It is interesting to observe just how much (or little) psychiatric services adapt to changing circumstances. The progressive move to community care, with the resettlement of seriously ill patients outside hospital and the avoidance of admission for many acutely ill patients, has shifted the focus of the psychiatric team away from its traditional institutional base – or rather the focus should have shifted. Yet it is probable that many psychiatrists, while paying lip service to the needs of patients in the community, have not altered their weekly routine. Hospitals, and the security they represent, retain their magnetic attraction for many staff. But with the growing number of out-patients and chronically disabled patients being supported by team members outside hospital, how should the multidisciplinary team respond?
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