[On the History of a Special Connection Between Academic and Non-Academic Psychiatric Institutions: Erlangen (1903-1974)].

Objective: To examine the more than 70-year history of a special connection between academic and non-academic psychiatric institutions.

Method: Relevant archival material as well as primary and secondary literature were critically examined.

Results: As early as 1818, Johann Michael Leupoldt (1794-1874), an assistant professor in Erlangen, held a seminar on "madness". But the University Psychiatric Clinic was not established until 1903 as part of the association to the mental asylum on a contract agreement between the Friedrich-Alexander-University Erlangen and the County Senate of Middle-Franconia. Clinic patients were registered as "institutional residents", and the Clinic had no income of its own. Especially relevant is the fact that the Head of Department and Director of the Clinic was formally considered as a "senior doctor of the asylum". The efforts to gain more autonomy were not successful until the mid- 1970s because of the socio-political situation.

Discussion: The complicated dependent employment relationship of the Head of Department on the Director of the asylum undoubtedly contributed to their "mésalliance tradition" over several decades. A public scandal arose in 1978 with a supervisory complaint to the government of Middle-Franconia with accusations of failure to protect patient documentation and medications during the relocation of the departments of the mental asylum to the newly constructed Regional Hospital on the "Europakanal". The lack of documents concerning the separation between the university and the district may be due to these processes.

Outlook: Cooperation between the University Clinic and the Regional Hospital exists in an altered form today. The Psychiatric Clinic can thus include patients from the Regional Hospital in scientific studies. The present study can contribute to discussions on demand-controlled integrated psychiatric care in combined academic and non-academic psychiatric institutions and points out how interinstitutional psychiatric care can succeed.