Sunday, 30 April 2017

Are we failing our mentally impaired?

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When I was a youngster I had my appendix taken out, and then my tonsils and my adenoids. My sister satirically mocked that I was “not all there.” Not being “all there” was a euphemism for insanity. Another crude expression was “not being the full quid.” After decimal currency was introduced not being the “full dollar” didn’t have the same impact so this expression was mercifully discontinued.

Back then local people considered to be “not of sound mind” were generally sent to Porirua Hospital. Those severely impaired might be sent to Lake Alice Hospital in the Rangitikei which had a maximum security unit.

There is strong evidence to suggest that the standard of care in these hospitals left a lot to be desired.

In 1992 the government of the day resolved to progressively close these establishments due at least in part to their clinical techniques being out of step with modern medical practices.

This was a western-worldwide trend at the time, probably bolstered by the Academy-award-winning film One flew over the cuckoo’s nest which exposed conditions in these sanatoriums at their very worst. An unfortunate American expression for a family member who had mental health problems was to suggest the stork delivering the baby must have flown over a cuckoo’s nest en route to the expectant mother.

However in a submission to the Parliamentary Select Committee on NZ Mental Healthcare, 80-year-old Andy Espersen from Nelson, a psychiatric nurse who has worked in our mental hospitals, questioned the 1992 decision suggesting that these institutions ought to be re-established, particularly for those suffering from schizophrenia.

He wrote: “For 150 years prior to 1992 every person duly diagnosed with schizophrenia would in effect become a ward of the state, simply because it was recognised that the sufferers from this illness would find it difficult to cater for themselves. For charitable reason asylums were built throughout our nation. The relevant legislation also ensured that crimes committed by them would be excused because of their illness.”

Mr Espersen believes that of the 10,000 men and women contained in our prisons at least 2000 of them will be suffering from schizophrenia. Instead of building more prisons, he said, we should be re-establishing modern secure hospitals that could care for these people humanely instead of punishing them unrelentingly.

The president of the NZ Bar Association, Tony Bouchier, obviously agrees. In an interview on “Nine to noon” recently he said this: “One of the main reasons the prison muster is so high is that our prisons are our proxy for the mental institutions we don’t have. And everybody in criminal law will tell you this, from judges through to defence council. If there was another way to deal with these people through proper mental health facilities our muster would be a lot smaller.”

The problem for me is if Mr Espersen’s submission is seriously considered and mental institutions are rebuilt the old lexicons might also come back into vogue. I might therefore have to seek surgery to have my appendix, tonsils and adenoids refitted to convince the authorities that I really am in fact “all there.”

“Men will always be mad and those who think they can cure them are the maddest of all.” - Voltaire


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