Overseas Development In Treating Mentally 111

Press, Volume XCVIII, Issue 28999, 14 September 1959, Page 9

Overseas Development In Treating Mentally 111

A high English authority, the Hon Walter S. Maclay, 0.8. E., M.D., Senior Commissioner, Ministry of Health, England, is in basic agreement with Dr Harold Bourne, of Dunedin, on the point that the traditional type of mental hospital is an anachronism, reports a correspondent of “The Press.”

“Many of your readers may feel that Dr Bourne is a visionary, but in England a number of successful experiments have proved in practice that his ideas can be successfully applied in the interests of the mentally ill,” says the correspondent. Speaking last year to the Cana<Ran Mpntal Hospital Institute, Dr Maclay told of the remarkable changes that are taking place in attitudes toward the mentally ill and in their treatment. He said:

“In case you think I am living in fairyland, let me tell you what has been happening. In the Manchester region, owing to certain circumstances, there are some psychiatric units of 100 to 200 beds attached to general hospitals.

• “Each of these units, has its own catchment area, from which it admits all types of mental illness and provides appropriate treatment; each is linked with a big mental hospital to which it was anticipated they would send a stream of patients. To our surprise, they are sending only a very small number and seem to be able to deal with their case load without getting silted up,” said Dr Maclay. “We are inclined to think that this is because the units are small so patients get individual attention; they are in the centre of the community so they don’t lose touch with their friends; there are no vast grounds so they go into town for their recreation and attend local cinemas and football matches instead of special hospital ones.

“It would appear, in fact that one of the most important trends in psychiatry is a change from a demand for more beds in big isolated hospitals to a demand for more adequate treatment in more suitable surroundings; it is improbable that any further mental hospital beds of the traditional mental hospital type will ever be required, and to me it is certain that the provision of more and more beds is not the way to overcome crowding.”

Dr Maclay spoke of the success of domiciliary treatment (treatment in the community) in the Graylingwell area in the South of England. In this experiment there was a reduction in admissions to the mental hospital by 57.2 per cent. The headquarters of this experiment provides accommodation for an out-patient department, a day hospital, and a domiciliary service.

“A point of considerable interest is that not only was the impact of the service fell on the recent short-stay type of recoverable patient, but also on the admission of the more advanced and acute mentally ill patient upon whom much effect was not expected,” said Dr. Maclay. “Among these there has been a 40 per cent, reduction. “The effect of this service on the admissions of old patients, (those over 65), is also important when it is remembered that national statistics show that 20 per cent of admissions, and 30 per cent of mental hospital residents are over that age, Here the effect is most apparent in the 65-75 age group, but among the whole group of 65 years and over there was a reduction from 186 to 107, a 42.5 per cent reduction,” said Dr Maclay.