Community Based Alternatives to Institutional Care

How do I cope?

The concept of ‘Community Based Care’ appears to have been lost in the great debate about Callan Park. It would appear that NSW is well and truly behind the times and local government is not listening to the people at the heart of the matter…those with mental illness and their families.

I had a chance to talk to someone recently who has spent time in several mental facilities. He was well dressed, well spoken and didn’t want to give me his name, why?  Because he was afraid, he said, that he had tried to tell his story and that of other mental illness sufferers at a rally at Callan Park, but was shouted down by a howling mob.

In my conversation with him, he said, “Oh God, I forgot! Only a very small number of people really know what’s best for all of us suffering mental illness, we won’t mention any names, but to those of us  with mental illness that have been, or have thankfully avoided being institutionalised, they’re known as BWB (Banner Waving Bastards).”

“The BWB think we want gardens to walk in to help our recovery, but what we really want is more home care services, delivered by people who understand our day to day needs, so that we have the  help we need  to let us stay in our own homes with our families and  our loved ones.”

“Once you’ve been institutionalised, even for a short time, you lose the respect of family and friends and people in the community avoid you.  Your record goes everywhere with you, each time someone finds out, it’s like being victimised again and again!”

In Victoria all stand-alone psychiatric hospitals have been closed and replaced with 24 hour mobile mental health crisis teams and case management teams that make home visits, thereby allowing mental patients to manage their illness and retain their dignity in the community. They have also set up fully supervised residential cluster houses and an impressive range of less supervised accommodation, creating supportive ‘households’ in the community.

And no, the Victorian State Government didn’t forget the acute and long-term mental health facilities, but they did make sure to build them on general hospital sites in order to guarantee that the best physical, mental and diagnostic care is provided to every mental health patient.

By moving the location of these facilities to general hospital sites, the Victorian government has given mental health patients massive benefits, from reducing the stigma of mental illness, to better access to general health care (sometimes a catalyst for the onset of mental illness).

So the question is this…for the long term health of our community should we be advocating for:
A)    Community Based Alternatives: to support those with mental illness now and to provide preventative measures for the future; or
B)    Institutional Care: by building more mental institutions – more beds – handing out more medication – more places to lock the mentally ill away from their community?