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.