Allen Frances asks "How do we create a compassionate, cost effective mental health system?" and Psychiatric Times collects some answers in a blog post. There seems to be general agreement that the US mental health system needs fixing. Francis explains that, "Sixty years ago, community psychiatry was the big new idea". He thinks, "The dream worked well in many countries, but turned into a bitter nightmare in the US".
I'm not so sure that community care is the problem. Nor that the situation is much worse in the USA. Providing personalised mental health care worldwide is not easy and is not necessarily any better in the community than it was in the asylums.