Social and community psychiatry

Social and community psychiatry is a subspecialty within psychiatry focused on identifying and treating mental health disorders in community-based settings. This subspecialty emerged as a direct consequence of several factors including deinstitutionalization, increased focus on biological aetiologies and treatment of mental health disorders, and the change in the nature of funding for mental healthcare. This chapter highlights several important issues related to community-based delivery of psychiatric care including: accurate assessment of the prevalence of mental health disorders and use of mental health services across all components of the mental health system of care; the evolution of office-based psychiatric practice, from lengthier psychotherapy visits toward shorter visits and greater use of psychotropic medications; the evolution of depression treatment in primary care; and understanding the relationship between culture and psychiatric illness.