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Welfare Reform on the Web (April 2011): Mental health services - overseas

The economic consequences of the deinstitutionalisation of mental health services: lessons from a systematic review of European experience

M. Knapp and others

Health and Social Care in the Community, vol. 19, 2011, p. 113-125

Many countries have closed psychiatric hospitals in favour of various community-based arrangements. These closures have raised many practical and policy issues, not least because huge resources were tied up in the hospitals. Understanding the economic consequences of deinstitutionalisation is therefore fundamentally important. This review of empirical evidence from the UK, Germany and Italy, which have made good progress with the rebalancing of care, shows that there are strong economic arguments for closing psychiatric hospitals, but rebalancing care will not generate great savings. Decision-makers should plan a dynamic community-based mental health care system to match the needs of people moving out of institutions and should take the long view.

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