Suchergebnisse

During the second half of the 20th century the mental hospital population in England and Wales has fallen by some two‐thirds. This dramatic shift in mental health policy has been based, in part, upon a policy assumption concerning the therapeutic benefits of hospital discharge for mental patients. This view derives from an acknowledgement of the potentially negative impact of institutional life and, conversely, a recognition of the beneficial effect of a return to independent living in the community. Yet, in recent years, concern has grown about the risks posed to the health and safety of patients and to the safety of other members of the community as a result of hospital discharge. In turn this has led to a policy shift in favour of increasing use of compulsory community powers. This article identifies the tensions in policy that exist between the goal of independence, the recognition of risk and the implementation of compulsory community powers, and seeks to provide an assessment of the extent to which they can be reconciled.

Since the late 1950s, successive British government's have embraced the philosophy of caring for dependent groups in the community in prefer ence to institutions. Yet through this period it has become commonplace for social policy analysts to deride the gap between political and profes sional rhetoric, and the lived experiences of the users of services and informal carers.The policy has become characterised as by the communority, and not care in the community (Walker, 1982). After much prevarication, the present govermment has provided a policy framework which purports to offer the prospect of a better deal for those who need care, and their carers. This paper axamines the adequacy of this policy framework, and argues that serious faiging exist withine it. Unwar ranted assumptions, contradictory policy aims, and substantial amissions characterise the most recent attempt to improve communty care policy. Based on this analysis, we argue that a radical; historically based, review of recent develppments of the mental health services is urgently required.