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An international comparison of two systems of community mental health care

  • Digby Tantam (a1) and Barbara J. Burns (a1)


A neighbourhood health centre in the US is compared with the mental health services in an area of the UK.

Patients with severe, but long-standing psychiatric illnesses, or patients with transient emotional problems are likely to be treated by a general practitioner in London and by non-medical mental health specialists in Boston. These patients receive more overall care, more specialist, non-medical care but make as many visits to a medical provider, other than a psychiatrist, in Boston as they do in London. Psychiatrists see more acutely ill patients for a shorter time than non-medical specialists in both places, and in both Boston and London there is a highly selective referral process which results in psychiatrists from both areas seeing approximately the same proportion of the population of their catchment areas.

The integration of these findings with community attitudes in planning services is discussed.


Corresponding author

1Address for correspondence: Dr Digby Tantam, The Maudsley Hospital, Denmark Hill, London SE5 8AZ.


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American Psychiatric Association, DSM-II (1968). Diagnostic and Statistical Manual of Mental Disorders (2nd edition). American Psychiatric Association: Washington D.C.
Beigel, A. (1977). Evaluation on a shoe-string. In Resource Materials for Community Mental Health Programs (ed. Hargreaves, W. A., Attkisson, C. C. and Sorenson, J. E.), pp. 1631. DHEW Publication no. ADM 77–328. NIMH: Rockville, MD.
Brook, P. & Cooper, B. (1975). Community mental health care: primary team and specialist services. Journal of the Royal College of General Practitioners 25, 93110.
Burns, B. J., Orso, D., Jacobson, A., Leet, R. & Goldner, N. (1977). Utilization of health and mental health services in organized medical care settings. Final report submitted in fulfilment of NIMH Contract no. 278–0027 (DB), 01 1977.
Cooper, J. E., Kendell, R. E., Gurland, B. J., Sharpe, L., Copeland, J. R. M. & Simon, R. (1972). Psychiatric Diagnosis in New York and London: A Comparative Study of Mental Hospital Admissions. Maudsley Monograph no. 20. Oxford University Press: London.
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., Gourlay, A. J., Cowan, D. W. & Barron J. de (UK Team); Gurland, B. J., Sharpe, L., Simon, R., Kuriansky, J. & Stiller, P. (US Team) (1975). Cross-national study of the diagnosis of mental disorders: a comparison of the diagnoses of elderly psychiatric patients admitted to mental hospitals serving Queens County, New York and the London Borough of Camberwell. British Journal of Psychiatry 126, 1120.
Edwards, G., Hawker, A., Hensman, C., Peto, J. & Williamson, V. (1973). Alcoholics known or unknown to agencies: epidemiological studies in a London suburb. British Journal of Psychiatry 123, 169183.
Giel, R. & Harding, T. W. (1976). Psychiatric priorities in developing countries. British Journal of Psychiatry 128, 513522.
Hare, E. H. (ed.) (1971). Triennial Statistical Report, Years 1967–1969. Bethlem Royal Hospital and Maudsley Hospital: London.
Johnson, D. A. W. (1973). An analysis of out-patient services. British Journal of Psychiatry 122, 301306.
Kaeser, A. C. & Cooper, B. (1971). The psychiatric patient, the general practitioner and the out-patient clinic: an operational study and a review. Psychological Medicine 1, 312325.
Office of Population Censuses and Surveys (1968). A Glossary of Mental Disorder. Studies on Medical and Population Subjects no. 22. HMSO: London.
Querido, A. (1962). Mental health programmes in public health planning. Mental Hygiene 46, 626654.
Regier, D. A., Goldberg, I. D. & Taube, C. A. (1978). The de facto US mental health services system. Archives of General Psychiatry 35, 685693.
Ryan, W. (ed.) (1969). Distress in the City: Essays on the Design and Administration of Urban Mental Health Services. The Press of Case Western Reserve University: Cleveland.
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. (1966). Psychiatric Illness in General Practice. Oxford University Press: London.
Wing, J. K. & Hailey, A. M. (eds.) (1972). Evaluating a Community Psychiatric Service: The Camberwell Register 1964–1971. Oxford University Press for the Nuffield Provincial Hospitals Trust: London.
Wing, J. K. & Wing, L. (1970). Psychotherapy and the NHS: an operational study. British Journal of Psychiatry 116, 5155.
World Health Organization (1968). The International Classfication of Diseases (8th edition). WHO: Geneva.
World Health Organization (1973). Psychiatry and Primary Medical Care. Regional Office for Europe. WHO: Copenhagen.
World Health Organization (1974). The Methodology of Psychiatric Out-patient Data Collection: Report on a Pilot Study. Regional Office for Europe, WHO: Copenhagen.


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