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Community care of the seriously mentally ill: continuing problems and current issues
1Institute for Health, Rutgers University, New Brunswick, NJ.
Community Mental Health Journal
|February 1, 1990
Summary
The community care crisis for seriously mentally ill (SMI) individuals arises from systemic issues, not just individual problems. Addressing this requires viewing mental health as a social welfare concern, not solely medical.
Area of Science:
- Social Sciences
- Public Health
- Mental Health Services Research
Background:
- The current community care system for the seriously mentally ill (SMI) faces significant challenges.
- These challenges are rooted in organizational, financial, and structural factors within the healthcare system.
Purpose of the Study:
- To analyze the structural factors contributing to the crisis in community care for SMI.
- To examine the prevailing tendency to medicalize and individualize SMI issues, neglecting social welfare perspectives.
Main Methods:
- Qualitative analysis of systemic issues in mental health care.
- Examination of policy and program development concerning SMI.
Main Results:
- A preference exists for medicalizing and individualizing SMI problems over addressing them as social welfare issues.
- Deinstitutionalization, homelessness, service provision, financing, and employment present significant obstacles.
- The mental health system exhibits ambivalent ideology and inherent contradictions, with social control often central to policy.
Conclusions:
- The crisis in community care for SMI is a complex issue requiring a shift from individual medical models to structural social welfare approaches.
- Public policy and program development must acknowledge and address the systemic contradictions and the role of social control.