‘Bodies fixed but not minds’

Press, 8 July 1982, Page 4

‘Bodies fixed but not minds’

Health-care services in New Zealand have been very good at fixing people’s bodies but not their minds, according to the Director of Mental Health, Dr Basil James. “About 20 per cent of all patients in general hospitals have significant mental problems,” he said in Christchurch last evening. "The role of mental health has been diminished in health care, and has been relatively neglected,” he said. “Look, for example, at the multitude of reasons for which alcohol abusers come into hospital — for liver complaints, orthopaedic complaints, and stomach complaints. Every time their complaints are . attended to but the cause of the problem -7 in this-case alcoholism — has been-’ignored and not treated.”

Dr James said that only one-third t of all New Zealanders who had a mental health problem were receiving . the treatment they needed., ® . “But , by extending mental

health services into the community, we hope to be able to see these so-far unrecognised problems,” he said. Dr James is in Christchurch to speak to members of the North Canterbury Hospital Board about its proposals for a regional policy for community mental health. He will also address a meeting of the Community Mental Health Association this evening. “We have a legacy in New Zealand of mental health care centred on institutions,” he said. The Government’s suggestion .. that mental health care be extended into the community would encourage the discharge of some "institutionalised” patients. "We have to ensure that as many patients as reasonably possible can live outside a mental institution,” Dr James said.

The North Canterbury Hospital Board recently released an interim report containing various suggestions for reducing the number of long-stay psychiatric patients

in hospitals by releasing them into the community.

Within five years, the report said, 140 long-stay patients could be released, the equivalent of four wards. The saving from closing these wards would pay for new commjinity services for those patients discharged.

Dr James said that hospital boards throughout New Zealand were being encouraged to produce similar plans, since the number of mental health long-stay patients in institutions was far in excess of Government guidelines.

The Government had set bad guidelines of one psychiatric bed per 1000 . people about two years ago, and now that’ there was less money to pay for hospital beds, these guidelines had become firmer, he said. “Obviously we cannot pitch people out on to the streets. We have to ensure that they have somewhere suitable to go and good community services,” he said.

Dr James said that inevitably greater pressure would result on relatives of the patients and on voluntary community organisations. “The capacity of the patient’s family to cope with him on discharge back into the family home will always be taken into consideration, as will all the other circum-

stances of the patient before release into the community is considered,” he said.

There were many patients who would not be able to be released, especially those “special patients” who had been committed to psychiatric institutions after committing a serious crime.

Dr James, who was appointed Director of Mental Health last October, is one of the public servants responsible for deciding when such “special patients” should be released from psychiatric hospitals.

“If the crime is a serious one, everyone is reluctant to see the person released too soon,” he said. “I would say that the minimum sentence served by a ‘special patient’ who committed a serious crime would be seven years, but usually it is considerably longer. I know that a person who is given a ‘life’ sentence can be out of prison in about nine years, and so a psychiatric committal is not very different."