[What must the community contribute to the managements of chronic psychiatric patients?--Reflections from England].

Chronically disabled psychiatric patients who are living outside hospital still need help. The degree of disability they show and the support which they receive from family or friends differs greatly. How they manage will depend on their ability to adapt and one can recognize the difference between those who adapt well in spite of disability and those for whom this is very difficult. In consequence their need for support from others varies. In England some national voluntary agencies traditionally offer support. However, today the combined work of voluntary organisations, hospitals and statutory community authorities in local areas is often impressive and two examples are described. Even so families are perhaps still the most important form of support although some are unable or unwilling to help. Other alternative forms of help noted are two-patient marriages, long-term hospital support of discharged patients and regular employment. Examples of innovations in Australia and the U.S.A. are also described.