[Legitimation and criticism of community psychiatry: concomitant phenomena and sequelae of a long-term model project].

Abstract

This article describes the development and criticism of community psychiatry in Germany since the 1975 Inquiry Commission on Psychiatry as well as its precursors and reference points. While the inquiry called for fundamental reforms such as the establishment of community-based care structures, the concrete content and structural guidelines remained vague. This lack of clarity meant that community psychiatry was characterized less by central reforms than by a large number of regional model projects. With a view to the historical context, this project orientation is interpreted as an expression of a shift in focus since the 1980s towards self-help, civil society actors and the flexibilization of the social state. Although projectification has led to diversification and professionalization, it has also resulted in uncertainty, lack of sustainability and fragmentation of care. Community psychiatry is thus seen as a mirror of social and political change.