communitary psychiatry

The development of attitudes towards the mentally ill, the progress of psychotherapeutic care and medicines, allowed the looking after of psychotic patients outside of the hospital institution, while keeping their social links with their personal environment. The setting up of alternative structures in the context of the communitary psychiatry was supposed to enable the reinsertion of the stabilized psychotic patients. In Paris, the lack of such structures, and the difficult socio-economic context condemn these patients to drifting aimlessly, locked out of any institution, which worsen their pathological state...

Present trends of communitary Psychiatry are considered, with an assessment of their measurable parameters and degrees of feasibility. Three models are set forth, taking into account their principal factors: primary mental health agents, actual resources, socio-political structures, geographical setting, cultural patterns, possible strategies, and community participation. Model I is a traditional one, it relies on decisions taken from the administration, which endows both scientific authority and normative power...