Care in the Community

(Slideshow uses sound)

Care in the community has remained a controversial topic since Margaret Thatcher’s Conservative party implemented changes to mental healthcare in the 1980s.

But what were the reasons behind the change from institutionalised ‘mental asylums’ to the, seemingly more humane, community run care homes?

Many attribute the creation of care in the community to Thatcher’s government, but the idea was not a new one. The notion of care in the community had been around since the 1950s.

But it was only until reports in the 1960s, outlining the appalling conditions of mental health institutions across the country, that the case for community care began to gather pace.

It wasn’t until the 1980s that something was done to change the previous system. The Conservative party was seemingly set on introducing community run care, which led to Griffith’s ‘Green’ paper on community care, and the government’s ‘White’ paper response: Caring for people.

The key idea behind care in the community was to give mentally ill patients the chance at a semblance of normal life. Many would stay in their own homes and perform everyday activities that they would be restricted from doing in a hospital.

However, as Nigel Eastman and Jill Peay point out in their book ‘Law without enforcement’ Thatcher’s government failed to acknowledge the true reality of care in the community, ignoring the fact that only willing patients would have to volunteer themselves for treatment.

He goes on the argue that only those who are autonomous, or rational, have a right to refuse treatment, and that mentally ill patients should have it forced upon them if it is for their own good.

He is not alone in thinking that care should be forced upon the mentally ill, especially when it leads to mentally ill patients committing crimes that they have no control over.

Judith Laing tells us in her book ‘Care or Custody’, there is overwhelming evidence that failings in the care in the community programme have led to the increasing numbers of mentally ill patients that have been coming into contact with the criminal justice system in the last 20 years.

Another example of this was seen recently when a social worker was stabbed to death, by a mentally ill man, while visiting a home in Preston.

There has always been a heated debate over whether we should allow the severely mentally disabled to be left unattended, when they are capable of horrific acts without fully understanding their actions.

How would you feel if a member of your family was killed by a mentally ill patient? But alternatively, how would you feel if a family member was institutionalised in a mental asylum? There is no easy answer to the question of ‘what should be done for the mentally ill’; many believe there are simply no realistic alternatives to the community care program.

Care in the community is still seen as a good idea, but some believe it has failed due to lack of funding. There are close to 70 care home in Eastbourne alone (population 100,000). Can the budget really sustain payment on this amount of property in such an uncertain economic climate?

All that is certain, is that whichever party is in charge come the next general election, they will almost certainly be keeping the community care program for the foreseeable future. See this article for an interview with Liberal Democrat MP Stephen Lloyd on Community Care.

Care Homes in Eastbourne

Patients in private care homes are in danger of human rights abuses but there are no real alternatives, Liberal Democrat MP Stephen Lloyd has said.

Nine out of ten care homes in England and Wales are in the private sector , but as the law stands the Human Rights Act does not extend to these homes.

Residents who experience human rights abuses cannot use the Human Rights Act to challenge the care home provider, and can also face eviction.

Care homes often charge residents over £1000 a week to stay in care, depending on the quality of the home.

Stephen Lloyd MP, said: “There are no realistic alternatives to private care homes.

“The challenge we have here is that the UK simply does not have enough care homes in the public sector. NHS budgets are also under severe pressure at the minute, hence the need for private care homes.”

He also said that 'Care in the Community' was a bad move: “Its principle was not wrong - to try and ensure people with mental health problems could build a life outside institutions.

“However, it was drastically under funded and, frankly, was more of a cost cutting exercise rather than done in the best interests of patients.”

Take a look at this map showing the location of every care home in Eastbourne:


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'Care in the Community' was originally employed by the Conservatives in the 1980s and was designed to ensure that people with mental health problems could build a life outside institutions.

However, Support Worker Pauline Kilgallon believes that residents in care homes receive care of a high standard.

She said: “At the care home we would call them residents or service users, we help them maintain their lifestyles and assist them if they need assistance with personal care.

“Some of them can't use the kitchen facilities; it's too much of a risk. So we provide them with food, we take them to college, or if they have appointments to visit people, just general, day to day living.”

However, the Human Rights Act also works for the staff in care homes, with staff often putting themselves at risk. Pauline said:

“Some of the more aggressive patients will thump you, and there have been instances of staff getting beaten up.

“You just have to keep your wits about you, and you usually know the person who is liable to do that so you never turn your back on them, and we always make sure we have an exit from the room if it gets dangerous.

“We get training in avoidance techniques and how to deflect people. We just learn avoidance techniques, so if they're running at you, you can give them a little tap and sent them off in the other direction.”

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