As part of the establishment of the Global Forum for Community Mental Health the convening group members discussed their understanding of community mental health.

Two important themes arose from the discussion on the origin and meaning of community mental health. Firstly, a powerful evocation was given about the way in which long term patients of old and poorly managed psychiatric facilities needed to assert their right to be in the community. Secondly, the group then discussed what is necessary for people with mental health problems to make the transition from an institutional setting to a community setting. The transition implies the closing of hospitals and re-utilising the funds released to support the community initiative. If the facilities are not closed they should be reorganised to support the long term setting of mentally ill people in the community. In fleshing out the discussion a bit further and at the risk of stating the obvious, a move from hospital to the community must be seen as a permanent one. In other words the shift of people from hospitals to the community should not be simply to make room for others who are being transferred into the hospital precinct.

The group then discussed how community mental health derived from a community development perspective. This narrative included issues about the way in which it is possible to build a programme of community mental health in the community itself and about the majority of people who have a variety of mental illnesses and who do not find themselves in hospital.

The discussion then centred around mobilisation of strategies and budgets which permit families to be trained, medical practitioners to be orientated and for appropriate diagnosis and treatment to be carried out at local and home based levels. The discourse for the Global Forum for Community Mental Health goes somewhat further and espouses what Basic Needs describes as the Model for Mental Health and Development. This model draws upon the fields of economic and social development, human rights and, of course, medical care. The modules of the Model for Mental Health and Development are i) Capacity Building, ii) Community Mental Health iii) Sustainable Livelihoods, iv) Research and Policy, v) Management and Administration.

If you have come to the community from a long stay in hospital certain supporting techniques will be required as you make the transition. If you already reside in the community, you will still need support. The best support techniques draw on the informal but powerful structures that derive from the community itself. A commitment to community mental health assures all of us concerned about mental illnesses that the imperatives that have driven us from our birth can still remain important to us, that the people we love can still be loved and that the things we enjoy doing can still get done.