Community Care: An Analysis of Assumptions

1975 ◽  
Vol 127 (3) ◽  
pp. 276-285 ◽  
Author(s):  
David Hawks
Keyword(s):  
Mental Illness ◽  
Social Work ◽  
Mentally Ill ◽  
Community Care ◽  
Care And Treatment

SummaryThe implementation of a policy of ‘community care’ is seen to involve a number of assumptions, some of which are rarely examined. These can be roughly categorized as involving the nature of mental illness, the nature of community, the course and treatment of mental illness, the proper scope of psychiatry, the burden on the community and the efficacy of social work. Data bearing on these assumptions are reviewed, and the conclusion is offered that they are far from being uncontentious.It is suggested that the movement toward community care has many of the attributes of a moral enterprise which, unless substantiated by benefits to the patient or his family, may be the latest diversion of the psychiatric conscience from the care and treatment of the chronic mentally ill.

scholarly journals The Health Service Ombudsman

1994 ◽  
Vol 18 (11) ◽  
pp. 694-695
Author(s):  
R.A. Oswald
Keyword(s):  
Mental Illness ◽  
Health Service ◽  
Mentally Ill ◽  
Professional Standards ◽  
Local Management ◽  
Independent Investigation ◽  
Care And Treatment

“We have no credibility”. That was the response of a woman with a mental illness who put a complaint to the Health Service Ombudsman. Unlike many – not just patients but also a significant number of NHS staff – she had heard that the Ombudsman could carry out a completely independent investigation of complaints although she was not clear about the extent of his jurisdiction. Some people feel intimidated when trying to take on what they see as a powerful and defensive NHS and others experience a sense of despair that because of their illness their concerns have no validity. Those providing care and treatment generally do the best they can to attain high professional standards but delivery does not always match expectations and the outcome can be a complaint. Services for the mentally ill are not immune from shortcomings and, if local management fails to satisfy the complainant, the Ombudsman can step in.

scholarly journals After the madhouses: the emotional politics of psychiatry and community care in the UK tabloid press 1980–1995

2021 ◽  
pp. medhum-2020-012117
Author(s):  
Leah Sidi
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Community Care ◽  
Term Care ◽  
Hospital Patients ◽  
Emotional Politics ◽  
The Uk ◽  
Gendered Stereotypes ◽  
Tabloid Press

The deinstitutionalisation of mental hospital patients made its way into UK statutory law in 1990 in the form of the NHS and the Community Care Act. The Act ushered in the final stage of asylum closures moving the responsibility for the long-term care of mentally ill individuals out of the NHS and into the hands of local authorities. This article examines the reaction to the passing of the Act in two major tabloid presses, The Sun and The Daily Mirror, in order to reveal how community care changed the emotional terrain of tabloid storytelling on mental health. Reviewing an archive of 15 years of tabloid reporting on mental illness, I argue that the generation of ‘objects of feeling’ in the tabloid media is dependent on the availability of recognisable and stable symbols. Tabloid reporting of mental illness before 1990 reveals the dominance of the image of the asylum in popular understandings of mental illness. Here the asylum is used to generate objects of hatred and disgust for the reader, even as it performs a straightforward othering and distancing function. In these articles, the image of the asylum and its implicit separation of different types of madness into categories also do normative gender work as mental illness is represented along predictable gendered stereotypes. By performing the abolition of asylums, the 1990 Act appears to have triggered a dislodging of these narrative norms in the tabloid press. After 1990, ‘asylum stories’ are replaced with ‘community care stories’ which contain more contradictory and confusing clusters of feeling. These stories rest less heavily on gendered binaries while also demonstrating a near-frantic desire on the part of the mass media for a return of institutional containment. Here, clusters of feeling becoming briefly ‘unstuck’ from their previous organisations, creating a moment of affective flux.

Mental Health Social Work Reimagined

2019 ◽  
Author(s):  
Ian Cummins
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Work ◽  
Social Policy ◽  
Mental Distress ◽  
Community Care ◽  
Current Crisis ◽  
Social Work Values ◽  
Historical Perspectives ◽  
Insight Into

This book argues that mental health social work needs to be located within the wider political and social policy landscape. Wider societal attitudes to mental illness are examined followed by a discussion of the development of community care. The author argues that these historical perspectives provide an insight into the roots of the current crisis in mental health services. The book goes on to analyse a range of contemporary issues and challenges in mental health social work. It argues that social inequality and policies of austerity have increased levels of mental distress. It calls for a rediscovery of core social work values and a rejection of bureaucratic managerialism.

