The civil war in Spain drove thousands of people insane and left untold numbers in need of psychiatric care. Carlos Castilla del Pino, who has died of cancer aged 86, was the psychiatrist who cured many of them and his writings on mental health changed the methods of treatment in Spain.
He himself had suffered trauma in the civil war. His family were small landowners in San Roque, a town opposite Gibraltar. Carlos was the only boy, with three older sisters. When he was 13, at the start of the war, General Francisco Franco's forces took the town on their arrival from Africa. A week later, an anarchist column from Málaga retook it and killed two of his uncles and a cousin. The same day, Falangists from Algeciras drove out the anarchists. In a town of 5,000 people, 250 were killed on one day, 27 July 1936. Castilla del Pino describes these events in the first volume of his autobiography, Pretérito Imperfecto (Imperfect Past Tense, 1997).
While still at school, he read all of Freud and set up his own experimental laboratory. In the 1940s he studied medicine in Madrid. He specialised in neurobiology, practised psychiatry and gained first-hand experience of the primitive treatment of the mentally ill under Franco in a general hospital and then a terrible psychiatric hospital. He moved to Córdoba in 1949, where he spent the next 38 years in practice.
Here, Castilla del Pino developed his theories of humane treatment of the mentally ill. He promoted medication and community support, rejecting incarceration and electric shock treatment. It was impossible then for those on the losing side in the war - the peasants and workers he treated - to express their feelings and thoughts. Castilla del Pino insisted on the need for personal communication to combat depression. He was, in reality, a liberal humanist, but having to work under the conditions of the dictatorship gave him a reputation as the "red psychiatrist", not least because he insisted on the importance of social environment in mental illness.
A militant anti-Francoist and a member of the Communist party until 1980, Castilla del Pino was repeatedly denied the chair of psychiatry at the University of Córdoba till 1983. His 40 books varied from highly technical tracts to lucid essays aimed at the general public, such as the popular Un Estudio Sobre la Depresión (A Study of Depression, 1966), La Incomunicación (Non-communication, 1969), La Intimidad (Intimacy, 1989) or Envidia (Envy, 1994).
His last years were especially hard because of the deaths of five of his seven children. He said publicly he was not a good father and that he had not liked some of his children. He also explained that he had felt relieved when his own father died. Breaking these taboos was part of his onslaught on the hypocrisy in too many Spanish families, which underlay much mental illness.
He separated in 1989 from his first wife, Encarnación, and is survived by his second, Celia, and two children.
• Carlos Castilla del Pino, psychiatrist, born 15 October 1922; died 15 May 2009
