Beyond the walls of the asylum: information and organization in the provision of community mental health services

Abstract

In the last twenty years or so the UK National Health Service (NHS) has witnessed tremendous changes in the provision of mental health services. As the vast Victorian asylums have progressively been run down and closed attention has switched to the planning and delivery of services based on the idea of ‘care in the community’. This paper explores some of the temporal and spatial dimensions of the problems of organizing that have marked this transition. Drawing on research conducted within a hospital department responsible for psychiatric services in the community, it addresses some of the issues faced by mental health professionals in struggling to put in place and maintain mental health services while simultaneously under pressure to demonstrate their professional accountability. In this regard, particular attention is paid to the role of technology (principally information and the information systems) in managing services in the context of the transition to care in the community as well as addressing some of the problems generated by it.