Minor Mayhem in Milwaukee

1982 ◽  
Vol 10 (3) ◽  
pp. 363-371
Author(s):  
Mona Wasow
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Problem Solving ◽  
Civil Rights ◽  
Mentally Ill ◽  
Due Process ◽  
Care And Treatment ◽  
The Way

On June 10, 1982, a forum was presented in Milwaukee that dealt with the mental health commitment laws. There are terrible confusions among professionals today about what mental illness is, what competency means, what constitutes “dangerousness,” and how to apply civil rights in a truly meaningful way to those in desperate need of help. We are in need of some modifications of our mental health commitment laws, which are presently confounded with ideologies and ignorances about mental illness and “due process,” and often stand in the way of providing help for acutely mentally ill people. That these issues are complex is obvious, but if more energy were put into problem solving, and less into winning highly value-laden debates, we might come up with some solutions toward getting better care and treatment for the mentally ill.

Psychiatric Rehabilitation

1982 ◽  
Vol 45 (12) ◽  
pp. 372-376
Author(s):  
Elizabeth Burrows
Keyword(s):  
At Risk ◽  
Mental Illness ◽  
Mentally Ill ◽  
Community Care ◽  
Psychiatric Rehabilitation ◽  
Current Approach ◽  
Process Of Care ◽  
Historical Developments ◽  
Dictionary Definitions

Rehabilitation has come to mean more than what is contained in standard dictionary definitions, as the author explains at the outset. Historical developments are described because in future years the current approach to mental illness might be regarded as a watershed between custodial and community care. Consideration is also given to some aspects of present day practices with ‘Long-stay’ and ‘New long-stay’ patients. Finally rehabilitation may be regarded as no longer an adjunct but an integral part of the process of care of the mentally ill. All rehabilitation is at risk if adequate resources are not available.

scholarly journals Outlook Regarding Mental Illness In Patients And Caregivers In Eastern Nepal

2021 ◽  
Vol 10 (1) ◽  
pp. 62-71
Author(s):  
S. Adhikari ◽  
A. Jha
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Help Seeking ◽  
Positive Attitude ◽  
Tertiary Care ◽  
Good Knowledge ◽  
Care Hospital ◽  
Significant Difference ◽  
Care And Treatment

Introduction: Mental health is an integral component of overall health. Various factors along with stigma affect knowledge, perspectives and behavior of the people ultimately affecting help seeking and treatment. The patient and their caregivers are directly involved in overall management and outcome. Hence ascertaining those aspects among them is important and so are aims of this study. Material And Method: A cross sectional comparative study was carried out among 160 participants (80 patients and 80 caregivers) visiting neuropsychiatry outpatient department of a tertiary care hospital. Data was collected through semi-structured proforma and Attitude towards mental illness questionnaire (modified). Data were analysed by using SPSS version 25 and Microsoft excel. Results: The socio-demographic profiles between both groups were similar. About 75% from both the groups had good knowledge about mental illness. Almost 60% from both groups had positive perception/attitude regarding mentally ill and mental illness with an only significant difference in relation to rights to mentally ill. More than 70% from both groups had positive attitude regarding help-seeking with only significant difference in view about people with mental illness seeking help from psychiatrist. About 50% from both groups had positive attitude regarding care and treatment. Conclusion: With good knowledge and positive attitude/perception regarding mental illness, self-stigma persisted regarding some domains. Despite positive attitudes for help-seeking, ambivalent views regarding care and treatment into both groups necessitate easy accessibility and upgrading of mental health services.

