Reinstitutionalisation in mental health care

doi:10.1136/bmj.326.7382.175

BMJ 2003;326:175-176 ( 25 January )

Editorials

Reinstitutionalisation in mental health care

This largely unnoticed process requires debate and evaluation

The first 150 words of the full text of this article appear below.

Since the 1950s mental health care in most industrialised countries has been characterised by deinstitutionalisation, withnational reforms varying in their pace, fashion, and exact results. ¹ ² The development of comprehensive community mental health careis widely regarded as not yet complete. In England the nationalservice framework and NHS Plan aim at establishing new communitybased services $---$ for example, for home treatment, assertive outreach,and early intervention. Yet despite the apparent evidence of ongoingdeinstitutionalisation, we argue that a new era in mental healthcare has already started $---$ reinstitutionalisation. It is displayinga synonymous pattern across Europe, as with deinstitutionalisation,but this time it has been occurring largely unnoticed by the scientificcommunity and unscrutinised by politicians and themedia.

What are the signs of reinstitutionalisation? Firstly, the number of forensic beds is rising, in the United Kingdom, withdramatic increases in the private sector. Plans to increase thisnumber . . . [Full text of this article]

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Rapid Responses:

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