ABSTRACT
Psychiatric hospital closures and the plight of homeless people on the streets of Britain’s cities have been newsworthy items for more than a decade. To many people, the two are inextricably linked. Care in the community sometimes looks tarnished even before it starts. As an article in The Economist noted So debased has the phrase ‘in the community’ become that the flippant young use it as a euphemism for ‘behaving oddly’. Central and local community care policies and the closure of long-stay hospital beds affect all client groups, yet most attention focuses on the psychiatric population. A scientific group convened in 1989 by the World Health Organisation to select criteria for evaluating ‘the effectiveness of treatment of schizophrenic disorders’ produced a list which is typical of outcome dimensionalities employed in evaluations. Hospital and community-based rehabilitation training programmes set great store by the skills needed for the basic activities of daily living.
