In Chapter 1, of Aging and Mental Health, Segal, Qualls, and Smyer reference a paradigm shift in the way mental health services were delivered (2018). The authors note that, “inpatient services were shifted from state mental hospitals to private psychiatric hospitals, psychiatric units in general hospitals, and “swing beds” in general hospitals (Segal et al., 2018). Deinstitutionalization was a nationwide policy to encourage more emphasis on community based psychiatric services (Sealy & Whitehead, 2004). Beginning as early as the 1960’s to 1970’s, provinces have slowly begun to take action on cutting down psychiatric hospital beds. Sealy and Whitehead, provide a 40 year empirical assessment of deinstitutionalization across Canada, and note that there has been wide variety between the timing and intensity of cutting beds (2004). Authors Sealy and Whitehead elaborate more on the three components required for deinstitutionalization of psychiatric hospitals (2004):
- 1) the shift away from dependence on mental hospitals
- 2) “transinstitutionalization,” or an increase in the number of mental health beds in general hospitals
- 3) the growth of community-based outpatient services for people with mental illness.”
At first glance, I can infer a few values from this public policy. Reducing psychiatric hospitals beds and facilities can redistributes the negative stigma that is associated with “insane asylums.” Additionally, per capita costs for community based services are now more evident, which alleviates pressure on the health care system (Sealy & Whitehead, 2004). However, cutting public funds for particular initiatives tends to imply where priorities and values lie. Do these cuts to psychiatric hospitals imply is that mental illness support is not as highly valued by the government? I continue to contemplate whether this decision was morally “good” or “bad.”
References:
- Sealy, P. & Whitehead, P. (2004). Fourty years of deinstitutionalization of psychiatric services in canada: An empirical assessment. Canadian Journal of Psychiatry 49(4). Retrieved from https://ww1.cpa-apc.org/Publications/Archives/CJP/2004/april/sealy.pdf
- Segal, D. L., Qualls, S. H, & Smyer, M.A. (2018) Aging and mental health. (3rd ed.). UK: Wiley Blackwell
Mental Health Policy for Older Adults 