Reducing violence in severe mental illness

Community care does not do well

Papers p 1093

Two years ago, Munk-Jørgensen initiated a continuing debate about the development of psychiatric care for severely mentally ill people in a paper entitled “Has deinstitutionalization gone too far?”1 He pointed out that the reduction in numbers of psychiatric hospital beds had been accompanied by a continuing increase in the number of forensic psychiatric patients as well as an increase in suicides and readmissions in Denmark. Similarly, Webster et al reported a doubling of the number of forensic patients within the past decade in Canada.2 In the USA, meanwhile, a considerable proportion of severely mentally ill people do not live within the community but are imprisoned3 or homeless.4 The study by Walsh et al in this issue (p 1093) is the …