Community mental health studied in U.S.

Press, 10 June 1978, Page 7

Community mental health studied in U.S.

Many large psychiatric hospitals in the United States are being closed because of the success of community-based mental health programmes, according to the chief psychologist for the North Canterbun Hospital Board (Mr H. R. Unger). Mr Unger, who returned this week from study leave in the United States, said that community mental health programmes which he studied there had important implications for New Zealand. As national adviser on psychology to the Department of Health, Mr Unger is involved with the setting up of new community mental health schemes in New Zealand. Mr Unger said that the main features of the success of community mental health programmes in the United States were the coordination of voluntary agencies working on mental health; the recognition that these voluntary agencies would not be taken over by any new community-based schemes; the use of consultants in psychology, social work and nursing; the recognition that what might meet with success in one population area might not be suitable for another: and the acceptance that good health meant the adoption of a “wholistic” approach to health care. The term “wholistic” referred to the acceptance in many parts of the United States of the fact that when a person was treated they should be regarded as a “whole,” he said. The community mental health programmes did not separate a person’s mental, physical and spiritual health into unconnected areas. Given this basis, t’.e professionals and lay people working in community mental health programmes worked closer together than was now possible in New Zealand Emphasis on community involvement in mental health work had also been paralleled by recognition that such programmes should be carefully monitored as they were respon-

sible to the total community. It was becoming increasingly common in many parts of the United States to make access to treatment as easy as a telephone call, Mr Unger said.

“It has been found that most crises develop between 4 p.m. and 8 p.m., and in the successful community mental health programmes telephone contact is an important facet,” he said.

Many people requiring assistance needed help because they had a problem living in the community. Therefore helping them to work out the problem, while still living in that community, was recognised as the most successful way of restoring mental health. “The client is seen as an important part of this treatment process and he is not regarded as a ‘patient,’ but as a person with rights and needs, and the capacity to make deci-

sions influencing his future,” Mr Unger said.

The growing acceptance of the principle of comm u n i t y-based mental health programmes meant that many hospitals were being closed.

“The idea of bringing the facilities too where the people are. rather than cutting them off from their natural surroundings, means of course that there are no rehabilitation problems and more chances of change where it is needed," Mr Unger said.

It also meant that better use was made of professional consultants working with lay organisations. “In short, mental health is being recognised as a normal part of community development, with all the responsibility which that implies.

“Such attitudes can be found in New Zealand The supportive network is there and only requires the correct type of ‘tapping’ and stimulation,” said Mr Unger.