Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-05T10:15:17.776Z Has data issue: false hasContentIssue false

Community Care: An Analysis of Assumptions

Published online by Cambridge University Press:  29 January 2018

David Hawks*
Affiliation:
Department of Psychology, Whitchurch Hospital, Cardiff, CF4 7XB

Summary

The implementation of a policy of ‘community care’ is seen to involve a number of assumptions, some of which are rarely examined. These can be roughly categorized as involving the nature of mental illness, the nature of community, the course and treatment of mental illness, the proper scope of psychiatry, the burden on the community and the efficacy of social work. Data bearing on these assumptions are reviewed, and the conclusion is offered that they are far from being uncontentious.

It is suggested that the movement toward community care has many of the attributes of a moral enterprise which, unless substantiated by benefits to the patient or his family, may be the latest diversion of the psychiatric conscience from the care and treatment of the chronic mentally ill.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1975 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Apple, D. (1960) How laymen define illness. Journal of Health and Human Behaviour, 1, 219–25.Google Scholar
Baumann, B. (1961) Diversities in conceptions of health and physical fitness. Journal of Health and Human Behaviour, 2, 3946.Google Scholar
Brown, G. W., Bone, M., Dallison, B. & Wing, J. K. (1966) Schizophrenia and Social Care. Maudsley Monograph, No. 17. Oxford University Press.Google Scholar
Carstairs, G. M. (1961) Advances in psychological medicine. The Practitioner, 187, 495504.Google Scholar
Clausen, J. A. & Yarrow, M. R. (1955) Paths to the mental hospital. Journal of Social Issues, 11, 2532.CrossRefGoogle Scholar
Coser, R. L. (1963) Alienation and the social structure: case analysis of a hospital. In The Hospital in Modern Society (ed. Freidson, E.). Free Press.Google Scholar
Cumming, E. & Cumming, J. (1957) Closed Ranks: An Experiment in Mental Health Education. Cambridge, Mass.: Harvard University Press.CrossRefGoogle Scholar
Department of Health and Social Security (1963) Health and Welfare: the Development of Community Care. Command 1973. London: H.M.S.O.Google Scholar
Gore, C. P. & Jones, K. (1961) Survey of a long-stay mental hospital population. Lancet, ii, 544–6.Google Scholar
Gruenberg, E. M., Snow, H. B. & Bennett, C. L. (1969) Preventing the social breakdown syndrome. Social Psychiatry, 47, 179–95.Google Scholar
Hoenig, J. & Hamilton, M. W. (1965) Extra-mural care of psychiatric patients. Lancet, i, 1322–5.Google Scholar
Hoenig, J. & Hamilton, M. W. (1966) The schizophrenic patient in the community and his effect on the household. International Journal of Social Psychiatry, 12, 165–76.CrossRefGoogle ScholarPubMed
Klein, D. C. (1968) Community Dynamics and Mental Health. New York: Wiley.Google Scholar
Johnson, D. A. W. (1973a) Treatment of depression in general practice. British Medical Journal, ii, 1820.CrossRefGoogle Scholar
Johnson, D. A. W. (1973b) A further study of psychiatric out-patient services in Manchester. British Journal of Psychiatry, 123, 185–91.Google Scholar
Johnson, D. A. W. (1974) A study of the use of anti-depressant medication in general practice. British Journal of Psychiatry, 125, 186–92.Google Scholar
Laing, R. D. (1960) The Divided Self: a Study of Sanity and Madness. Chicago: Quadrangle.Google Scholar
Lewis, A. J. (1958) Between guesswork and certainty in psychiatry. Lancet, i, 171–5 and 227–30.Google Scholar
Lindsay, J. S. B. (1962) Trends in mental hospital population and their effect on planning. Lancet, i, 1354–5.Google Scholar
Loeb, M. B. (1966) Community psychiatry: what it is and what it is not. In Community Psychiatry (eds. Roberts, L. M., Hallack, S. L. & Loeb, M.). Madison: University of Wisconsin Press.Google Scholar
May, A. R. & Gregory, E. (1968) Participation of general practitioners in community psychiatry. British Medical Journal, ii, 168–71.Google Scholar
Norton, A. (1961) Needs and beds. Lancet, i, 884.Google Scholar
Rehin, G. F. & Martin, F. M. (1968) Patterns of Performance in Community Care. London: Oxford University Press.Google Scholar
Riessman, F. & Miller, S. M. (1964) Social change versus the ‘psychiatric world view’. American Journal of Orthopsychiatry, 34, 2938.CrossRefGoogle ScholarPubMed
Sainsbury, P. & Grad, J. (1966) Evaluating the community psychiatric service in Chichester. In: Evaluating the effectiveness of mental health services (ed. Gruenberg, E.). Milbank Memorial Fund Quarterly, 44, Part 2, No. 1.Google Scholar
Sarbin, T. R. & Mancuso, J. C. (1970) Failure of a moral enterprise: attitudes of the public towards mental illness. Journal of Consulting and Clinical Psychology, 33, 159–75.Google Scholar
Seebohm Report (1968) Report of the Committee on Local Authority and Allied Personal Social Services, Command 3703. London: H.M.S.O.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966) Psychiatric Illness in General Practice. London: Oxford University Press.Google Scholar
Shepherd, M., Goodman, N. & Watts, D. C. (1961) The application of hospital statistics in the evaluation of pharmacotherapy in a psychiatric population. Comprehensive Psychiatry, (1961) 2, 1119.CrossRefGoogle Scholar
Suchman, E. A. (1964) Socio-medical variations of ethnic groups. American Journal of Sociology, 70, 319–31.Google Scholar
Susser, M. W. (1965) Rationale for the community care of mental disorder. Hospital Care, 3, 52–9.Google Scholar
Tizard, J. A. & Grad, J. (1961) The Mentally Handicapped and their Families . Maudsley Monograph, No. 7. London: Oxford University Press.Google Scholar
Tooth, G. C. & Brooke, E. M. (1961) Trends in the mental hospital population and their effect on future planning. Lancet, i, 710–13.Google Scholar
Wilde, W. A. (1968) Decision-making in a psychiatric screening agency. Journal of Health and Social Behaviour, 9, 215–21.Google Scholar
Wing, J. K., Monck, E., Brown, G. W. & Carstairs, C. M. (1964) Morbidity in the community of schizophrenic patients discharged from London mental hospitals in 1959. British Journal of Psychiatry, 110, 1021.CrossRefGoogle ScholarPubMed
Wootton, B. (1959) Social Science and Social Pathology. London: George Allen and Unwin.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.