"Should community care be used in the treatment of the mentally ill?" For decades, large numbers of mentally ill patients have been treated in the community instead of in mental asylums, in a policy known

There are many arguments in favour of this issue. The strongest of these is the simple fact that wards in mental institutions across the country are heavily crowded, with each ward having approximately thirty percent of beds which are occupied by patients who do not need to be there and could feasibly be cared for in the community. Moreover, community care treatment is preferred by the mentally ill and is often thought to improve symptoms, especially of the more severe mental illnesses such as schizophrenia. In-depth studies by health workers have proved this as it is found that, increased security, such as that of a mental hospital, often frightens and angers patients and is not the ideal environment in which they should be cared for. Additionally, mental asylums are essentially prisons, preventing patients from living a normal life and therefore, caring for patients in the community is seen as a more humane approach to their treatment as well as one which shows a public acceptance of the variety of disorders which are known as mental illness. It is also widely known to be much cheaper than hospitalising patients and research shows that hospital care swallows up over two thirds of the government’s mental health budget. In the same way, treating a mental patient in hospital can cost up to fifty thousand pounds a year, whereas treating the same patient in the community costs only twelve thousand pounds. 

Studies have also found that community care does, in no respect, increase the workload or burden on carers and the amount of work required for one patient is usually the same as it would be if they were being treated in hospital. As well as this, it is of common belief that community care is a policy that has not been fully ‘tried out’ and implemented by the government and is still somewhat at experimental stages. Many people understand the policy to be under-resourced by the government and believe that because community care has not yet been fully implemented in Britain, the mental health service cannot accurately decide whether or not it has failed or succeeded.

Although there are many arguments in favour of this issue, many critics are firmly against the idea and disagree with any form of community care for the mentally ill. Those who strongly oppose these views instead see community care as a cost-cutting measure rather than a genuine alternative. Many people believe that the government is simply using community care to satisfy its mental health care budget and has not fully considered the serious effects it may have. Furthermore, it is believed that community care does not sufficiently cater for the needs of many patients. For example, many mental health patients require regular examinations of their state of mind, and care in the community deprives people of the facilities which they frequently require that could be found in hospitals. In addition, hospitals are a place where staff can closely assess the needs of patients to find the best methods of treatment and community care does not allow for this level of monitoring.

A major problem with care in the community and one which is notorious due to the large amount of publicity it has received, is the high number of murders which have been committed by mentally ill people living in the community. The individual case previously mentioned, involving Glaister Earl Butler is not an isolated one and there have been numerous other cases including a commuter, Jonathon Zito, who was stabbed to death in an unprovoked attack by a schizophrenic while waiting for a London train. As cases like these continue to emerge in the media, critics of the community care policy are starting to consider whether the government is putting its money before the lives of millions of innocent people.

The inability of the medical profession to cure mental illness has resulted in many differing views on the sensitive issue of community care. Is it simply a way of saving the National Health Service money or is it a genuine response to the problems surrounding long-term hospital care? My view on this topic is that patients with the more severe mental illnesses should not be integrated into the community as it poses a serious risk to public safety. It appears that the medical profession is prepared to take chances with the lives of citizens by releasing people into the community, knowing that there is a significant risk that they could harm others. I believe that this is wrong and generally, I am concerned about community care expanding further into more areas. Mental health workers seem incapable of reliably monitoring the progress of community care patients to ensure that they are taking appropriate medication. Glaister Butler was, for instance, found with eighteen months worth of medication at his residence and this is unacceptable. If community care is going to continue to be used in the treatment of the mentally ill, serious changes in the government’s mental health policy will have to occur. One significant topic, and one which is vital for the welfare of the mentally ill, is that they need widespread public acceptance and community care is the first step towards this.

 

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