The Role of Hospital Inpatient Mental Health Care in Modern Health Care Systems

Smith discusses the study by I.M. Perera which challenges the notion that countries with resources for and commitments to enhancing mental health services should expect to decrease inpatient services as they expand community-based services for these conditions. Her research suggests the opposite: community care and inpatient services are complementary and expand together in mature systems--it's not a zero-sum game. Perera notes that "achieving a top policy priority--a robust community care system--requires the destigmatization of the mental hospital." Perera is correct to note that more research is needed to determine whether and why hospital and community-based care are positively correlated. One assumption is that the association between hospital and community-based care is unidirectional and that larger hospital services promote more community care.