[Social psychiatry as practical application of epidemiology]

The paper describes the development of an epidemiologically oriented community mental health service (the external psychiatric services of the Canton of Baselland). Because helpful intervention is intended not only to those labelled as patients as is the case in outpatient clinics, the main emphasis is on outreach toward the prospective endangered population, those suffering from chronic mental disease or those in danger of relapses. To this end it is of utmost importance to create networks of collaboration with all other social helping institutions as well as with family physicians, psychiatrists, community officials, ministers, public health nurses as well as with voluntary helpers. The creation of transitional and rehabilitative institutions for sheltered living, rehabilitation for work and for leisure time structuring can take place through the service itself or in collaboration with existing voluntary or charitable organizations. The described service has, on account of extremely restricted personnel, chosen to seek collaboration with a great number of community organizations. The offices of the two ambulatory services (there are two for two somewhat unequal parts of the Canton), function therefore, next to their treatment function, also as centers of coordination for rehabilitative efforts. Coordination of social and health services in the community has been realized in a number of towns. A decentralized but relatively fine-meshed network of caring for the psychically ill or handicapped could be established in the relatively short time of eight years. Network formation is recommended as an epidemiologic technique for the treatment and care of a population at risk, this especially in view of prophylaxis of relapses of severe psychiatric disease.