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Over the years, mental health care has shifted from residential and state treatment to community based treatment, this shift is attributed to the financial constraint faced by consumers and the fact that most pharmaceutical drugs nowadays have fewer side effects. The purpose of institutional care to those diagnosed with mental illness is to achieve recovery by employing practices that are evident based.
These practices include the management of the illness and treatment, aggressive community treatment, family psycho education, dual diagnosis treatment and employment support (Oss, 2004, p. 6). The article ‘Community health mental principles: A 40 year case study’ deals with the principles of CMHC and its goals, the article ‘All roads lead to community based care highlights the importance of community based mental care while the article ‘When state hospitals were communities’ highlights the features and advantages of state hospitals.
Community based institutions provided better care than state hospitals because community based mental health care centers are responsible for a specific target population that was smaller than that of state mental health facilities, their primary goal is to treat patients closer to home in an environment that is less restrictive. Community based mental health facilities used of an array of professional services that play a vital part in the road to recovery; they were also in close association with other community organizations, agencies, and employed citizens to participate in their governance to ensure transparency and accountability (Ahr, 2007, pp. 15-17). These features made community based mental institutions better than state institutions.
State institutions were autonomous self-contained communities which catered to a large number of mental health patients; for example, in 1954 the Westborough insane hospital had 2000 patients (Bazemore, 2005, p.11-2). State mental health facilities isolated patients by placing them in large campuses outside towns; they had buses and a policing system that took the patients on field trips to the towns.
However, Community based centers integrated the patients with the community by ensuring that they were closer to home, this contributed to their well being and recovery. Patients in state facilities were abandoned and sometimes left to die and be buried in the hospitals as evidenced by the presence of cemeteries in some hospitals (Bazemore, 2005, p.11-2) these studies provide evidence that support community based centers over state hospitals.
Lack of funding has been a major drawback for community based mental health facilities that have led to abandoning some of the institution’s goals such as prevention and early intervention (Matarazzo, 1980, pp. 807-19). Unlike community based facilities, state mental health facilities emphasized on rehabilitation through work (farming and cottage industries). The patients would produce furniture and agricultural products for the campus and the surplus sold to nearby towns, for example, Worcester insane hospital produced a hundred bushels of turnip and 35000 tones of cabbage in 1907. This production helped in sustaining the institution in addition to the government funding.
From this analysis, we can draw the conclusion that although community based mental health centers have financial constraints they are indeed better than state mental health facilities because they treat patients in a more compassionate and exclusive way. They develop a personal relationship with the patient and the patient’s family and ensure that quality care is administered to the patient with the overall goal of recovery.
References
Ahr, P. (2005). Community mental health principles: A 40-year case study. Behavioral Health Management, 25(1), 15–17.
Bazemore, P. (2005). When state hospitals were communities. Behavioral Health Management, 25(4), 10–12.
Matarazzo, J.D. (1980). Behavioral health and behavioral medicine: Frontiers for a new health psychology. American Psychologist, 35, 807-817.
Oss, M. (2004). All roads lead to community-based care Behavioral Health Management, 24(2), 6.
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