THE WARD-IN-A-HOUSE - RESIDENTIAL CARE FOR THE SEVERELY DISABLED

This paper is concerned with the care of the most difficult and severe ly disabled new patients presenting to mental health services in the U .K. Questions of definition will be examined and the clinical and soci al characteristics of the population discussed. Since the defining cha racteristics (and prevalence) of this group are strongly affected by t he overall service context, the range of community provisions within o ne health district (Cambridge) will be described. Examples of a new ki nd of institutional solution-the 'ward-in-a-house'-will then be presen ted, together with the underlying principles of management and care. T he benefits and limitations of the model will be discussed.