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From Community to Meta-Community Mental Health Care

1
King’s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, P.O. Box 27, London SE5 8AF, UK
2
Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex HA4 7LP, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(4), 806; https://doi.org/10.3390/ijerph15040806
Received: 13 February 2018 / Revised: 17 April 2018 / Accepted: 17 April 2018 / Published: 20 April 2018
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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PDF [310 KB, uploaded 3 May 2018]

Abstract

Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care. View Full-Text
Keywords: mental health; community; meta-community; psychiatry mental health; community; meta-community; psychiatry
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Bouras, N.; Ikkos, G.; Craig, T. From Community to Meta-Community Mental Health Care. Int. J. Environ. Res. Public Health 2018, 15, 806.

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