‘Out of sight and out of mind’ was certainly the approach taken to mental health before the late 20th century. There are six psychiatric hospitals in Northern Ireland, St. Luke’s, Armagh (1825); Purdysburn/KHCP Belfast (1829); Gransha, Derry (1829); T&F, Omagh (1853); Downshire, Downpatrick (1869); and Holywell, Antrim (1898), all still open and operating psychiatric hospitals. Mental health policy has developed comprehensively since the 19th century and change is still ongoing however it is still clear that mental health services in Northern Ireland fall considerably behind those in the United Kingdom.
This essay will discuss how and most importantly, why mental health policy has developed in Northern Ireland throughout the 19th and 20th century. It will first illustrate life inside the asylums, the policies that supported institutionalisation, and why change was needed. Next it will establish the progression in policy to support community and integrated care; it will examine this change and its effectiveness throughout society. Moving onto the 21st century, it will focus on a few of the main policies established throughout this period. Finally a conclusion will be made, assessing the current policy in Northern Ireland and how far we have to go to enhance the quality of life of those struggling with mental illness.
First off, it is important to understand the political and social whereabouts of Northern Ireland from 1898 to gage the changes that have been made in policy. Before 1921, the North and South of Ireland were under British rule. When the government of Ireland Act 1920 partitioned the island of Ireland into two separate states, Northern Ireland and Southern Ireland, the North of Ireland remained under British rule while...
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The study said mental health problems were “widespread, at times disabling, yet often hidden.” This is due to the under-funding for these types of health services in the United Kingdom. "Mental health services have been underfunded for decades and too many people have received no help at all, leading to hundreds of thousands of lives put on hold or ruined," wrote task force chairman Paul Farmer, the chief executive of mental health charity Mind. This study also showed that only one in four adults receives a diagnosis of their mental illness in any given year. Mental health represents “the largest single cause of disability in the UK.” Sad to say in this system, “most children and younger ones actually receive no support at all, and even those that do, the average wait for an appointment was 32 weeks” in the year of
On October 31, 1963, President Kennedy signed the Community Mental Health Act into law with the aim to change the delivery method of mental health care (National Council for Behavioral Health, 2013). The primary aim was to release the mentally ill from institutions and allow them to successfully integrate into functional members of society. In an effort to achieve this goal, delivery of care would be a coordination of effort from a network of outpatient clinics, community services, partial hospitalizations, and when needed emergency services. The funding for these services was to be from a combination of government, private programs and self-pay sources. However, due to the recent recession government sources reduced funds available for mental health services (Thomas). This economic reality coupled with an already fragmented health care system has left mental ill vulnerable. Patients that fall into the cracks in the system often end up in homeless shelters, jails/prisons or the morgue (Szabo, 2012).
The BBC documentary, Mental: A History of the Madhouse, delves into Britain’s mental asylums and explores not only the life of the patients in these asylums, but also explains some of the treatments used on such patients (from the early 1950s to the late 1990s). The attitudes held against mental illness and those afflicted by it during the time were those of good intentions, although the vast majority of treatments and aid being carried out against the patients were anything but “good”. In 1948, mental health began to be included in the NHS (National Health Service) as an actual medical condition, this helped to bring mental disabilities under the umbrella of equality with all other medical conditions; however, asylums not only housed people
The island was divided into Northern Ireland and The Republic of Ireland in the 1920s. Northern Ireland was created through demographic compromise, which is a part of the United Kingdom. Many theories have developed over time, but no exact theory has yet to describe the complex struggle of the “Troubles”. The Troubles that broke out in the late 1960s had roots going back many decades lasting until 1998. The society has for many years been strictly divided between Unionists/Protestants, who want Northern Ireland to remain a part of the union with Great Britain and Nationalists/Catholics, who do not want this union.
Critical to understanding the extent of the problem is a clear definition of mentally ill, “a person suffering from mental illness and, owing to that illness, there are reasonable grounds for believing that care, treatment or control of the person is necessary for the person’s own protection from serious harm, or for the protection of others from serious harm” [Mental Health Act 2007 (NSW)]. Noting that the statute specifies the ‘control’ of this group which adds to the notion that people with mental health problems are inherently more dangerous members of our society. Furthermore mental health problems within the prison system (inmate population) are estimated to be three to four times higher than in the general Australian popula...
A brief history on Australia’s mental health care begins in 1811 with the opening of the first Lunatic Asylum in Castle Hill NSW. The Australian’s in the 1800’s viewed mental illness as madness and related this to bad blood or character flaws. The authorities at the time managed mental illness by physical restraining patients, placing patients into isolation and control the patient’s lives. No real treatment was available for mental illness and the staff in this period consisted of untrained care assistants (Happell, 2007). Very little had change in the mid to late 1800’s, Medical superintendents are now in charge and the philosophy of the time increased to one of human care, although slowly. The asylums were often overcrowded and this resulted in custodial management (Happell, 2007). In 1867 Parliament begins to send patients with mental illness to asylum rather than prison. The 1900’s sees the
Perkins, R. Repper, J. (1998) Dilemmas in Community Mental Health. Oxon: Radcliff Medical Press Ltd.
In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the neediest subset of individuals. Instead, they served those who had minor psychiatric diagnoses and needed little treatment. As a result, the United States experienced an increase in the number of homeless individuals, most of whom still exhibited psychotic symptoms. Involuntary Outpatient Commitment (IOC) was created to serve those “forgotten” mentally ill individuals without placing them back in institutions. Ideally, IOC will increase community tenure for the severely mentally ill, decrease the likelihood of decompensation, and provide the necessary treatment by means less restrictive than hospitalization, (Borum et al., 1999).
Read, J., & Sanders, P. (2010). A straight talking introduction to the causes of mental health problems Herefordshire, UK: PCCS Books.
Whenever one thinks of psychiatric hospitals in the nineteenth century, visions of inhumane tests and poor living environments rack the brain. Although some events like these did occur during the time of author Nellie Bly, the treatment and lack of social acceptance of the mentally ill was much more alarming and needed immediate change. In the 1800s, mental illness was considered beyond terrible and embarrassing, but it is now considered a disease of the mind, something that is much more accepted.
The 1960’s individuals’ with mental illness were supported or cared for in asylums ,by mostly untrained staff, which were at that time called keepers. (Boschma, 2003). During the 1960’s a report called the Ely Report was written. This report stated that there was ill treatment of patients,
“At some point in the 1970s the decision was made to close state-run mental health institutions. Much of this was motivated by The Community Mental Health Act in 1963. Reports at the time indicated significant abuse of patients and a general lack of credible mental health care. The idea was that funds would be redirected from the states to local communities to manage and monitor the needs of individuals with mental health issues. Unfortunately, this transfer of funds never happened and local communities were simply overwhelmed”. (DeMoss, 2016).
Due to the vast misrepresentation of mental health problems, such as increased levels of violence, by the media (Gerrig, Zimbardo, A.J., Cumming, & Wilkes, 2012) and antiquated negative terms such as ‘psycho’, ‘mental patient’ and ‘lunatic’, there is a negative social perception of mental health issues (Hungerford, et al., Chapter 1 The provision of mental health care in Australia, 2012). Negative social perceptions and misunderstandings of mental health can result in the stigmatisation, discrimination and oppression of people living with mental health