Why is care in the community perceived as a failure?

Psychiatric admission wards often are an integral part of the general hospital and not evident to the casual passer-by. [...]the dramatic architectural presence of the asylums has been replaced by an apparent absence. The proportion of homeless people with severe mental illness has remained steady a...

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Bibliographic Details
Published in:British journal of psychiatry 2001-11, Vol.179 (5), p.381-383
Main Author: Leff, Julian
Format: Article
Language:English
Subjects:
Aggression
Community
Community Mental Health Services - organization & administration
Community Mental Health Services - standards
Community service
Delivery of Health Care - organization & administration
Delivery of Health Care - standards
Editorials
Homeless people
Homeless Persons
Homicide
Hospitalization
Humans
Men
Mental disorders
Mental Disorders - therapy
Mental health
Mental health care
Patients
Personality disorders
Psychiatric hospitals
Psychiatry
Public Opinion
Schizophrenia
United Kingdom
Violence
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Summary:Psychiatric admission wards often are an integral part of the general hospital and not evident to the casual passer-by. [...]the dramatic architectural presence of the asylums has been replaced by an apparent absence. The proportion of homeless people with severe mental illness has remained steady at between a quarter and a half (Craig & Timms, 1992; Fisher et al, 1994; Hamid et al, 1995; Adams et al, 1996). [...]the public were correct in perceiving an increase in the absolute number of conspicuously mentally ill people on the streets during the 1980s, but where have they come from? A number of surveys have shown that very few homeless men with mental illness have spent any length of time in a psychiatric hospital (Timms & Fry, 1989; Craig & Timms, 1992; Hamid et al, 1995). [...]the staff in the closing psychiatric hospitals strove to prevent patients with a history of violence, or a propensity to it, from being discharged into the community, and such patients formed a large part of the difficult-to-place group who were cared for in highly staffed and specialised facilities (Trieman & Leff, 1996). A single homicide by a person with mental illness or personality disorder, emblazoned by the media, is sufficient to reinforce the public association of violence with mental ill health and the assumption that ‘care in the community’ is responsible.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.179.5.381