Components of a modern mental health service: a pragmatic balance of community and hospital care: overview of systematic evidence

The British Journal of Psychiatry : the Journal of Mental Science
Graham Thornicroft, Michele Tansella

Abstract

There is controversy about whether mental health services should be provided in community or hospital settings. There is no worldwide consensus on which mental health service models are appropriate in low-, medium- and high-resource areas. To provide an evidence base for this debate, and present a stepped care model. Cochrane systematic reviews and other reviews were summarised. The evidence supports a balanced approach, including both community and hospital services. Areas with low levels of resources may focus on improving primary care, with specialist back-up. Areas with medium resources may additionally provide out-patient clinics, community mental health teams (CMHTs), acute in-patient care, community residential care and forms of employment and occupation. High-resource areas may provide all the above, together with more specialised services such as specialised out-patient clinics and CMHTs, assertive community treatment teams, early intervention teams, alternatives to acute in-patient care, alternative types of community residential care and alternative occupation and rehabilitation. Both community and hospital services are necessary in all areas regardless of their level of resources, according to the additive and seque...Continue Reading

References

May 1, 1992·Acta Psychiatrica Scandinavica·Merete NordentoftF Schulsinger
Dec 1, 1989·The British Journal of Psychiatry : the Journal of Mental Science·Graham Thornicroft, P Bebbington
Jul 1, 1995·Psychiatric Services : a Journal of the American Psychiatric Association·P A DeciJ K Dias
Nov 1, 1994·Social Psychiatry and Psychiatric Epidemiology·S DaviesGraham Thornicroft
Aug 1, 1996·The American Journal of Psychiatry·W H SledgeB Druss
Aug 1, 1996·The American Journal of Psychiatry·W H SledgeT W Helminiak
Apr 1, 1996·The British Journal of Psychiatry : the Journal of Mental Science·G ShepherdM Cooney
Jan 1, 1995·Schizophrenia Bulletin·Anthony F LehmanD M Steinwachs
Mar 1, 1996·Psychiatric Services : a Journal of the American Psychiatric Association·P Polak, Richard Warner
Nov 1, 1996·Psychiatric Services : a Journal of the American Psychiatric Association·D R BeckerG R Bond
Feb 14, 1998·BMJ : British Medical Journal·Peter TyrerT Johnson
May 20, 1998·The American Journal of Orthopsychiatry·G B TeagueR E Drake
Feb 2, 1999·The British Journal of Psychiatry : the Journal of Mental Science·Graham ThornicroftG Szmukler
May 20, 1999·BMJ : British Medical Journal·P Johnstone, G Zolese
Jun 22, 1999·Journal of Nursing Management·J E Steel
Jul 2, 1999·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Eric Latimer
Aug 12, 1999·The International Journal of Social Psychiatry·F HollowayK Lewis-Cole
May 2, 2000·The British Journal of Psychiatry : the Journal of Mental Science·Graham ThornicroftT Wykes
Nov 1, 2000·Psychiatric Services : a Journal of the American Psychiatric Association·S J Ziguras, G W Stuart
May 2, 2001·The British Journal of Psychiatry : the Journal of Mental Science·Vikram Patel, A Sumathipala
May 2, 2001·Psychiatric Services : a Journal of the American Psychiatric Association·T BurnsWulf Rössler
May 29, 2001·Psychiatric Services : a Journal of the American Psychiatric Association·S D PhillipsE C McDonel Herr
May 31, 2001·Acta Psychiatrica Scandinavica·T K LarsenP Vaglum
Jun 5, 2001·The British Journal of Psychiatry : the Journal of Mental Science·S SimmondsPeter Tyrer
Aug 11, 2001·The Journal of Behavioral Health Services & Research·E W LambertL Bickman
Oct 9, 2001·The International Journal of Social Psychiatry·F Holloway, J Carson
Oct 27, 2001·BMJ : British Medical Journal·M Von Korff, D Goldberg
Feb 13, 2002·Archives of General Psychiatry·Anthony F LehmanKaren McDonnell
Feb 28, 2002·Acta Psychiatrica Scandinavica. Supplementum·I Becker, J L Vázquez-Barquero
Mar 23, 2002·BMJ : British Medical Journal·Petros IsaakidisJohn P A Ioannidis
Apr 19, 2002·The Journal of School Health·Janet CollinsLloyd Kolbe
May 7, 2002·Psychological Medicine·J CattyA Healey
May 25, 2002·The American Journal of Hospice & Palliative Care·Sharon DixonShirley S Travis
Jul 2, 2002·The British Journal of Psychiatry : the Journal of Mental Science·S J ZigurasA C Jackson
Jan 23, 2003·Psychological Medicine·S M HarriganH Krstev
Feb 15, 2003·Epidemiologia e psichiatria sociale·Patrick D McGorry, Eoin J Killackey
Feb 15, 2003·Epidemiologia e psichiatria sociale·Richard Warner, Patrick D McGorry
Mar 4, 2003·The British Journal of Psychiatry : the Journal of Mental Science·Matthew FianderRobert E Drake
Aug 2, 2003·The British Journal of Psychiatry : the Journal of Mental Science·Michele Tansella, Lorenzo Burti
Sep 6, 2003·Acta Psychiatrica Scandinavica·J AddingtonDonald Addington
Apr 2, 2004·The British Journal of Psychiatry : the Journal of Mental Science·D RauneP E Bebbington

