Academic journal article Organisational and Social Dynamics

Consultancy on Deregistration to a Care Home for the Long-Stay Mentally Ill: You Can Take Stig out of the Dump, but Can You Take the Dump out of Stig?

Academic journal article Organisational and Social Dynamics

Consultancy on Deregistration to a Care Home for the Long-Stay Mentally Ill: You Can Take Stig out of the Dump, but Can You Take the Dump out of Stig?

Article excerpt

Abstract

With the Olympic Games coming to London at the time of writing, summer 2012, and the country in economic crisis, the government is attempting to clean up the streets at the same time as cutting services by instructing mental illness to behave itself and meet mad targets. This leaves the mentally ill at most risk of being dumped. Following the dismantling over two decades ago of out-of-sight asylums, most care of the chronically mentally ill has been in registered care homes in the community. The legal definition of a care home is an establishment that provides accommodation with personal care, including assistance with bodily functions where required www.caremanagementmatters.co.uk/documents/PeterGrose.pdf.

'Registration is a legal requirement under the Health and Social Care Act 2008 for all health and adult social care providers to register with the Care Quality Commission.' (forum.ukqcs.co.uk/home/forum/topic/36/8/1/17/)

However, in an attempt at reducing budgets, under the guise of cutting red tape and enhancing empowerment and independence, there is a proposal to deregister these housing associations by insisting that their customers become independent of the following needs: personal care, having their medication supervised, and having limited access to and responsibility for money. If a care home is deregistered then, in agreement with residents, the provision of residential accommodation, together with nursing or personal care, is discontinued, and instead these two elements are provided separately and tenancy agreements are put in place in the form of 'supported housing'. It is expected that the primary task of support workers will adapt to empowering the charges in 'their care' so that self-responsibility on the part of the mentally ill will increase. The difficulty is that the nature of mental illness would seem to make this impossible, which makes the demands themselves mad.

Key wordsrcare, dump, personalisation, deregistration, projection, commissioners, containment, psychosocial.

INTRODUCTION

Stig of the Dump is a modern classic children's novel by Clive King, published in 1963. It is an adventure story about a secure, adventurous boy, Barney, befriending a dislocated primitive caveman, Stig, who, deprived of his own people, language, community, and orientation of time and place, has made a creative adaptation of a rubbish dump. From the outset, there is mutual respect, creativity, and a nonverbal dialogue between the two, but the power imbalance changes as Barney finally enters Stig's world and feels like the outsider to a whole other universe with its own vigour and sophistication.

I present this story as a metaphor to explore the policies and provision for mentally ill patients in the UK National Health Service (NHS). The story was published during the 1960s at the same time as the then Minister for Health, Enoch Powell, made his 'Water Tower' speech, conveying his intention of 'nothing less than the elimination of by far the greater part of this country's mental hospitals as they stand today' (studymore.org.uk/xpowell.htm). The problem is, it seems likely that there may have been a fantasy of the abolition of mental illness accompanying the intention to eliminate mental hospitals. This may be manifested either through turning a 'blind eye' in care homes themselves, or through a 'gap in services'. This potentially leaves Stigs with no place to go, with their only option to make the best of being dumped.

This paper will consider the front line experience of not just 'care in the community' ('the policy of transferring responsibility for people in need from large, often isolated, state institutions to their relatives and local welfare agencies', www.dictionary.reference.com/ browse / community +care), but give consideration to the wholesale shipment of the mental asylum back into society. A brief consultation was undertaken in an inner-city registered housing association, Horizon, that provides care to those who would in times past have found themselves in asylums; that is to say, the chronically mentally unwell, in this case, those who often have a history of both homelessness and mental illness. …

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