At the beginning of the twenty-first century, most people in the UK, including those with serious mental illness, are now cared for in the community — either by primary care alone or more commonly by specialist mental health services. This follows a relatively rapid closure of hospital beds in the old Victorian asylums from the 1960s through to the 1990s, and continued declines in both the number of admissions and the duration of average hospital stays over subsequent years. There are multiple complex political and economic reasons underpinning the development of community care (see Chapter 2 for a detailed discussion) and the move towards our current community-based mental health care system has been slow and incremental.
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