Citations

Dec 20, 2008·Social Psychiatry and Psychiatric Epidemiology·Lars H MyklebustReidun Olstad
Jul 9, 2009·Social Psychiatry and Psychiatric Epidemiology·Paola RoccaF Bogetto
Aug 28, 2009·Social Psychiatry and Psychiatric Epidemiology·Nana ZavradashviliFrancesco Amaddeo
May 18, 2010·Social Psychiatry and Psychiatric Epidemiology·Riccardo PertileFrancesco Amaddeo
Oct 12, 2012·Social Psychiatry and Psychiatric Epidemiology·Dan SiskindHarvey Whiteford
Aug 19, 2006·European Archives of Psychiatry and Clinical Neuroscience·Giuseppe CarràCarlo Lorenzo Cazzullo
Jul 25, 2006·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Corrado Barbui, Camilla Lintas
Jul 13, 2012·Psychological Medicine·Graham Thornicroft, Michele Tansella
Jun 11, 2011·Epidemiology and Psychiatric Sciences·M Alonso SuárezC González-Juárez
Nov 30, 2010·International Journal of Epidemiology·Ezra SusserZena Stein
May 25, 2006·Current Opinion in Psychiatry·Alan Rosen
Mar 19, 2005·BMJ : British Medical Journal·Graham Thornicroft, Diana Rose
Apr 2, 2010·International Journal of Mental Health Systems·Lars H MyklebustReidun Olstad
Jan 27, 2011·International Journal of Mental Health Systems·Alex CohenVikram Patel
Oct 21, 2009·PLoS Medicine·Mari Jair de JesusGraham Thornicroft
Dec 3, 2014·Journal of Behavior Therapy and Experimental Psychiatry·Fredrik FolkeLisa Ekselius
Apr 12, 2013·TheScientificWorldJournal·Wouter VanderplasschenEric Broekaert
Mar 13, 2014·International Journal of Environmental Research and Public Health·Amélie PrigentKarine Chevreul
Dec 7, 2013·Der Nervenarzt·K StenglerT Becker
Mar 20, 2010·Social Psychiatry and Psychiatric Epidemiology·Rafael Henriques CandiagoPaulo Belmonte-de-Abreu
Feb 13, 2009·Social Psychiatry and Psychiatric Epidemiology·Antonio PretiPROGRES-Acute Group
Aug 5, 2014·International Journal of Mental Health Systems·Nadja van GinnekenVirginia Berridge
Jul 1, 2014·The Lancet. Psychiatry·T Becker, Nicolas Rüsch
Jan 1, 2014·African Journal of Primary Health Care & Family Medicine·Elijah MaranguFethi Mansouri
May 20, 2011·The British Journal of Psychiatry : the Journal of Mental Science·Kristian WahlbeckThomas Munk Laursen
Jun 10, 2011·The British Journal of Psychiatry : the Journal of Mental Science·Mira Harrison-WoolrychDavid C G Skegg
Apr 4, 2013·The British Journal of Psychiatry : the Journal of Mental Science·Graham Thornicroft, Michele Tansella
Feb 20, 2009·Nordic Journal of Psychiatry·Ulf MalmJonas Eberhard
Apr 13, 2010·Journal of Mental Health·Monika Gullslett WinnessH S Kim
Aug 26, 2014·International Journal of Environmental Research and Public Health·Taina Ala-NikkolaKristian Wahlbeck
Mar 30, 2013·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Li-Ren ChangHai-Gwo Hwu
Jan 24, 2016·Social Psychiatry and Psychiatric Epidemiology·Regis Eric Maia BarrosCristina Marta Del-Ben
Jan 24, 2012·European Psychiatry : the Journal of the Association of European Psychiatrists·W GaebelEuropean Psychiatric Association
Oct 12, 2012·Asian Journal of Psychiatry·Geetha JayaramKrishnamachari Srinivasan
Oct 12, 2010·European Psychiatry : the Journal of the Association of European Psychiatrists·V PeritogiannisT Hyphantis
Feb 27, 2015·Australian and New Zealand Journal of Public Health·Meredith HarrisLouisa Degenhardt
