Public attitudes towards mental health facilities in the community

Taking account of community attitudes towards mental health problems may be crucial to the success of community care. Exceeding the limits of the community's tolerance could lead to the policy 'backfiring'-jeopardizing the future of community care and increasing rather than decreasing the stigma attached to mental health problems (Hall et al. 1991, p. 302). There is evidence that local opposition to community facilities has escalated over the past 3 years and frequently threatens the siting of community mental health facilities. This paper reviews research into attitudes towards community facilities for people with mental health problems, and explores the nature of public protest in order to make recommendations for the consensual siting of mental health facilities in the community. Although a substantial body of research exists concerning attitudes towards people with mental health problems, far less work has focused on attitudes towards facilities for people with mental health problems. An understanding of this literature is sought in the nature of community opposition more generally: the siting of locally unwanted land uses (for example power stations and waste disposal sites) and the phenomenon of the 'not in my back yard' (NIMBY) attitude are discussed critically and rival theoretical explanations are explored. Taken as a whole, this literature gives rise to strategies that might reduce opposition and achieve positive working relationships. Nevertheless, in view of the scarce, inconclusive and somewhat contradictory research in this area, there is a need for specific investigation into the concerns of local communities, and an assessment of factors that exacerbate and ameliorate these concerns.