The general hospital and mental health care: a British perspective.

For over a century, the specialist mental hospital was the basis of psychiatric care in all industrialized countries. Britain was among the first to establish national requirements for asylum care, although these institutions were financed and managed locally. Psychiatric treatment in general hospitals began in the later eighteenth century, but, except for some outpatient clinics, this practice ended prematurely in the mid-nineteenth century, not to resume until after World War II. The National Health Service (NHS) provided the framework within which general hospital psychiatry was re-created, forming the nucleus for district services. Although the intent of NHS reform in the 1980s was to establish a reduced market hospital system that would continue to offer long-term care, this service seems likely to continue for only a few more years. ¿Reforms¿ in the NHS and social services have placed the whole of British mental health care in a situation of uncertainty.