Introduction

Community psychiatry is a portmanteau couplet that can mean many different things. To some it merely seems to imply ‘extra-mural’ psychiatry (i.e. any mental health care that goes on outside the walls of hospitals), to others it represents a specific form of care that involves particular skills and procedures and to others still it appears to be a form of policy to close outdated hospitals. This book focuses on the essential elements of research in community psychiatry and, as an initial task in research is to define exactly what is being measured, we need to define our terms before proceeding to research inquiry. This chapter is concerned with four main issues; the components of community psychiatry, their effectiveness, the development of the results of research into clinical practice and the proper focus of research in the subject.

What are the essential components of community psychiatry?

Community psychiatry is at different times a government policy, a planning strategy and a method of delivering psychiatric care. The first two of these are not open to research in the same way as the third and sometimes seem to be ignored or derided by research workers as they are not based on hard data. They are, however, fundamental in community psychiatry because they emphasise the importance of society in implementing the care of the mentally ill. Society decided in the early and middle years of the nineteenth century that patients with significant mental illness should be cared for in asylums where they should be protected from others in society.