Continuity of Care in the Mental Health Service

In the last few years, immense changes have occurred in the medical and social services of several countries, including, particularly, the United Kingdom. These have included the administrative reorganization of the National Health Service (which involved the disappearance of traditional public health arrangements); the amalgamation of various ad hoc social services into a generic organization for each major local authority; the acceptance, as a longterm objective, of the replacement of mental hospitals by services based on district general hospitals; and a change in primary health care from solopractice general practitioners to group practice centers, in which a team of doctors works in close partnership with members of related professions. Moreover, all these changes have occurred against a background of unprecedented social, cultural, and technological ferment. It is in this setting of restructuring services and fragmenting institutions that the principle of continuity of care assumes more importance than ever. Among the processes currently taking place in the sphere of mental health services, probably the most fundamental is that the formerly all-embracing mental hospital is evolving into a dispersed institution though its all-embracing care was never for more than a selected group of clients out of the total affected by psychiatric morbidity in the general community. In place of this often excessive intervention for a certain number of affected people, there is now the objective of providing a continuous spectrum of services (medical and social) as a comprehensive