Objective - The aim of this article is to explain the current status of deinstitutionalisation and of community care development in the UK. Design — Literature review of articles and reports on deinstitutionalisation. Setting — Articles included in the review related either to the whole of the UK, to England and Wales, or to a specific area such as London. Main outcome measures — The review was carried out pertaining to the question of the extent to which community care can or should take over the functions of the asylum, with particular reference to those at risk of behaving violently. These functions include those that are manifest, or explicit, and those that are latent, or unintended but implicit (Bachrach, 1976). Results — The example of patients at risk of violent behaviour is one that highlights the continuing relevance of both these sets of functions, which are argued to be exerting a powerful influence on the processes of asylum closure and community care development. This influence is seen in delayed asylum closure, transinstitutionalisation (the shift of some patients from asylums to other institutions), and the institutionalisation of aspects of community care. Conclusions — Both the manifest and the latent functions of asylums must be acknowledged by those involved in planning community care; where it is felt desirable that community care does not take over certain functions, the consequences of this must be anticipated so that they can be prevented or dealt with in other ways.

Aims – To evaluate the quality of acute psychiatric care concerning the management of violent behaviour and rapid tran-quilization. Methods – Data concerning 13 indicators, drawn from NICE recommendations, were collected in 19 Departments of Mental Health, in the frame of the SIEP-DIRECT's Project, to evaluate the implementation of NICE recommendations in Italian Mental Health Services. Results – In about two thirds of Departments of Mental Health (DMHs) professionals were trained in the management of violent behaviour, while written procedures existed only in one fourth of DMHs. About a half of the professionals working in Psychiatric Wards in General Hospital were trained in rapid tranquilization, while procedures on this topic are practically absent and specific care for monitoring intensively the heavily sedated patient was not frequent. Conclusions – Management of violent behaviour and rapid tranquilization are two critical areas in the care performed by Psychiatric Wards in General Hospital. Training on these topics is more frequent than implementation of procedures. NICE recommendations and SIEP indicators are useful tools for improving the quality of acute psychiatric care.

Declaration of Interest: None.