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A Discussion Document by a Working Party of the Social and Community Psychiatry Section^*

Summary and recommendations: We have considered the development and present roles of community psychiatric nursing services and have come to the following conclusions:—

1. The development of community psychiatric nursing services has been of benefit to patients, has assisted in the development of community psychiatry and may have reduced pressure on hospital resources. These services should be maintained and expanded. This expansion should be monitored to ensure that the expected benefits can be demonstrated.

2. There is a need to consider the development of 24-hour, seven days a week CPN services. Evaluation of such developments is important to show whether the increased commitment is justified.

3. At present the CPN should be a member of the psychiatric team, but in the future if numbers increase it may be possible for CPNs also to be members of primary care teams. The value of CPNs working as members of primary care teams requires evaluation.

4. There is need for further experimentation and no one pattern of CPN service can at this stage be seen as ideal.

5. The training of psychiatric nurses should become increasingly community-orientated. Shorter courses should be made available so that all CPNs have some formal training.

6. Psychiatric nurses working with in-patients and day patients should have the opportunity to follow up patients in the community when continuity of care or other factors make this desirable.

7. The expansion of CPN services should not be so rapid that it depletes hospital in-patient services of staff and so endangers the care of the chronically ill.

8. There should be a degree of specialization in CPN work and evaluation studies should be made comparing ‘specialist’ and ‘generic’ services.