Reinstitutionalisation in mental health care

Priebe and Turner's article is stimulating and worthy of debate.
However, I consider that they overstretch the definition of "institution"
to the point of newspeak when they include within the term
"institutionalising" those of us working flexibly in assertive outreach
with people who do not automatically accept the received wisdom of
standard services.

One contributing factor to an increase in institutional care is
improved follow-up and new ascertainment of people with mental illness in
the community. However good one's community services, at least some of
these people are likely to require institutional care at some time. This
finding was evidenced in the study of Tyrer et al. (1)

Yours,

David Dodwell

(1) Tyrer P et al. A randomised controlled study of close monitoring
of vulnerable psychiatric patients. Lancet 1995;345:756-759.

Competing interests:  
None declared