Portfolio of Hope

Mental health care, although extremely advanced today and widely considered to be on the same level as physical health care, has not always been so advanced. Fortunately, it has changed for the better over the last 70 years, with the closure of asylums and transition to more community-based treatment being at the forefront of such positive change.

Prior to the creation of the NHS in 1948, mental health treatment involved what is today considered to be extremely dangerous and ‘old-fashioned’ practices.

As mental health in the mid-19th century was largely misunderstood and overwhelmed with stigma, the treatment offered mirrored this damaging approach to what we now know to be a very delicate subject.

Talking therapy was unheard of, instead people suspected to have a mental health condition were simply banished to an asylum where they would receive sedative drugs and cold baths, as just two examples, in an effort to ‘cure’ the poor mental state of their agitated patients. The majority of people who were sent to an asylum would remain there, locked away from the rest of society, for the entirety of their lives.

This harmful approach to treatment would finally change in 1959, a little over a decade since the creation of the NHS, with the introduction of a ‘mental health act’ being passed by parliament. Under this new act, only those who were medically suitable to be hospitalised were sent to asylums. It was no longer a legal requirement for everyone with mental health problems to be separated from society. This helped to remove some of the stigma that was previously associated with mental health.

A year on from the mental health act being passed, all asylums were made to close by the government who deemed them to be counterproductive in their efforts to help mentally ill patients recover. To replace them? General hospital wards and community centres.

In 1983, another positive step was made. The mental health act introduced 14 years previously was amended to include consent. This meant that most people in treatment for their mental health were engaging in treatment voluntarily, as opposed to it being due to a legal requirement stating they had to be. This is the same case as today, with the emphasis being on community care. Hospital is avoided and used as a ‘last resort’, with any hospital stays that are considered necessary being short-term. In its place there is an emphasis on community care, with mental health teams forming a vital part of the NHS. Whilst all mental health teams have the same goal, to provide support to those with mental health problems in a community setting, there are several different types of mental health teams, all of which do a slightly different job. Examples of mental health practitioners that can be found within mental health teams include crisis teams, psychiatrists, occupational therapists, care coordinators, social workers, CPNS (community psychiatric nurse), and psychologists. In order to deliver the most effective treatment, all members of the mental health team must work together.

As I have described, the changes to the way in which mental health treatment has changed over the years has certainly been that of a positive one. Not only has stigma been abolished, but social barriers have been broken down, public attitude has changed for the better, and as such, mental health is now being talked about more openly and positively than ever before, and that can only be a good thing.

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