Sep 7, 2007·Lancet·Shekhar SaxenaHarvey Whiteford
Mar 12, 2016·The Journal of Behavioral Health Services & Research·Anna DurbinJanet Durbin
May 1, 2008·Early Intervention in Psychiatry·Blanaid GavinGerard Bury
Jun 19, 2008·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Graham ThornicroftAnn Law
Sep 13, 2006·Journal of Psychiatric and Mental Health Nursing·G BrennanL Bowers
Nov 17, 2010·Journal of Psychiatric and Mental Health Nursing·H SjølieH S Kim
Oct 13, 2011·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Maya SemrauGraham Thornicroft
Feb 3, 2012·Journal of Psychiatric and Mental Health Nursing·C A CamuccioR Zanotti
Mar 23, 2011·Journal of Psychiatric and Mental Health Nursing·P NolanN Brimblecombe
Jul 2, 2011·Early Intervention in Psychiatry·Sue M CottonPatrick D McGorry
Jul 6, 2011·Early Intervention in Psychiatry·Eric Y H ChenWilliam G Honer
Mar 31, 2015·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Nicola WrightJustin Waring
Jul 31, 2010·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Graham ThornicroftDawit Wondimagegn
Sep 4, 2015·Community Mental Health Journal·Vincent LorantTitle 107 Study Group
Oct 3, 2015·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Tirma MoreraDaniel Pratt
Jun 30, 2015·Journal of Psychiatric and Mental Health Nursing·I HamiltonA Savage Grainge
Mar 18, 2015·International Journal of Mental Health Systems·Fikir AddisuMarkos Tesfaye
May 23, 2015·BMC Health Services Research·Markus WübbelerJochen René Thyrian
Jun 6, 2014·Administration and Policy in Mental Health·Niklaus StulzUrs Hepp
Mar 29, 2011·Social Science & Medicine·Giuseppe Nicola Giordano, Martin Lindström
Apr 22, 2016·Current Opinion in Psychiatry·Stefan Weinmann, Markus Koesters
Jan 14, 2011·Trials·Sudipto ChatterjeeCOmmunity care for People with Schizophrenia in India (COPSI) group
Sep 9, 2016·International Journal of Mental Health Systems·Mohammed Abdullah Al-Sughayir
Jun 28, 2016·Nordic Journal of Psychiatry·Solveig Osborg OseIvar Pettersen
Oct 8, 2016·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Graham ThornicroftClaire Henderson
Mar 5, 2016·The Journal of Bone and Joint Surgery. American Volume·Douglas S WeinbergHeather A Vallier
Dec 9, 2016·International Journal of Environmental Research and Public Health·Taina Ala-NikkolaKristian Wahlbeck
Apr 10, 2013·The Australian and New Zealand Journal of Psychiatry·Dan SiskindHarvey Whiteford
Feb 10, 2011·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Frank FlanneryNick O'Connor
Aug 1, 2006·The International Journal of Social Psychiatry·Peter TyrerJeremy Slaughter
Mar 24, 2016·Australian Health Review : a Publication of the Australian Hospital Association·Ana FernandezLuis Salvador-Carulla
Apr 2, 2017·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Mara Grunau
Jan 20, 2017·BMC Research Notes·Eugenio Velasco-OrtegaJ J Segura-Egea
May 1, 2009·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Bruce Singh
Dec 14, 2012·Clinical Child Psychology and Psychiatry·Fiona Duffy, Joanne Skeldon
Mar 6, 2007·The International Journal of Social Psychiatry·B MorenoF Torres
Jan 10, 2008·The International Journal of Social Psychiatry·Peter TyrerJacqui Thomas
Sep 10, 2017·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Donald AddingtonChris Summerville
