150 years of mental health services

<p>This paper by discusses the development of mental health care services over the last 150 years and identifies an underlying concern with the costs of caring for people with mental health problems. Two broad themes are identified; the creation of psychiatric hospitals so that people with mental health problems could be segregated for care and treatment and the development of locally-based services which would enable care in the community. They are not totally distinct for, as Busfield (1986) reminds us, current ideas and practices incorporate the residues of past thought and action, and the social and economic conditions that gave rise to them; they are shaped by the past as well as by existing social conditions (p8).

<p><p><p>Tracing the historical development of mental health care, this paper outlines the policy and service development for adults<p><p>with mental health problems. In the next section the rise and fall of psychiatric institutions is outlined and is followed by an<p><p>examination of national trends in the development of specialist psychiatric services. Local variation within the national pattern is examined in section 4 and the final section outlines the role economic evaluation can play in improving the low level of knowledge about mental health care provision.