3. The move into the community

Abstract

‘The move into the community’ considers deinstitutionalization. Nearly every large mental hospital in the UK and most in the US and Western Europe have closed. The emptying of the institutions was partly due to the discovery of antipsychotic and antidepressant drugs, but changes in social attitudes towards the mentally ill, radical rethinking within psychiatry, and financial considerations were also influential. The first twenty years of community care were relatively successful. However, closures often ran ahead of provision of adequate alternative services. Stigma, an exaggerated sense of risk from the mentally ill, family break-up, high social mobility, and increasing levels of drug and alcohol use have made community care of the mentally ill more difficult.