Community psychiatry: weasel words?

Abstract

The practice of modern high quality psychiatry would be well served by the abandonment of the expression ‘community psychiatry’ and a moratorium on its further use for at least a decade.

The evolution of psychiatric care – a spiral model

“…"Did we dream as we marched out of the asylums, that we would have lost so much -budgets, expertise, facilities, and morale -in the name of community psychiatry? But it is our patients who will be the real losers if they are either neglected in the pseudo commu nity or re-intitutionalised as result of public backlash" (Robertson, 1994). Some still warn that "It may yet decay into the disillusionment of reinstitutionalisation" (Elpers, 1987).…”

Community psychiatry in developing countries – a misnomer?

“…In Britain the unprecedented degree of criticism faced by the existing mental health services can be gauged by the articles appearing in their defence in the British literature, partially in reaction to the Government's announcement that community care has failed (Tyrer, 1998b;Burns & Priebe, 1999) and increasingly restricted measures are proposed, such as supervised discharge, etc. There are even pleas to abandon the term community psychiatry because``what started as an ideal has become an excuse for buck passing, asset stripping and skimping on provisions'' (Robertson, 1994). However, the concept of so-called community psychiatry as it is practised in the developing world seems to be quite effective and appropriate for the populations it is supposed to serve (Goldberg, 1987(Goldberg, , 1992.…”