Clarifying the philosophy behind the community mental health act and community-based interventions

The passing of the Community Mental Health Act was supposed to signal a change in the treatment of mental disorders. The idea was to embed interventions as much as possible in a community, so that treatment is accessible and appropriately designed. However, many programs that strive to be community-based never achieve this status. The problem is that becoming community-based is often treated as merely a methodological or tactical change, rather than a new philosophy. Clinics were built and services offered without a coherent theory to explain why better assessments and treatments should accompany a community-based strategy. The purpose of this article, therefore, is to clarify the basis for such an approach so that mental health services are not simply placed in communities, but rather are defined and controlled by the persons who reside in these neighborhoods.