Community care for mental patients

Press, 27 February 1981, Page 13

Community care for mental patients

By

DENIS DWYER,

Information Officer, North Canterbury Hospital Board

The concept of caring for more psychiatric patients in the community instead of in a large institution is not a new one; locally, the move in this direction has been developing over the last decade. Playing a key role has been the group-house scheme of Sunnyside Hospital. The scheme began in 1971 with the aim of placing hospital patients in the community and providing them with a network of services and care to meet their needs.

By 1975 there were eight group houses.: Today there are 21, with 109 patients aged from 16 to 86. Sunnyside’s - community services supervisor is Mr Colin Bell, who explains that long-term hospital patients often tend to become too dependent on the institution.

“There is no doubt that with the right preparation and the; right resources, life for some patients can ’ be more fulfilling in the community than in a hospital. Independerice and self-es-teem can be developed through opportunities for responsibility and support from others in the group house, from’hospital resources, and from the community.” • The right preparation includes the selection and training of patients and supervisors. The’ right resources include people and places. ’ The fulcrum of the service is at Sunnyside Hospital where there are special reha-

bilitation wards and from where domiciliary nursing is available.

The first such rehabilitation ward was established at the hospital in 1971 so that all long-term patients could be properly assessed for suitability of placement in the community, and last year two other wards were reorganised to assess needs and prepare patients for living out of hospital. Domiciliary nursing began in 1967. Besides supporting the 21 houses in the grouphouse programme, the domiciliary service visits patients who have returned to their homes. Social workers also visit to supervise housekeeping, cooking, medication, and hygiene. They encourage residents to ta'ke riights out and holidays, and help in job placement. Group-house patients are given as much- to do as possible. Every group house has a house father or house mother — one of the residents who is the leader and looks after the others in such ways as communication with the staff, and budgeting.

Several residents are working in normal employment while others receive welfare benefits. Residents

pay all their own expenses and the budget is carefully structured with so much going to rent, power, food and so on. For social activities some residents ‘drop in’ to the City Mission or St John’s and others attend Aldersgate for activities on Fridays. There are, too, social visits to the houses by interested individuals and voluntary support groups from the churches and vouth clubs who take

patients shopping, to sporting clubs, or on outings or stay just to chat. (Yet, for many group-house residents, social contacts are still too limited. “We appreciate these community services greatly.” says Colin Bell, “but we still ne'ed more support. Many residents cannot get work and it is often hard for them to fill in their time. Some come into hospital as daycare patients for activities.” Negotiations are presently underway with one parish to set up a day-care unit in the centre of Christchurch. It is envisaged this would be open Monday to Friday offering programmes of enrichment. By the very nature of their illness, the chronic mentallyill patients do need extra care and services, and the demands on domiciliary staff, transport and accommodation are heavy. The need remains for a full range of professional psychiatric facilities and services in city and suburbs, and submissions for more-staff have lately been made to the Department of Health. There is also a need for legislation to ensure that a high quality of care is provided in boarding houses and rest homes.

Despite these deficiencies, the Sunnyside group-house experience has clearly shown that selected patients can progress in the community with an enriched living pattern, and that barriers of prejudice can be removed.