SciELO - Scientific Electronic Library Online

vol.91Emergency Medical Technician profile in SpainPELFI Project: Recruitment and Sociodemographic Characteristics of Immigrant and Autochthonous Families from Alicante and Barcelona City Subcohorts author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727


MADOZ-GURPIDE, Agustín; BALLESTEROS MARTIN, Juan Carlos; LEIRA SANMARTIN, Mónica  and  GARCIA YAGUE, Ernesto. The Need of a New Integral Approach to Patient Care with Severe Mental Disorder Thirty Years after the Psychiatric Reform. Rev. Esp. Salud Publica [online]. 2017, vol.91, 201701007.  Epub Jan 18, 2017. ISSN 2173-9110.

More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance. We think this is a right time to check the state of the community-based care programmes for severe mental disorders, and the role of mental health center. We propose to have a reflexion about two relevant topics: where we are and where we are heading.

Keywords : Mental Health; Community Mental Health Services; Clinical Governance; Health Care Reform; Community Psychiatry; Physician-Patient Relations; Continuity of Patient Care; Mental disorders; Social Stigma.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )