History of Mental Health Day Centres

Mental health day services in England can be traced back to the post Second World War era. Social psychiatry emerged, emphasising the importance of community life and integration as preventive measures for mental health.

Psychiatrists, looking to explain mental illness, shifted their focus from biological causes to environmental factors. This led to the emerging idea that treatment did not necessarily require long-term separation of patients from their environment, often within institutions. 

In the 1960s day hospitals arose, seeking to foster recovery through rehabilitation within the community. These hospitals implemented strategies like social support, early treatment, occupational therapy, and recreational activities to promote social functioning and reduce the stigma around mental health. The approach successfully decreased the reliance on in-patient treatment. Day services have continued to help those facing mental health challenges, who rely on them to remain independent in the community. Yet, this form of provision has often been likened to institutions for offering passive forms of care that create dependency. 

The marketisation of social care in the 1990s introduced competition and profit into public service, and the policy of personalisation of care, introduced in 2000, emphasised patient choice and provided individuals with a personal budget to spend on treatment, rather than funding centralised services. The focus on individual choice and autonomy led to an over-emphasis on individual outcomes of treatment, at the expense of social and collective outcomes. These changes, alongside public funding cuts, meant reduced services and closures of day centres. As a result, the quality of life of people with serious mental health problems and their caregivers - who rely on these centres for companionship, social support and respite - has suffered.

The lack of investment in therapeutic mental health services, coupled with the long-term impact of diminishing services, has given rise to a new wave of activism in which service user groups and their allies now fight to keep these services open and demand access to them.