Issues in psychiatric day-care programs in non-urban areas: a case study

As community mental health continues to grow in credibility, it has expanded, not only into new areas of treatment (e.g., child abuse), but also into new geographical areas, such as rural Canada. However, transplantation of urban-based community mental health models into the rural community poses major problems. To illustrate such problems as well as possible solutions, this paper describes a day-care program in a non-urban area, the overall settings of the program, a description of its structure and the issues facing it, as well as some of the ways we have dealt with them. We then discuss some recent changes we made in the program and how we evaluated these, to illustrate how such a program can institute an ongoing program evaluation. Finally, some data on the outcome of the program is presented.