Social psychiatry in the United Kingdom: the approach to schizophrenia.

Abstract

British contributions to theoretical and applied social psychiatry have been determined in large part by a traditional empiricism and by developments in social welfare legislation over the past 70 years. The establishment of a national health service covering the whole population and the attempt to provide comprehensive social services have created special opportunities for epidemiological research and for practical community psychiatry. These developments have by no means been uniform throughout the country, and there has been plenty of scope for individual initiative. Open-door policies, domiciliary visiting, social and occupational rehabilitation, therapeutic communities, and long-term continuity of care were first introduced in pioneering centers and subsequently adopted elsewhere. The idea that disorders such as schizophrenia not only have the character of acute illnesses but can also take the form of chronic disabilities has led to recognition of the fact that services must be tailored to the needs of individuals, and to an emphasis on the importance of the family and other social environments. There is a readiness to capitalize on successes and to learn from mistakes, assisted by a wide range of evaluative studies, which promises well for the future.