Can deinstitutionalised care be provided for those at risk of violent offending?

OBJECTIVE The aim of this article is to explain the current status of deinstitutionalisation and of community care development in the UK. DESIGN Literature review of articles and reports on deinstitutionalisation. SETTING Articles included in the review related either to the whole of the UK, to England and Wales, or to a specific area such as London. MAIN OUTCOME MEASURES The review was carried out pertaining to the question of the extent to which community care can or should take over the functions of the asylum, with particular reference to those at risk of behaving violently. These functions include those that are manifest, or explicit, and those that are latent, or unintended but implicit (Bachrach, 1976). RESULTS The example of patients at risk of violent behaviour is-one that highlights the continuing relevance of both these sets of functions, which are argued to be exerting a powerful influence on the processes of asylum closure and community care development. This influence is seen in delayed asylum closure, transinstitutionalisation (the shift of some patients from asylums to other institutions), and the institutionalisation of aspects of community care. CONCLUSIONS Both the manifest and the latent functions of asylums must be acknowledged by those involved in planning community care; where it is felt desirable that community care does not take over certain functions, the consequences of this must be anticipated so that they can be prevented or dealt with in other ways.