Care In The Community V The Old Big Hospitals.

[NicoretteGummed]

No long comments on this thread,merely two questions:-

(1)-What Do you prefer out of "Care In The Community" V "Old Big Hospitals"

(2)-How do you rate the "Care In The Community" Policy in your country out of Ten.??

(1)-I prefer "The Care In The Community Policy"-Just.

(2)-It Being The Real World I rate it a 5/10

[calypso]

Hiya, why can't we have long comments? The old hospitals were bad, but if they modernised them and the training of the nurses and docs. so I prefer hospitals as care in the community is so shit. xxx

[Apotheosis]

Without searching out all the articles & references - [of which I've already posted reams on this forum]

If a genuinely humane asylum system was put in place; as part of a comprehensive system of care that promoted genuine recovery/healing/& independence - then I think it would be a good thing.

http://www.madinamerica.com/2011/11/solutions/

The problem is how such an approach would be embraced, funded & implemented?

The majority of people cannot move away from, or see outside of the 'label & drug'/pathological/materialistic/reductionistic ~ paradigm/mentality/approach/'understandings'.

This looks nice -

http://www.theretreatyork.org.uk/

Places of genuine asylum, of genuine therapeutic care & healing are needed - But under the current social/political/economic/medical climate - I don't see how it would be possible as a standard? The idea of such places is so far removed from the actual reality; as to be a complete fantasy.

The Old Hospitals were shit & don't 'care' in the community is shit.

[Apotheosis]

Here's a good article that is relevant to the subject -

http://www.madinamerica.com/2012/01/...esearch-today/

Excerpt -

In the last years of the 18th century, Quakers in York, England, acting in rebellion against the harsh ministrations of English mad doctors, developed a form of care known as “moral therapy.” The medical wisdom at the time was that the mad, by virtue of having lost their reason, had descended to the level of “brutes, but the Quakers in York thought differently: They declared that the “mad” were “brethren” and should be treated as such. The Quakers in York built a small retreat in the countryside, where the mad were given shelter and food, and treated with gentleness and kindness. In this manner, the Quakers hoped to “assist nature” in helping the mad get well. They believed that their mad brethren had a God-given inner capacity for regaining self-control and reason, and thus their therapeutic challenge was to provide a gentle environment that could best promote such healing.

In fairly short order, the Quakers in York reported that this care was proving to be quite successful, and in the first decades of the 19th century, Quakers in the United States built a number of such small retreats, in the countryside outside Boston, Philadelphia, Hartford and other cities. The patients were encouraged to garden, exercise, take long walks, and engage in social activities. And this therapy worked. Modern historians who have reviewed the records of these retreats have determined that more than half of the newly insane would be discharged within three years. Moreover, a long-term study of 984 patients discharged from Worcester Asylum in this period found that 58% remained well throughout their lives.

Today, we often hear of how our society is discovering that some people can “recover” from mental illness, as if this is an extraordinary finding. If the Quakers from the early 19th century could hear such pronouncements, they would undoubtedly furrow their brows and wonder, this is considered new?

[NicoretteGummed]

Hiya, why can't we have long comments?

The old hospitals were bad, but if they modernised them and the training of the nurses and docs. so I prefer hospitals as care in the community is so shit.

xxx

Yeah,Point Conceded.

A fair and Valid Comment.

I just can't see it happening for at least 10 Years given The current Economic Situation.

But then again having said that, surely there are people in Important Places who might think that Care In The Community Indirectly causes more Spending even than The Large Hospital System in the long run.??

I wonder why these voices don't ever speak up.??

I'm talking about Politicians,Celebrities,and others in The Public Eye.

[Fragile]

I think hospitals very much have a place, but I don't think their current form is constructive to anyones long-term well being. I do however think that even in its current form, we need more beds for people in crisis.

I guess then the question is, how do we provide a longer term solution? I don't think Asylums are the solution. Why should we have to seek Asylum from the world? It doesn't seem right. But perhaps it is about choice.

I think proper social support would be a start. I don't mean a 'care-ordinator' taking you out for a coffee at Starbucks once a fortnight. I mean real, humane, therapies and possibly mentoring. Therapies could also be delivered much more cheaply, and therefore more widely, by scraping CBT psychologists - it doesn't take 7 years of work, mostly research, to deliver a therapy. I also think the role of simple councilling is massively under-valued. Sometimes people just want to know that someone cares, and that someone is willing to listen. There's too little human contact in the current system, that's just one of the many problems.

Edit to add: Whilst I think CBT psychologists are mostly a waste of money - I do still think that CBT should be made available. Rather, it should be practiced by people on lower salaries, and it shouldn't be forced on people as the only non medical option.

[anonymous1]

No long comments on this thread,merely two questions:-

(1)-What Do you prefer out of "Care In The Community" V "Old Big Hospitals"

(2)-How do you rate the "Care In The Community" Policy in your country out of Ten.??

(1)-I prefer "The Care In The Community Policy"-Just.

(2)-It Being The Real World I rate it a 5/10

Care in the community is practically non-existent - 3/10. It seems to consist of a cpn visiting you for a chat once every couple of weeks and then you are left by yourself for the rest of the time. Near me there are no classes of occupational therapy. Being at home by yourself when you are delusional or psychotic can be scarey.

I did have a positive experience of being in a private hospital which the NHS funded because they didn't have enough beds - there apart from the meals being nicer, there was something to do every day and group therapy every day. I don't see why more NHS hospitals can't be modeled on this - the therapy groups and simple activities (art, crosswords, quizes etc) were run by a cpn and an occupational therapist.

The normal NHS hospital was fairly dire - you were just left to lie on your bed all day (although to begin with that was pretty much all I could manage) or there was a tv room - although some of the nurses were kind which was a help if you wanted to chat. There was barely any organised activity - apparently there was a funding problem for occupational therapy. After a very long stay in hospital its fair to say that I became institutionalised to some extent.

[anonymous1]

I think proper social support would be a start. I don't mean a 'care-ordinator' taking you out for a coffee at Starbucks once a fortnight. I mean real, humane, therapies and possibly mentoring. Therapies could also be delivered much more cheaply, and therefore more widely, by scraping CBT psychologists - it doesn't take 7 years of work, mostly research, to deliver a therapy. I also think the role of simple councilling is massively under-valued. Sometimes people just want to know that someone cares, and that someone is willing to listen. There's too little human contact in the current system, that's just one of the many problems.

Edit to add: Whilst I think CBT psychologists are mostly a waste of money - I do still think that CBT should be made available. Rather, it should be practiced by people on lower salaries, and it shouldn't be forced on people as the only non medical option.

I agree that better social support is definitely needed. However, regarding CBT psychologists, I do remember one really helping me when I was having quite severe delusions and panic attacks by looking at my core beliefs - and we only got to that after some time of seeing her. I agree that others can be trained in cbt, I'm just concerned that they would be trained in enough depth - because some people just seem to gloss over the surface with cbt and not really get to the root of the problem.

[mckie]

Care in the community appers to be very patchy. A great deal is on families, and family life has disintegrated as there is so much movement internationally both for work and pleasure. In some cases the information given to families about where they can get help is difficult, and cybercontact can be helpful, but face to face contact, at least on the discharge of patients is in my opinion a necessary requirement. Medical and Social care should go hand in hand, and the family be condiered (in most cases) to be part of the team.