Forms of interaction in modern communities - a lifecourse approach to mental health policy and practice

Understandings of mental health problems and opinions on optimal treatments vary widely across societies. There has been a growing consensus, since the 1950s, that care for people with mental health problems should be delivered in the community, with most countries now delivering services in this way (Scull, 2015). This commitment looks likely to continue, despite protestations from some clinicians that asylums remain necessary in some circumstances (Sisti et al, 2015). The Lancet Commission on global mental health called for countries to scale up mental health provision and in doing so to redistribute mental health budgets “from large hospitals to district hospital and community-based local services” (Patel et al, 2018, p. 1554). Similarly, the World Health Organisation has committed to doubling community mental health facilities by 2030 (WHO, 2022).
Although community mental health care has been viewed as a positive development, there remains ambiguity around how it should be defined and conceptualised (Rogers and Pilgrim, 2021). Cross-national comparisons show stark differences between policies (Shen and Snowden, 2014) and there are wide variations in the availability of support and treatment (Wang et al, 2007). The organisation of community mental health care also varies, with differences existing in the extent to which it is provided within primary care services, outpatient clinics, community mental health centres, residential care services or by community mental health teams (Cockerham, 2020; Rogers and Pilgrim, 2021). The ethics of imposing western mental health models on developing countries has also been questioned by critics (Mills and White, 2017).

From a sociological perspective, community-based mental health care is significant in several ways. First, mental health is intertwined with socio-economic and sociocultural factors, highlighting the importance of addressing social contexts within policy and treatment. Second, community-based approaches promote social integration by leveraging social resources such as families, social networks, and community organisations. This highlights the need to examine how such resources are organised and their impacts on community care. Third, there is a need to examine how people with mental health problems view community mental health care and whether it meets their needs.
Whilst several books have focussed on community mental health care, most do so to inform clinical practice. Our aim is to provide an edited collection providing scholarship on the sociology of community mental health, highlighting international perspectives.