Reconceptualizing assumptions about community mental health.

Beliefs that patients fall between the cracks in the transition from hospital to community services, that the aftercare population is shut out of community mental health agencies, and that services are duplicated to a high degree continue to be widely accepted. Using data from a study of a publicly funded mental health aftercare system in a major urban county, the authors reconceptualize these and similar assumptions about mental health aftercare. It appears that the primary focus of concern should be on the nature and quantity of the services being delivered rather than on increasing the proportion of patients connecting with them. Current services appear to be largely oriented toward helping the patient maintain a borderline existence in the community. Instead, much more emphasis is needed on meaningfully rehabilitating patients and reducing their chronic need for professional support.