by patients around the issues of confinement, treatment, and transfer. To what extent were patients coerced, and to what extent did the state enforce confinements? Apparently not as much as psychiatrists hoped, and less than patients feared. If hospitals were overcrowded, it was for lack of beds, not because people were being rounded up and institutionalized. According to Ablard, "involuntary psychiatric hospitalization in Argentina was governed more by the whims and vagaries of a poorly funded medico-legal bureaucracy than by an efficient state apparatus." (121)

Chapter 5 takes a close look at the role of the patient's family in confinement, treatment, and release, as well as the relationship between families and doctors. Here, too, Ablard uncovers some counterintuitive findings: for instance, that a majority of female mental inmates in the first half of the 20th century had been confined by their employers. In this chapter, too, he concludes that there existed a "loose legal regimen" and that, despite the wishes of reformers, tight social control was out of the question. However, this vaccum in centralized control meant that the experiences...

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