title: Mental health service provision in England.
abstract: OBJECTIVE
  To describe mental health service provision for adults of working age in England.
  
  
  METHODS
  Services in an inner London area are described so as to illustrate current patterns of service organization in England. National trends are then discussed.
  
  
  RESULTS
  Despite relatively low public expenditure, substantial progress has been made in deinstitutionalization and development of comprehensive community-based services. Persisting difficulties include high staff turnover, a minority of patients. who do not engage with community services, user and carer dissatisfaction with emergency services, and social exclusion because of stigma. Recent government policy advocates resolving some of these problems using new service models such as assertive outreach and crisis teams.
  
  
  CONCLUSIONS
  Closure of the large asylums has largely been accomplished. England is now entering a new phase in community service development, with a range of innovative developments aimed at resolving problems still encountered after the initial phases of integrated community service development.
authors.affiliation: Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London, UK. s.johnson@ucl.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Johnson
authors.forename: M
authors.initials: M
authors.lastname: Zinkler
authors.forename: S
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D000368:Aged; D004739:England; D006801:Humans; D008131:London; D008605:Mental Health Services / Q000458:organization & administration* / Q000639:trends; D008875:Middle Aged; D012111:Residence Characteristics