Background This article aims to provide an introduction to emerging evidence and debate about the relationship between climate change and mental health. Discussion and Conclusion The authors argue that: i) the direct impacts of climate change such as extreme weather events will have significant mental health implications; ii) climate change is already impacting on the social, economic and environmental determinants of mental health with the most severe consequences being felt by disadvantaged communities and populations; iii) understanding the full extent of the long term social and environmental challenges posed by climate change has the potential to create emotional distress and anxiety; and iv) understanding the psycho-social implications of climate change is also an important starting point for informed action to prevent dangerous climate change at individual, community and societal levels.
Objective: To describe the ongoing process of German psychiatric reform and the structure and functioning of mental health services. Method: Information sources used include official reports describing mental health services, relevant publications related to organization and functioning of services. Results: There has been far‐reaching change in mental health care since the late 1960s: psychiatric hospitals have lost about 50% of their beds and one psychiatric hospital has been closed. One hundred and sixty‐five general hospital psychiatric units have been built up. Out‐patient, community and residential services have been developed. There is a lack of diversified residential and rehabilitation services, particularly for the most severely ill. Co‐ordination of care is not always ensured, transfer of patients to remote nursing homes has occurred in some places. Carers and service users articulate their views to an increasing degree. Conclusion: Political and professional enthusiasm have been important in implementation of the German reform. Evolving it further will require major efforts.
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