“Mental health services have gone through a radical transformation over the past 30 years – perhaps more so than any other part of the health system. This process began with a wholescale transformation process known as deinstitutionalisation – that is, shifting care and support of people with mental health problems from psychiatric institutions into community based settings. At the start of the process, these institutions housed approximately 100,000 people; by the end, all had closed. The replication of mental health deinstitutionalisation across the UK and subsequently in a number of other countries has resulted in a volume of international and cross-comparative research to inform learning on the processes involved in transformation more widely. Context The primary agenda driving deinstitutionalisation was one of public and moral necessity. This was based on a growing emphasis on human rights as well as advances in social science and philosophy critiquing psychiatry and the boundaries of what constituted mental illness, which reached its height in the 1950s and 60s. A series of scandals in the 1970s around ill-treatment of mental health patients and a strong, vocal service user movement provided harrowing stories of people’s experiences of care, which contributed to this critique. As one of our interviewees, who was involved in the process of hospital closure, noted: ‘The over-riding fundamental reason was that it was the right thing to do.’ This moral agenda, however, was supported by a number of other developments that facilitated the possibility and opportunity for transformation. Clinically, developments in medical treatment demonstrated that people with severe mental illness could be treated and that institutionalisation itself was iatrogenic (ie the treatment itself caused harm), resulting in the subsequent growth in outpatient treatment. New legislation restricted who could be admitted to institutions and set a precedent that the community was the most appropriate place for treatment. Politically, there was consensus among parties about hospital reconstruction, and further legislation set a vision for the provision of mental health services as part of this. Alongside this, Enoch Powell, then Minister for Health, announced the intention to halve the number of hospital beds for people with mental health problems.” https://www.kingsfund.org.uk/publications/making-change-possible/mental-health-services#:~:text=Mental%20health%20services%20have,with%20mental%20health%20problems.
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Kazan- Kazan National Research Technical University Казанский национальный исследовательский технический университет имени А. Н. Туполева he graduated in Economics in 1982 View more posts