[A review on mental health and psychiatric services in England]

Psychiatric care in Japan has received criticism not only within Japan but from other parts of the world. By contrast, the services for mentally ill in England is considered to be superior and is therefore presented briefly to benefit the development of better community psychiatric care in Japan. The history of psychiatric services in England is described briefly. After World War II, deinstitutionalization has been occurring and the in-patient rate per 100,000 population which was 354 in 1954 and has decreased to 120 in 1990. Despite a decrease in the in-patient rate, the admission rate per 100,000 population has been increasing gradually during this period. Deinstitutionalization process and the development of community care services are summarized. Among these are alternative services such as primary care, day care and residential services in the community which are considered to be important elements. Problems associated with deinstitutionalization process are also discussed. In developing community care services in Japan, lessons can be learned from the success and failures of England's attempt over the last 30-years to build a better, more community-based system.