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Rapid changes are taking place in the practice of psychiatry and nowhere is this more pronounced than in the area of community and home-based care. This book explains the theory and practice of community psychiatry concentrating on the evidence from research and highlighting recent developments. In looking ahead to impending developments requiring further research, it will help clinicians, economists, and civic planners in the organization of community psychiatric care.
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Rapid changes are taking place in the practice of psychiatry and nowhere is this more pronounced than in its community aspects. Much has changed and this sometimes appears to have done so without adequate forethought or research although there is already a considerable body of knowledge that underscores recent developments. In this book prominent researchers in this expanding subject debate the implications of recent knowledge derived from a variety of sources and look ahead at impending developments that will need further research inquiry. The chapters are wide in scope and topical in content and the discussions after each are frank and informative. This book will be of help to all those involved in the organisation of psychiatric care. COMMUNITY PSYCHIATRY IN ACTION: ANALYSIS AND PROSPECTS COMMUNITY PSYCHIATRY IN ACTION: ANALYSIS AND PROSPECTS Edited by PETER TYRER Professor of Community Psychiatry Academic Unit of Psychiatry St Charles' Hospital, London, UK and FRANCIS CREED Professor of Community Psychiatry Rawnsley Building Manchester Royal Infirmary Manchester, UK CAMBRIDGE UNIVERSITY PRESS Published by the Press Syndicate of the University of Cambridge The Pitt Building, Trumpington Street, Cambridge CB2 1RP 40 West 20th Street, New York, NY 10011-4211, USA 10 Stamford Road, Oakleigh, Melbourne 3166, Australia © Cambridge University Press 1995 First published 1995 Printed in Great Britain at the University Press, Cambridge A catalogue record for this book is available from the British Library Library of Congress cataloguing in publication data Community psychiatry in action : analysis and prospects / edited by Peter Tyrer and Francis Creed. p. cm. Includes index. ISBN 0 521 47427 2 (he) 1. Community mental health services. 2. Community psychiatry. 3. Community mental health services - England. 4. Community psychiatry - England. I. Tyrer, Peter J. II. Creed, Francis. [DNLM: 1. Community Mental Health Services. WM 30 C733426 1995] RC45.5.C61746 1995 362.2'2 - dc20 DNLM/DLC for Library of Congress 94-35007 CIP ISBN 0 521 474272 hardback EBF Contents List of contributors page 1 Essential issues in community psychiatry Peter Tyrer 2 Evaluation of community treatments for acute psychiatric illness Francis Creed 3 Synopsis of the Daily Living Programme for the seriously mentally ill: a controlled comparison of home and hospital based care Isaac Marks 4 Evaluation of a complete community service Christine Dean 5 Early intervention study of psychiatric emergencies Peter Tyrer 6 Evaluation of psychiatric services: the merits of regular review Brian Ferguson 7 A home based assessment study Tom Burns 8 Home treatment as an alternative to acute psychiatric inpatient admission: a discussion Frank Holloway 9 The toxicity of community care Til Wykes 10 Community mental health services: towards an understanding of cost-effectiveness Martin Knapp 11 Future research strategies edited by Peter Tyrer Index viii 1 11 29 45 55 65 73 85 97 111 \A1 161 Contributors Dr Tom Burns St George's Hospital Medical School, Jenner Wing, Cranmer Terrace, Tooting, London SW17 ORE, UK Professor Francis Creed Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK Dr Christine Dean Centre for Mental Health Services, King's College, Campden