Local control wanted for mental health care

Press, 22 November 1989, Page 9

Local control wanted for mental health care

By

DEBORAH MCPHERSON

A consortium of Government agencies coming under the umbrella of area health boards has been proposed to enforce more accountability and monitoring in community mental health care.

The National Mental Health Consortium has called for the establishment of local groups comprising housing, labour, social welfare, community and health sectors to come under the control of area health boards. The consortium’s director, Dr Basil James, said that the problem with New Zealand’s community care was that it housed so many Government agencies, communities and other sections that no-one knew who had responsibility.

Dr James was the opening speaker at a two-day conference in Chrischurch on psychiatric care in the community.

The consortium wanted to reverse this lack of accountability, by a more co-ordinated service, he said.

Local accountability would demolish the attitude that conditions such as alcoholism were

everybody’s problem, which meant that nobody was accountable, said Dr James. The consortium has also recommended that the Health Department take responsibility at a national level for over-all de-

velopment and delivery of com-munity-based health care.

Dr James said a balance was needed between community and hospital-based care in the treatment of mental illness.

Community care had a low priority in the Western world because traditionally a higher value was placed on curing than caring.

Community care implied a package including medical, housing, employment, support networks, and social activities.

Area health boards found it difficult, however, to feel obliged to extend the health dollar to the other issues that community care raised, said Dr James. As deinstitutionalisation and the run-down of hospitals was already occurring, the first priority should be to provide care for those already in the community, said Dr James. “But it’s a mistake to make that the only priority. “There is also concern about the increasing number of pyschiatrically ill and intellectually handicapped people who filter through the course and end up in prison.”