Beyond the walls: the mentally ill in Ireland outside the institutions in 1901

2015 ◽  
Vol 32 (3) ◽  
pp. 275-282 ◽  
Author(s):  
B. D. Kelly ◽  
N. Sherrard
Keyword(s):  
Gender Differences ◽  
Mental Illness ◽  
Mentally Ill ◽  
Community Care ◽  
Psychiatric Hospitals ◽  
Roman Catholic ◽  
Point Prevalence ◽  
Systematic Analysis ◽  
Never Married ◽  
And Gender

ObjectivesIreland’s rates of psychiatric institutionalisation increased rapidly throughout the 1800s and early 1900s. This paper provides a systematic analysis of individuals with mental illness who were not resident in psychiatric hospitals, workhouses or other institutions in 1901.MethodsWe examined the online census records of all individuals described as ‘lunatics’ on the island of Ireland, not resident in psychiatric hospitals, workhouses or other institutions on census night, 1901.ResultsThere were 482 individuals described as ‘lunatics’ and not resident in psychiatric hospitals, workhouses or other institutions on 31 March 1901, yielding a point prevalence of 10.6 per 100 000 population. The lowest prevalence (7.8) was in Leinster (possibly owing to provision of workhouses and asylums); the highest prevalence was in Connaught (17.5) (p=0.013). A majority of them (60.4%) were women. Mean age was 45.7 years. In addition, a majority were single (never married) (63.7%); 33.3% of women were married, compared with 14.1% of men (p<0.001). The most common relationship to the head of the household was child (32.8%), although some were boarders or lodgers. The majority were Roman Catholic (82.0%) and could ‘read and write’ (64.5%). Among those for whom ability to speak Irish was recorded, 74.4% spoke both Irish and English.ConclusionThere were significant geographical and gender differences within the population recorded in the 1901 census as mentally ill and outside institutions. This group merits further study, especially with regard to their distribution in relation to asylum locations, and the extent to which they were cared for in communities, possibly prefiguring later models of community care.

Projection and Introjection

2014 ◽  
Author(s):  
R.D. Hinshelwood
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Mentally Ill ◽  
Mental Hospital ◽  
Community Care ◽  
Moral Agent ◽  
Ethical Principles ◽  
Organizational Dynamics ◽  
Dynamic Approach ◽  
Personal Functioning

Psychiatry straddles a medical approach to the mentally ill, and a dynamic approach to the experiences of severely disturbed people. One consequence of this is that ethical principles apply in different ways. The understanding of processes known as introjection, projection, and splitting seriously disrupt the functioning of a person and his ability to make adequate, responsible decisions. Severe mental illness can be regarded as the disruption of a moral agent, and in a sense treatment has to focus on the resumption of those functions that enable the person to take responsibility again. This chapter explores the ethics of the person’s loss of his personal functioning. Paternalism does not have a free rein, and needs to be carefully used as it supplants autonomy. Over-extended paternalistic care leads to excessive depletion of the patient, and was apparent in the old mental hospital as it still is in contemporary community care as specific organizational dynamics.

As good as it gets: an empirical study on mentally-ill patients and their stay at a general hospital in Sweden, 1896–1905

2019 ◽  
Vol 30 (2) ◽  
pp. 205-226 ◽  
Author(s):  
Malin Appelquist ◽  
Louise Brådvik ◽  
Ingemar Ottosson ◽  
Marie Åsberg
Keyword(s):  
Mental Illness ◽  
Empirical Study ◽  
Social Status ◽  
General Hospital ◽  
Mentally Ill ◽  
Hospital Care ◽  
Mental Hospital ◽  
Additional Information ◽  
Care And Treatment

General hospital care and treatment of mentally ill patients in a Swedish town was studied in records for 503 patients, 1896–1905. Restraint was extremely rare; 65% left the hospital as healthy or improved. Non-psychotic and alcoholic patients spent fewer days in hospital than patients with psychosis or dementia. There was no evidence of a social status bias. For 36% of the patients a certificate for mental hospital care was issued, with additional information. The cause of illness was stated as unknown for 42% of these patients; adverse circumstances were recorded for 18%. Heredity for mental illness was found in 50% of the patients, particularly in those with mania. Patients with a higher social status were underrepresented.

scholarly journals Community care in crisis – homelessness and mental illness

1991 ◽  
Vol 15 (5) ◽  
pp. 285-285
Author(s):  
Julian H. Race
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Community Care ◽  
Homeless People ◽  
Professional Care ◽  
The Church

One week before Christmas in the crypt at the Church of St Martin-in-the-Fields, Dr Malcolm Weller addressed a conference for CONCERN (Care of the Neglected: Combining Education, Rehabilitation and Nursing). The purpose of the conference was to highlight the plight of mentally ill, homeless people and to emphasise the strengths and shortcomings of the professional care available for them.

Sign in / Sign up

Export Citation Format

Share Document