Beyond location : reimagining community care for persons with severe mental illness in Malta

Abstract

This paper critically examines the complexities of implementing community care for individuals with severe mental illness (SMI) in Malta, challenging the assumption that relocating services from institutional settings automatically leads to better outcomes. Drawing on qualitative case vignettes and a review of current deinstitutionalisation efforts, we demonstrate how institutional practices can be replicated in community contexts, potentially undermining genuine social inclusion. Instead, we argue that authentic community care requires a multi-layered approach that facilitates personal agency, fosters meaningful community engagement, and encourages the development of relationships beyond service-based frameworks. To address these challenges, we propose a model centred on “circles of support,” highlighting the importance of diverse social networks and empowerment. The paper calls for a paradigm shift in Malta’s mental health sector, underpinned by person-centred policies, flexible support systems, and a holistic view of wellbeing.