Humane Psychiatric Care in De Meander: A Matter of Ethics

This article describes a number of concrete initiatives taken in the De Meander in Melle (near Ghent, Belgium), a psychiatric ward for patients with a mental disability or an acquired brain injury, with the aim of introducing and safeguarding a psychoanalytic ethic. In the latter, the particularity of the patient plays a central role. De Meander tried to achieve this by abolishing many of the ward rules, allowing more space for the singular solution of the patient. Furthermore, the author describes how aggression is addressed differently, in order to learn how to read this rather than punish it. From an ethical perspective, the values and standards of mainstream society are no longer strictly adhered to, but the starting point is the suffering and the questioning of the patient as a unique subject. The author describes how patients of De Meander are given more responsibility for their lives and future. Hierarchical positions are lifted by creating the possibility of circulation between different team members and by using the therapeutic potential of patients. Finally, the author describes how, via volunteer work, an opening to the outside world is created for so-called chronic patients. These various concrete initiatives are illustrated using clinical vignettes.