Models of community care

Abstract

This article traces the changing focus of care from institution to community and outlines the range of service models and their key ingredients, essential to successful community care. Specialist community teams - including assertive outreach and home-based treatment - show considerable advantage, but lack of fidelity to the service prototypes is a particular problem. The content of care must include evidence-based psychosocial interventions, but users' needs and priorities must be the guiding principle and with this in mind, work and employment should be afforded the highest priority with the ‘place and train’ model preferred to the traditional ‘train and place’ approach. The paper concludes with some considerations about the training and mix of staff needed to undertake these challenging roles.