Defining Mental Health Policy

Abstract

Mental health policies throughout the Western world can, at the present time, be summarised as policies geared towards the provision of a community-based range of therapeutic services for people with mental disorders, supported by the least possible number of publicly funded psychiatric beds and therefore costing as little as possible to the taxpayer. Throughout Europe, and especially in the UK, this has led to a reduction in the number of publicly funded psychiatric beds and the expansion of independent sector providers of community services. It has also led to the phenomenon referred to as ‘transinstitutionalisation’, in which many former psychiatric patients find themselves in other institutions, such as prisons or shelters for homeless people (for a discussion, see Heller et al. 1996; Ramon 1996; Rogers and Pilgrim 1996; Torrey 1997). The change in focus, from a hospital-based service to a community-based one, has been supported by changes in the law — both on mental disorder itself and on the general delivery of health services. On the one hand, the law has allowed for a more flexible approach to treatment, but on the other hand, it has become more prescriptive in defining the people who need to be treated not only for their own safety and well-being, but also for the safety of the public.