Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Science and Society
  • Published:

The psychiatric revolution: care in the community

Nature Reviews Neuroscience volume 3, pages 821–824 (2002)Cite this article

Abstract

The past 50 years have seen a revolution in psychiatric care that is resulting in the demise of psychiatric hospitals. The process of replacing the diverse functions of the old asylums with community-based services has occurred unevenly throughout the world. Here, we use international case studies to consider how far this change has been beneficial to its main subjects — the patients.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Jones, M. Social Psychiatry in Practice: the Idea of the Therapeutic Community (Penguin, Harmondsworth, UK, 1968).

    Google Scholar 

  2. Bennett, D. in Theory and Practice of Psychiatric Rehabilitation (eds Bennett, D. H. & Watts, F. N.) 15–42 (John Wiley & Sons, Chichester, UK, 1983).

    Google Scholar 

  3. World Health Organization. Atlas: Mental Health Resources in the World (WHO, Geneva, 2001).

  4. Hallam, A., Beecham, J., Knapp, M. & Fenyo, A. The TAPS project 23. The costs of accommodation and care. Community reprovision for former long-stay psychiatric hospital patients. Eur. Arch. Psychiatry Clin. Neurosci. 243, 304–310 (1994).

    Article  CAS  Google Scholar 

  5. Jones, D. The TAPS Project 11. The selection of patients for reprovision in evaluating community placement of long-stay psychiatric patients. Br. J. Psychiatry 162 (Suppl. 19), 36–39 (1993).

    Article  Google Scholar 

  6. Leff, J. & Trieman, N. The TAPS Project 46. Long-stay patients discharged from psychiatric hospitals: social and clinical outcomes after five years in the community. Br. J. Psychiatry 176, 217–223 (2000).

    Article  CAS  Google Scholar 

  7. Harding, C. et al. The Vermont longitudinal study of persons with severe mental illness: I. Methodology, study sample, and overall status 32 years later. Am. J. Psychiatry 144, 718–726 (1987).

    Article  CAS  Google Scholar 

  8. Angermeyer, M. C. & Kilian, R. in Quality of Life in Mental Disorders (eds Katschnig, H., Freeman, H. & Sartorius, N.) 19–30 (John Wiley & Sons, Chichester, UK, 1997).

    Google Scholar 

  9. Heinrichs, D. W., Hanlon, E. T. & Carpenter, W. T. Jr. The quality of life scale: an instrument for measuring the schizophrenic deficit syndrome. Schizophr. Bull. 10, 388–398 (1984).

    Article  CAS  Google Scholar 

  10. Leff, J., Trieman, N., Knapp, M. & Hallam, A. The TAPS Project. A report on 13 years of research, 1985–1998. Psychiatr. Bull. 24, 165–168 (2000).

    Article  Google Scholar 

  11. Pickard, l. et al. Evaluating the Closure of Cane Hill Hospital (Research and Development for Psychiatry, London, UK, 1992).

    Google Scholar 

  12. Reda, S. Public perceptions of former psychiatric patients in England. Psychiatr. Serv. 47, 1253–1255 (1996).

    Article  CAS  Google Scholar 

  13. Wolff, G., Pathare, S., Craig, T. & Leff, J. Public education for community care. A new approach. Br. J. Psychiatry 168, 441–447 (1996).

    Article  CAS  Google Scholar 

  14. Levy, C. 2 accused of looting home for the mentally ill in Queens. New York Times (28 June 2002).

  15. Levy, C. J. For mentally ill, death and misery. New York Times (28 April 2002).

  16. Levy, C. J. Here, life is squalor and chaos. New York Times (29 April 2002).

  17. Levy, C. J. Voiceless, defenseless and a source of cash. New York Times (30 April 2002).

  18. Crepet, P. A transition period in psychiatric care in Italy ten years after the reform. Br. J. Psychiatry 156, 27–36 (1990).

    Article  CAS  Google Scholar 

  19. Lelliot, P. & Wing, J. A national audit of new long-stay psychiatric patients II. Impact on services. Br. J. Psychiatry 165, 170–178 (1994).

    Article  Google Scholar 

  20. Salokangas, R. K. R. Community care and need for treatment of schizophrenic patients in Finland. Br. J. Psychiatry 164 (Suppl. 23), 115–120 (1994).

    Article  Google Scholar 

  21. Chakrabarti, S. et al. Comparison of the extent and pattern of family burden in affective disorders and schizophrenia. Indian J. Psychiatry 37, 105–112 (1995).

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Banerjee, G. & Roy, S. Determinants of help-seeking behaviour of families of schizophrenic patients attending a teaching hospital in India: an indigenous explanatory model. Int. J. Soc. Psychiatry 44, 199–214 (1998).

    Article  Google Scholar 

  23. Prince, R. The use of Rauwolfia for the treatment of psychoses by Nigerian native doctors. Am. J. Psychiatry 117, 147–149 (1960).

    Article  CAS  Google Scholar 

  24. Giel, R., Gezahegn, Y. & Van Luijk, J. N. Faith-healing and spirit-possession in Ghion, Ethiopia. Soc. Sci. Med. 2, 63–79 (1968).

    Article  CAS  Google Scholar 

  25. Korkeila, J., Lehtinen, V., Sohlman, B. & Tuori, T. Patients' expectations from their psychiatric community care in Finland. Nordic J. Psychiatry 52, 513–517 (1998).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. the Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK

    Julian Leff

Authors
  1. Julian Leff
    View author publications

    You can also search for this author in PubMed Google Scholar

Related links

Related links

DATABASES

OMIM

schizophrenia

FURTHER INFORMATION

World Health Organization

Encyclopedia of Life Sciences

schizophrenia

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leff, J. The psychiatric revolution: care in the community. Nat Rev Neurosci 3, 821–824 (2002). https://doi.org/10.1038/nrn937

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrn937

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing