The deinstitutionalisation of mental care

Abstract

In this dissertation I shall be discussing a controversial topic - the deinstitutionalisation of mental care. In chapter one, a brief historical account takes us up to the familiar established institutions for the mentally ill both abroad and in Malta. In the early seventies the break through in medicine encouraged psychiatrists and legislators in various European countries to reconsider the systems of care for the mentally ill. The experiment of deinstitutionalisation began. A study of the events and results of the situation in other countries will help enlighten the possibilities of new systems of care for the mentally ill in Malta. As a social worker student, I have studied the environment at Mount Carmel Hospital through personal involvement with patients on the premises. I further carried out a detailed study on the half way house and hostel, as the main unit of rehabilitation in Malta, the criteria for admission to half way house, the purpose and the functioning of the unit as a whole and measures of its effectiveness. In an effort to assess as reliably as possible the effectiveness of our main form of rehabilitation, I carried out two detailed surveys of all residents at the half way house and hostel. The surveys were carried out on the number of residents living at half way house and hostel as on 24th January 1989. A copy of the survey sheets is to be found in Appendix number. The survey includes two questionnaires: the first one is a study of the final length of stay of each resident as a patient in the hospital prior to admission to half way house, his percentage length of stay at half way house, target placements and areas of rehabilitation. The second questionnaire consists of opinion questions answered by nine members of staff including nurses, social workers, occupational therapists and psychiatrists. They were asked about each of the same residents. These surveys give a picture of the present situation at half way house and is a further inspiration into our future. This helped to further assess the existing reality of the rehabilitation unit. Discussions and assessment on surveys together with assessment of the different modes of the care of the mentally ill, are all to follow in the later chapters.