Community Mental Health Settings as a Context for Evidence-Based Practice

One avenue for improving access to quality mental health care for children, adolescents, and their families is to provide services in the communities where they live. There has been growing support for the implementation of evidence-based practice in community mental health settings to address the complex needs of diverse young clients. Evidence-based practice encompasses psychometrically sound assessments and empirically supported treatments with appreciation of the culture of communities in which they are provided. This chapter reviews the background of the community mental health movement, describes community mental health settings and the current status of youth evidence-based practices in community care contexts, and explores barriers to and prospects for bringing tested practices for youths into community-based care.

Paradigm 8: Community Care Is Destigmatizing

Chapter 9 addresses how there have been many negative consequences for people with a mental illness as a result of the rapid deinstitutionalization of mental hospitals without appropriate community services to provide a safety net. These have included criminalization, increased stigmatization, social exclusion, poor quality of care, and poorer health outcomes. It covers how these problems challenge the notion that the community mental health movement has been a destigmatizing force leading to greater social participation for people with a mental illness. Because they are now more visible, and often less supported by treatment systems, people with a mental illness living in the community may be at greater risk of experiencing social stigma.