ABSTRACT
Social work, perhaps more than most professions, is shaped by the context in which it is practised. Consequently, it will be helpful to review briefly the broad historical development of the pattern of mental health services. Put at its simplest, this has been a story of transition from treatment and care based in large institutions to care in the community, although that simple statement belies substantial areas of controversy, including disagreement about the main engines of reform (whether they are political and professional self-interest), what is meant by the concept of the community, and to what extent has de-institutionalisation been achieved.
