The development of an integrated psychiatric service in a Scottish community

The deployment of a specialist psychiatric team and closer integration with primary health care practitioners has led to a greater proportion of first contacts as out-patients being seen compared with national data, and a relatively lower in-patient admission rate. The increase was in those patients seen in health centres rather than in additional out-patient clinics. Despite this there is evidence of a slow accumulation of patients with psychosis whose main requirements is suitable supported accommodation. Such a deployment into the community is a more economic use of resource and can, with advantage, assist the traditional hospital-based services in the transition from a custodial role.