The future of community psychiatry and community mental health services

Alan Rosen, Neeraj S. Gill*, Luis Salvador-Carulla

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    40 Citations (Scopus)


    Purpose of review The aim of this article is to provide a framework and analysis of a series of critical components to inform the future design, development, sustaining, and monitoring of community mental health services.Recent findings Many mental health services remain too hospital-centric, often without adequate outreach services. On the basis of outcome evidence, we need to shift the balance of mental health services from hospital-centered with community outreach when convenient for staff, to community-centered and mobile, with in-reach to hospital only when necessary. Too few training programs emphasize the macroskills of public advocacy, working with service users, families, social movements, and the media to improve mental health and wellbeing of regional and local communities.SummaryWe should adopt a health ecosystems approach to mental healthcare and training, encompassing nano to macrolevels of service in every region. Catchment mental health services should be rebuilt as community-centric mental health services, integrating all community and inpatient components, but led and integrated from community sites. Community psychiatrists and mental health professionals of the future will need to be well trained in the nano to macroskills required to take responsibility for the mental health and wellbeing of their catchment communities and to provide leadership in service-planning, management, and continuing revision on the basis of rigorous evaluation. These approaches should be the core of all training in psychiatry and all mental health professions prior to any subspecialization.

    Original languageEnglish
    Pages (from-to)375-390
    Number of pages16
    JournalCurrent Opinion in Psychiatry
    Issue number4
    Publication statusPublished - 1 Jul 2020


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