The community psychiatrist in 2008: anachronism, Cinderella or pioneer?

Abstract

Contemporary psychiatry in the UK is practised in an era where the deinstitutionalisation programme is virtually complete. The vast majority of the large mental hospitals (once called asylums) that dominated mental healthcare have closed to be replaced by a complex network of community services (including a ‘virtual asylum’ of residential and nursing home provision). Psychiatrists of past generations recall the excitement (and concern) associated with the concepts of ‘community psychiatry’ and ‘community care’: some, including me, were appointed to post as a consultant community psychiatrist. In the era of ubiquitous community care is the community psychiatrist an anachronism? Or does the recent call for in-patient psychiatry to be recognised as a specialism (Dratcu, 2006) imply its obvious corollary, the specialist community psychiatrist?