- Community mental health services
Community mental health services (CMHS) support or treat people with
mental disorders (mental illness ormental health difficulties) while they continue to live in their own homes, rather than being admitted to more remote institutions such aspsychiatric hospitals (asylums).Community services include
Supported housing with full or partialsupervision (includinghalfway house s), psychiatric wards of generalhospitals (includingpartial hospitalization ), localprimary care medical services, day centers or clubhouses andself-help groups for mental health .They may be provided by government organizations and
mental health professionals , including specialized teams providing services across a geographical area, such asAssertive community treatment and Early intervention teams. They may also be provided by private or charitable organizations. They may be based onpeer support and theconsumer/survivor movement .The
World Health Organization states that community mental health services are moreaccessible and effective, lessensocial exclusion , and are likely to have less possibilities for the neglect and violations ofhuman rights that were often encountered in mental hospitals. However, WHO notes that in many countries, the closing of mental hospitals has not been accompanied by the development of community services, leaving a servicevacuum with far too many not receiving any care. [World Health Organization press release (2007) [http://www.who.int/mediacentre/news/notes/2007/np25/en/index.html Community mental health services will lessen social exclusion, says WHO] ]New legal powers have developed in some countries, such as the
United States , to supervise and ensure compliance with treatment of individuals living in the community, known asOutpatient commitment or Assisted outpatient treatment or Community treatment orders.History
The 19th to mid-20th century saw a large expansion of the number and size of asylums in Western countries. Originally based on principles of
moral treatment , they were ofen situated in rural areas or on the outskirts of cities. Followinghuman rights and financial concerns, adeinstitutionalization movement led to the closing down of many asylums. Community services (known in the UK asCare in the community ) were meant to take their place, but were often were poorly funded, uncoordinated and unable to meet complex needs. Homelessness and prison were the result for many. Expectations that community care would lead to fuller social integration were not achieved, with many remaining withoutemployment , having limited social contacts and often living in sheltered environments that still lead toinstitutionalization . Services in the community sometimes provided a newghetto , where service users meet each other but have little contact with the rest of the community. It has been said that instead of "communitypsychiatry ", reforms established a "psychiatriccommunity ".Fakhourya, W. & Priebea, S. (2007) [http://linkinghub.elsevier.com/retrieve/pii/S1476179307001085 Deinstitutionalization and reinstitutionalization: major changes in the provision of mental healthcare] Psychiatry Volume 6, Issue 8, August, Pages 313-316 doi:10.1016/j.mppsy.2007.05.008]ee also
Recovery model References
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