Although the practice of psychiatry was similar in the United States and Britain during the last century, since then their paths have diverged, especially since the Second World War and the institution in Britain of the National Health Service. The major postwar development in Britain has been in social psychiatry, with particular reference to hospitalized psychotic patients. More recently, plans have been made to close mental hospitals and shift the locus of inpatient care to the general hospital. Projections have been made to provide services on a sector basis, in which teams of psychiatrists, nurses, and social workers serve population groups of 60,000 each and provide outpatient and transitional facilities as well as inpatient care. The author compares the different approaches in the United States and Britain and notes that, while neither can provide an ideal service, both can learn much from the differences.