Thrace, the northeastern most province of Greece, is ethnically diverse, borders Bulgaria and Turkey and is a point where political refugees and economic immigrants cross into Europe. The author, a North American anthropologist, researched her PhD there during 1999–2004, a time of psychiatric reform and deinstitutionalisation. In part, she illustrates some difficulties in working across cultures, including mutual mistrust between patients and staff.
‘Bad Souls is an ethnographic study of responsibility among psychiatric patients and those who give them care.’ (p. 4). Davis draws a distinction between personal ethics and responsibility, and moralising about the behaviour and responsibility of others. She focuses on patients that have not done well (e.g. severe and enduring mental illness, personality disorder). Such difficult cases give only a partial view of psychiatry. Nevertheless, lessons can be learnt from these cases.
The services described are similar to community-oriented services one could find in the UK at the time, some more advanced than others. Reports of discussions with staff and patients ring true. Staff come across as both caring (about patients) and mindful of the fair administration of public finances, even when muddled or inconsistent at times. Nevertheless, Davis, a critical interrogator of psychiatric practice, may have been disappointed to conclude:
‘I sought but failed to find a coherent framework of local beliefs and practices that might make mental illness and healing intelligible outside the medical paradigms of pharmacology and psychotherapy or the ethical paradigm of personal responsibility promoted in community-based care. What I found outside those paradigms was conversion symptoms.’ (p. 137).
The final chapter implies that Davis’ answer to the riddles posed by difficult psychiatric cases, including problems arising out of need for compulsion and dependency on disability benefits, is not to have psychiatrists at all. This sets us back to the libertarian ideology of Thomas Szasz. It is surprising, therefore, that on the back cover Davis’ fellow anthropologists Elizabeth Povinelly and Vincent Catanzaro praise Bad Souls as a critique of neoliberal political assumptions and practices. Such praise is careless, not least because the PASOK Socialist Party governed Greece during 1999–2004, the years of Davis’ research. The reformed psychiatric services were imbued with Christian and Social Democratic ideals of social solidarity and the welfare state. Indeed, the services were funded and specified by the European Union (EU) as a requirement of Greece joining the Union and to enhance the human rights of people with mental disorder in the country.
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