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[Limits of deinstitutionalization: experience in England]
Psychiatrische Praxis
|October 26, 2000
Summary
England's mental health care reform shows advantages in community-based services post-hospital closure. However, the National Health Service (NHS) system still faces challenges with acute beds and rehabilitation.
Area of Science:
- Mental Health Services Research
- Health Policy Analysis
- Psychiatric Epidemiology
Background:
- The National Health Service (NHS) in England has undergone significant institutional changes, including the introduction of internal market elements.
- Over 90 mental hospitals have been closed as part of psychiatric reform initiatives.
Purpose of the Study:
- To outline psychiatric reform and the current mental health care system in England within the NHS context.
- To evaluate the impact of mental hospital closures and assess the feasibility of community-focused mental health care.
Main Methods:
- Description of the TAPS study, a longitudinal evaluation of mental hospital closure.
- Review of studies (DLP, PRiSM) examining home treatment and community-focused mental health services.
Main Results:
- The TAPS study identified various advantages associated with post-discharge care arrangements.
- Community mental health care, including home treatment models, has been demonstrated as feasible.
- The current system faces shortages and challenges in acute bed availability, intensive residential, and rehabilitation services.
Conclusions:
- Community-based mental health care models are feasible and offer advantages.
- Despite progress in reform and community care, the NHS mental health system requires further development to address service gaps.