Future of District Psychiatry

The Psychiatric patient, the general practitioner, and the outpatient clinic: an operational study and a review

“…In Great Britain, domiciliary visiting under the National Health Service has received even less critical scrutiny than the outpatient clinic. A number of district services have systematically extended their domiciliary facilities as a form of community care (Carse, Panton, and Watt, 1958;Macmillan, 1958;Leyberg, 1959;May, Sheldon, and MacKeith, 1962), but even these schemes have paid little attention to the role of the general practitioner. Of more immediate relevance are those studies based on a working collaboration between one or more clinical psychiatrists and a group of practitioners.…”

Psychiatric Day Treatment in the General Hospital

“…(16) Such liaison has reached a high degree of efhciency in certain districts, such as Worthing~4> and Croydon, (13) > where the day treatment centres have in fact not been situated in general hospitals, though at Oldham, the general hospital and community psychiatric services would seem to have achieved such a degree of success that relatively few patients need transfer to the psychiatric hospitals of the area.~l~> It is, of course, necessary for the community services to be in constant contact with the psychiatric in-patient and out-patient departments of the general hospital, and if the day department is also situated there it would appear to make for ease of communication.…”

Change in a British Psychiatric Service

“…The major orientation of the policy developed in the Croydon Psychiatric Service was reported by May, Sheldon, and Mackeith (1962). In essence this paper suggests that the focus for a community mental health service is naturally the community, and should involve more than the extension of the hospital into the community.…”