The aim of this chapter is to complete the Part I of this book by providing the historical context for the development of community mental health services.Amore detailed description of the model follows in Parts II and III of the book. Following this, in Part IV we shall turn to the practical application of the model in the process of re-forming mental health services.

We present here only a highly selective account of the historical background for the following reasons. First, we are not historians and an extended historical appraisal is beyond our competence. Second, several excellent relevant historical analyses have now been published,to which we refer readers who seek more a detailed understanding (Jones, 1972; Scull, 1979; Levine, 1981; Gilman, 1996; Grob, 1991). Finally, we want to avoid the risk of being excessively absorbed by a contemplative appreciation of the past, at the expense of addressing the future.

The matrix model and the development of mental health care.

The matrix model can be used as one framework to help understand the historical development of mental health services over the last 150 years. Several different approaches have been used in analysing these trends.The main forms of historical analysis are: socio-economic, political and clinical/ technical. These approaches can all be placed (within the over-arching structure provided by the matrix model) in relation to three historical periods.

Period 1 describes the rise of the asylum between about 1880 and 1950; Period 2 is the decline of the asylum, from around 1950 to 1980; and Period 3 refers to the re-forming of mental health services, since approximately 1980.