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- W236604154 abstract "SUMMARY De-institutionalization and community care movements had been prevailing in psychiatric services within these several decades. This article is a historical review about the community care movement in the LJK and the USA. Community care movement actually initiated long before the de-institutionalization movement in forms of informal social care by voluntary organizations. It gained its momentum in 1950s and 1960s because of the de-institutionalization movement and the use of psychoactive drugs in psychiatric treatment. Nevertheless, its basic ideologies are constantly challenged by professionals and its service models are constrained by resources and social stigmatization of mental illness. The whole movement reflected a vague and unclear concept of community, under-development of informal community care and under-estimation of the protective and custodial functions of good and humane institutional care for the mentally ill. The implications of this movement to community care of mental patients in Hong Kong are also suggested. Keywords: community care, psychiatric service, history, de-institutionalization movement, informal community care. INTRODUCTION De-instiauonalization and community care are the most influential movements in the mental health field within these thirty years (Thornicroft & ebbington, 1989; Brown, 1975: Archer & Gruenberg, 1982; Wing, 1981; Bachrach, 1976 & 1978, Hafner & Heidner, 1989; Bennett, 1979). This article is a historical review and critics about the community care movement in the U.K. and the USA. Community care in the mental health field can be defined as multi-faceted and multidisciplinary, involving not only those responsible for providing statutory health and social services but also the family, voluntary bodies and in fact, the whole community itself (D.H.S.S., 1978). HISTORICAL REVIEW The development of community care movements in the U.K. the U.S.A. can be mighty divided into three stages: 1. the pre-community care era 2. from de-institutionalization to community care 3. community care or re--institutionalization THE PRE-COMMUNITY CARE ERA Strictly speaking, the foetus of community care occurred long before the de-institutionalization movement. In 1200, community care for the mentally ill was evident try Geheel, Belgium, when people were placed in families for mental health care. In the U.K., the Mental Aftercare Association was founded in 1879 (Williams & Lancaster, 1988). The work of the Association was initiated on a comparatively small scale with focuses on residential and personal care of very limited amount of ex-patients (Hawkins, 1879). Apart from the Aftercare Association, three more voluntary association had operated on a national scale to promote the community care for the mental outpatients. They were the Central Association for Mental Welfare, National Council for Mental Hygiene, and the Child Guidance Council. The Faversham Committee in 1939 suggested amalgamation of these four voluntary associations to take part in community care of mental outpatients Wanes, 1972). Furthermore, the first general hospital clinic for psychiatric outpatients was established at St Thomas Hospital in about 1890. The number of outpatient clinics grew drastic* after the World War 1. Later, the Mental Treatment Act 1930 gave local authorities the power to arrange out-patients. There was a drastic increase in the number of outpatient clinics with at Least 216 outpatient clinics by 1942 (Blacker, 1946; Board of Control, 1930; Gibson, 1963; Hurst, 1949). In the United States, concepts and practices of community care vas actually originated from Cliff Seers' Book, A Mind That Found itself (Beers, 19031, and his establishment of the National Association of Mental Hygiene in 1909. Following this was the mental hygiene movement stressing early detection, and prevention of mental illness (Archer & Greenberg, 1932). …" @default.
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- W236604154 date "1996-09-01" @default.
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- W236604154 title "A Historical Review of the Community Care Movement in Psychiatric Services" @default.
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