NORMALISING MENTAL HEALTH ISSUES: A LOOK INTO COMMUNITY CARE

by Eve Lacroix

Between 2010 and 2015, budget cuts to mental health trusts in England have seen a decrease of 8%. Statistics reported by BBC News and Community Care revealed this meant almost £600m less funding despite a 20% rise of referrals to community mental health teams. Social worker Terry Skyrme works in a crisis team functioning in Norfolk and Suffolk. In 2014, he decided to start a campaign to improve services in the area, booking a room for 100 people, and seeing 300 turn up. With not enough hospital beds available, some people suffering from acute mental health distress are instead made to sleep in prison cells.

Sleeping in a prison cell is an unsettling image of social exclusion that comes with suffering from these often invisible illnesses. Yet, the mental health charity Mind estimates 1 in 4 people will suffer with a mental health issue in their life. With 50 million prescriptions being written for antidepressants in the UK each year, sufferers come from all parts of our communities.

Although today we make distinctions between disabilities, mental health problems and learning disabilities, boarders made up a mix of all three.

The Belgian city of Geel understands that exclusion and stigma is not the solution. Their tradition of community care has seen over 700 years of mentally ill “boarders” in their city. In 1480, a dormitory annex was built into the Saint Dymphna Church in the outskirts of the city. With capacity overflowing, boarders were welcomed into the homes, farms and stables of locals. As the city became more known as a sanctuary for the “mad” in the Renaissance, pilgrims migrated to Geel, and families sent their mentally ill relatives so that they could be cared of better. Although today we make distinctions between disabilities, mental health problems and learning disabilities, boarders made up a mix of all three. Families welcomed the mentally ill, who would help working in the farms, and in return would be fed, have a place to stay, and the ability to reintegrate a family and a community.

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The Belgian City of Geel – © The Independent

A common joke about the city was “Half of Geel is crazy, and the rest is half crazy!” The city’s effective, caring and respectful model of care instead of therapy continually interested the psychiatric world. In 1902, the International Congress of Psychiatry declared Geel the best practice to be emulated. By the late 1930s, the native population of 16, 000 mixed freely with 4,000 boarders. Today, the number has now dropped to about 300 boarders for a variety of reasons including more dual-income apartment lifestyles, increased use of mental health medicines, less funding from the government and a decrease in manual labour as the modern norm.

He marvelled at the city “where the mad are elevated to the dignity of the sick.”

Despite the decrease in boarders in Geel, much can be learned about the compassion and integration of the mentally ill in society. Philippe Pinel, founding father of French psychiatry sent his student Jean Etienne Esquivol to visit Geel in 1821. He marvelled at the city “where the mad are elevated to the dignity of the sick.”

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Hogewey – © The Huffington Post

Today, a similar model can be found in the Dutch gated model village Hogewey, a cutting-edge elderly-care facility where all its 152 inhabitants suffer with dementia and Alzheimer’s. Hogewey offers patients the semblance of a normal life— shops, a square, a Church, a post office, a theatre, and garden, all run by caretakers in civilian clothing. As handling money is often a source of confusion for people suffering with dementia and Alzheimer’s, money is included in the family care plan, and family members are encouraged to visit— some visiting everyday. Homes accurately resemble a style familiar to the patient, 1950s tablecloths and all.

CNN reported that Hogewey’s residents require less medication, live longer and happier than fellow sufferers in standard care homes.

In an interview with ABC News in 2012, Dr Paul Newhouse of the Vanderbilt University stated “The environmental approaches to reducing both cognitive and behavioural problems associated with dementia are really the key to improving quality of life for these patients without excess medication.” CNN reported that Hogewey’s residents require less medication, live longer and happier than fellow sufferers in standard care homes.

With social isolation and loneliness being associated with a higher chance of death, the models of Geel and Hogewey are comforting examples of the extent to which acceptance, compassion, and community care can increase quality of life.

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