Community Mental Health Care in the Future: Nine Proposals

TY - JOUR

T1 - Community Mental Health Care in the Future

T2 - Nine Proposals

AU - Thornicroft, Graham

AU - Tansella, Michele

PY - 2014/6

Y1 - 2014/6

N2 - The aim of this article was to put community psychiatry into a longitudinal and global perspective and to try to look into the future. Specifically, we set out the following nine proposals:1. Central and regional government should measure the treated percentage of people with mental illness (coverage) and set specific targets to increase coverage over set time periods.2. Health care services need to recognize the far lower life expectancy among people with mental disorders and develop and evaluate new methods to reduce this health disparity.3. Mental health services should provide specific modules to reduce stigma and discrimination experienced by people with mental illness.4. Mental health staff should provide care that service users (and their family members) find accessible and acceptable.5. Mental health care should consist of a careful balance of hospital and community care, with most care provided at or near people's homes.6. Mental health planners, both in times of economic growth and recession, should invest in treatments known to be effective and disinvest from treatments known to be ineffective or even harmful.7. Mental health staff and service users should develop and evaluate methods to improve shared decision making.8. Health care practitioners (of western and nonwestern traditions) should take practical steps to see each other as partners in an integrated system that increases the total amount of mental health care available, while ensuring that only effective and acceptable treatments are provided.9. Mental health services should develop dedicated programs for recovery: this implies that staff understand an individual's personal recovery goals and fully support his/her achievement.

AB - The aim of this article was to put community psychiatry into a longitudinal and global perspective and to try to look into the future. Specifically, we set out the following nine proposals:1. Central and regional government should measure the treated percentage of people with mental illness (coverage) and set specific targets to increase coverage over set time periods.2. Health care services need to recognize the far lower life expectancy among people with mental disorders and develop and evaluate new methods to reduce this health disparity.3. Mental health services should provide specific modules to reduce stigma and discrimination experienced by people with mental illness.4. Mental health staff should provide care that service users (and their family members) find accessible and acceptable.5. Mental health care should consist of a careful balance of hospital and community care, with most care provided at or near people's homes.6. Mental health planners, both in times of economic growth and recession, should invest in treatments known to be effective and disinvest from treatments known to be ineffective or even harmful.7. Mental health staff and service users should develop and evaluate methods to improve shared decision making.8. Health care practitioners (of western and nonwestern traditions) should take practical steps to see each other as partners in an integrated system that increases the total amount of mental health care available, while ensuring that only effective and acceptable treatments are provided.9. Mental health services should develop dedicated programs for recovery: this implies that staff understand an individual's personal recovery goals and fully support his/her achievement.

KW - Community mental health

KW - hospital

KW - balanced care model

KW - MIDDLE-INCOME COUNTRIES

KW - RANDOMIZED CONTROLLED-TRIAL

KW - REDUCING PSYCHIATRIC STIGMA

KW - SHARED DECISION-MAKING

KW - JOINT CRISIS PLANS

KW - TRADITIONAL HEALERS

KW - IMPLEMENTATION SCIENCE

KW - UNTREATED PSYCHOSIS

KW - CLINICAL-PRACTICE

KW - HUMAN-RIGHTS

U2 - 10.1097/NMD.0000000000000151

DO - 10.1097/NMD.0000000000000151

M3 - Article

SN - 0022-3018

VL - 202

SP - 507

EP - 512

JO - Journal of Nervous and Mental Disease

JF - Journal of Nervous and Mental Disease

IS - 6

ER -