ABSTRACT
Psychiatric hospitals provided medical treatment in combination with asylum for decennia. The mental healthcare system changed internationally, and community–based alternatives for the psychiatric hospital were developed. Wards were modernised and new ambulant services established. Individuals were 'trained' to live in the community, family support systems were created, as well as houses for supported living. Introduced in the 1970s, case management coordinated a person's healthcare to provide stability and continuity, while Training in Community Living extended this concept to include treating people in their own environment. Many variants on these programmes appeared. One study distinguished six types of programme models: broker service, clinical case management, assertive community treatment, intensive case management, strengths, and rehabilitation. Intensive community–based care is, in principle, based on voluntary commitment. However, due to the persuasive character, it can vary from voluntary to compulsive care.
