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What does dependency on community mental health services mean? A conceptual review with a systematic search

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Abstract

Purpose

Although community mental health services aim to support patients’ autonomy and independence, they have repeatedly been criticised for making patients dependent. Yet, it remains often unclear what exactly is meant with dependency in this context. This review aimed to identify the meaning of the term dependency on community services in the literature.

Methods

A systematic search and conceptual review of papers where dependency is used in the context of community mental health services. Narrative synthesis was used to identify thematic concepts linked to dependency in these settings.

Results

Fifteen papers met the inclusion criteria. The analysis identified five different concepts of dependency on community mental health services: dislocation from the outside world; inflexibility and lack of freedom; obligation as resentment or appreciation; living with or without meaningful activities; and security.

Conclusions

The findings suggest that, distinct from the exclusively negative connotation of the term dependency in a conventional medical context, dependency on community mental health services contains both negative and positive aspects. The different aspects might guide the future evaluation of the care provided in such services.

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Authors and Affiliations

  1. Psychiatric Clinic, University of Trieste, Trieste, Italy

    Tommaso Bonavigo & Elisabetta Pascolo-Fabrici

  2. Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK

    Tommaso Bonavigo, Sima Sandhu & Stefan Priebe

Authors
  1. Tommaso Bonavigo
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  2. Sima Sandhu
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  3. Elisabetta Pascolo-Fabrici
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  4. Stefan Priebe
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Correspondence to Tommaso Bonavigo.

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Bonavigo, T., Sandhu, S., Pascolo-Fabrici, E. et al. What does dependency on community mental health services mean? A conceptual review with a systematic search. Soc Psychiatry Psychiatr Epidemiol 51, 561–574 (2016). https://doi.org/10.1007/s00127-016-1180-0

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