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International Trends in Community Mental Health Services

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Textbook of Community Psychiatry

Abstract

This chapter will provide summaries of the state of community mental health in some countries around the world, allowing readers to compare and contrast the nature of services and to further understand the successes and challenges of innovative programing. While certainly not exhaustive, we will describe examples from countries of which we have the most firsthand knowledge and focus on some leading-edge innovations and system reforms. There are consistent themes across these nations: (1) movement away from institutional hospital-centricity; (2) provision of mental health services in the community; (3) provision of supported housing and purposeful and productive activity (e.g., work); (4) emphasis on human rights and facilitating least restrictive care; (5) committed leadership for stigma reduction and advocacy; (6) expansion of the mental health workforce, including peer workers, supporting integrated teamwork; (7) holistic and comprehensive assessment, addressing social determinants; and (8) provision of trauma-informed, recovery-oriented treatment across the life span. Future directions of international of international community psychiatry and mental health services should entail more: completion of de-institutionalization; inclusive interdisciplinary teamwork; voluntary and collaborative care with more individual choice and control; consultation with families; culturally respectful global mental health approaches integrated with primary health care, and optimal balance between face-to-face or home delivery care and telehelath or digitally augmented care.

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Acknowledgments

Many thanks to Mr. Paul O’Halloran (Australia), coauthor of the original chapter, who was not able to join us for this revision; Drs. Sashi Sashidharan, David Shiers, Jo Smith Norton, Peter Byrne and Professor Helen Killaspy (UK) for new inputs or ongoing discussions; Dr. Pat Bracken (Ireland); Professor Sir Mason Durie, Drs Andrew Howie,  Alister Bush and David Codyre, Ms. Janet Peters, Mr. David Epston and Mr. Hayden Wano (New Zealand); Professors Pat Dudgeon, Luis Salvador-Carulla, Patrick McGorry and Helen Herrman, Drs Louise Byrne, Michael Dudley and Paul Fanning, Mr. Doug Holmes, Mr. Tom Brideson, Ms. Viv Miller (Australia); Drs Nev Jones, David Pollack and Ken Thompson (USA); and Dr. Wes Sowers, USA, for patient editing and encouragement. Also partly updated from Rosen A et al. (2015). International Trends in Community-Oriented MHS, Ch 15, in Mpofu E, ed., Community-Oriented Health Services, New York: Springer, 2015.

Author information

Authors and Affiliations

  1. Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia

    Alan Rosen

  2. Brain & Mind Centre, University of Sydney, Sydney, NSW, Australia

    Alan Rosen

  3. Far West NSW LHD Mental Health Services, Broken Hill, NSW, Australia

    Alan Rosen

  4. The Mental Health Services [Themhs] Conference/Themhs Learning Network of Australia & New Zealand, Balmain, NSW, Australia

    Alan Rosen

  5. Transforming Australia’s Mental Health Service System [TAMHSS] Inc., Balmain, NSW, Australia

    Alan Rosen

  6. Former Inaugural Deputy Commissioner, Mental Health Commission of New South Wales, 2013–15, Sydney, NSW, Australia

    Alan Rosen

  7. International Mental Health Collaborating Network, Exeter, UK

    Roberto Mezzina

  8. World Federation of Mental Health, Woodbridge, VA, USA

    Roberto Mezzina

  9. Former Director, Diparimento di Salute Mentale, WHO Collaborating Centre for Research and Training in Mental Health, Trieste, Italy

    Roberto Mezzina

  10. Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Jacqueline Maus Feldman

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Correspondence to Alan Rosen .

Editor information

Editors and Affiliations

  1. Clinical Professor of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Wesley E. Sowers

  2. Clinical Professor of Psychiatry, New York University Grossman School of Medicine | NYU Langone Health, New York, NY, USA

    Hunter L. McQuistion

  3. Clinical Professor of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA

    Jules M. Ranz

  4. Professor Emerita of Psychiatry, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Jacqueline Maus Feldman

  5. Vice Chair/Professor, Department of Psychiatry, Case Western Reserve School of Medicine, Ohio, OH, USA

    Patrick S. Runnels

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Rosen, A., Mezzina, R., Feldman, J.M. (2022). International Trends in Community Mental Health Services. In: Sowers, W.E., McQuistion, H.L., Ranz, J.M., Feldman, J.M., Runnels, P.S. (eds) Textbook of Community Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-10239-4_62

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