Rural lessons for urban services

Abstract

In developed urbanised countries all over the world psychiatric beds, out-patient clinics and many so called ''community'' service bases are still located in centralised hospitals. This arrangement persists despite an increasing emphasis internationally on providing psychiatric care in the community. In much of the world, however, a centralised system is inaccessible for many patients and planners of rural services are obliged to depart radically from the traditional model. In this paper we examine special problems of mental health services in rural areas, the strengths of some of the solutions and deduce the core features of successful models. Finally, we consider how they might usefully be applied to relatively deprived areas in the inner cities of developed countries.