title: [The Need of a New Integral Approach to the Care of Patient with Severe Mental Disorder Thirty Years after the Psychiatric Reform].
abstract: More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance. We think this is a right time to check the state of the community-based care programmes for severe mental disorders, and the role of mental health center. We propose to have a reflexion about two relevant topics: where we are and where we are heading.
authors.affiliation: Centro de Salud Mental San Blas. Hospital Universitario Ramón y Cajal. Madrid. España.|Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Madrid. España.|Universidad de Alcalá de Henares. Alcalá de Henares. Madrid. España.
authors.forename: Agustín
authors.initials: A
authors.lastname: Madoz-Gúrpide
authors.affiliation: Centro de Salud Mental San Blas. Hospital Universitario Ramón y Cajal. Madrid. España.|Universidad de Alcalá de Henares. Alcalá de Henares. Madrid. España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Ballesteros Martín
authors.affiliation: Centro de Salud Mental Arganda del Rey. Hospital Universitario del Sureste. Madrid. España.
authors.forename: Mónica
authors.initials: M
authors.lastname: Leira Sanmartín
authors.affiliation: Centro de Salud Mental San Blas. Hospital Universitario Ramón y Cajal. Madrid. España.|Universidad de Alcalá de Henares. Alcalá de Henares. Madrid. España.
authors.forename: Ernesto
authors.initials: E
authors.lastname: García Yagüe
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D005791:Patient Care / Q000592:standards*; D010358:Patient Participation; D010817:Physician-Patient Relations; D013030:Spain; D013997:Time Factors
keywords: Clinical Governance; Community Mental Health Services; Community Psychiatry; Continuity of Patient Care; Health Care Reform; Mental Health; Mental disorders; Physician-Patient Relations; Social stigma; Spain