Jan 20, 2018·Health & Social Care in the Community·Sue GillieattAdrian Munro
Apr 21, 2018·International Journal of Environmental Research and Public Health·Nick BourasThomas Craig
Jun 24, 2017·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Amélie PrigentKarine Chevreul
Sep 26, 2015·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Yue LiChee Ng
Aug 31, 2018·The International Journal of Social Psychiatry·Jackie Liggins
Apr 29, 2018·Community Mental Health Journal·Vesna ZupančičTina Kogovšek
Aug 2, 2007·The British Journal of Psychiatry : the Journal of Mental Science·Giovanni de GirolamoPROGRES-Acute group
Mar 2, 2005·The British Journal of Psychiatry : the Journal of Mental Science·F J Huyse
Sep 25, 2019·International Review of Psychiatry·Roger M K NgDinesh Bhugra
Jul 11, 2019·Child Psychiatry and Human Development·Kimberly W Dossett, Graham J Reid
Jul 10, 2014·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Catherine Briand, Matthew Menear
Jun 3, 2017·The British Journal of Psychiatry : the Journal of Mental Science·Graham Thornicroft
Aug 23, 2020·The Psychiatric Quarterly· RicciMark Costa
Nov 30, 2011·Cadernos de saúde pública·Aline Gabriela Simon, Tatiana Wargas de Faria Baptista
Jun 3, 2018·International Journal of Environmental Research and Public Health·Minna SadeniemiLuis Salvador-Carulla
Nov 7, 2019·Cadernos de saúde pública·Maria Tavares Cavalcanti
Jul 27, 2006·Epidemiologia e psichiatria sociale·Giovanni de Girolamo, Michele Tansella
Oct 6, 2017·Journal of Advanced Nursing·Niall McCrae
Jun 3, 2018·International Journal of Environmental Research and Public Health·Taina Ala-NikkolaSamuli I Saarni
Oct 26, 2018·Health Systems and Reform·Gordon C ShenLonnie R Snowden
Mar 25, 2019·International Journal of Mental Health Nursing·Theresa Maureen Williams, Geoffrey Paul Smith
Oct 31, 2020·History of Psychiatry·Merve Kardelen Bilir, Fatih Artvinli

Related Concepts

Acute Disease
Diagnosis, Psychiatric
Assertive Community Treatment
Day Care
Hospitalization
Mental Health Services
Patient Care Team
Primary Health Care
Vocational Rehabilitation

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Synthetic Genetic Array Analysis

Synthetic genetic arrays allow the systematic examination of genetic interactions. Here is the latest research focusing on synthetic genetic arrays and their analyses.

Congenital Hyperinsulinism

Congenital hyperinsulinism is caused by genetic mutations resulting in excess insulin secretion from beta cells of the pancreas. Here is the latest research.

Neural Activity: Imaging

Imaging of neural activity in vivo has developed rapidly recently with the advancement of fluorescence microscopy, including new applications using miniaturized microscopes (miniscopes). This feed follows the progress in this growing field.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Epigenetic Memory

Epigenetic memory refers to the heritable genetic changes that are not explained by the DNA sequence. Find the latest research on epigenetic memory here.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Femoral Neoplasms

Femoral Neoplasms are bone tumors that arise in the femur. Discover the latest research on femoral neoplasms here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

© 2021 Meta ULC. All rights reserved