New initiatives in housing for the mentally handicapped.

Abstract

erm institutional care, particularly in the older and arger institutions is not only costly, but is unable to espond readily to the individual needs and capabilities atients. Hostel and hospital living tends to mean the of contact between patients and their families, rt icularly when long travel distances are involved, nd loss of ability to maintain social contacts within the ommunity. The bigger an establishment becomes the ore isolated and inward looking it grows, tending to ecome self-contained rather than relating to the outide community. Rules made for the general good can e oppressive to the individual and it is easy for the ersonality to become ’institutionalised’. The idea that he mentally handicapped have the basic right to live in he community like anyone else, and perhaps even ore need to do so, reinforces the view that they have he same human value and human rights as any other, nd leads to the view that services provided for them ust recognise the essential individuality and specific needs of each patient. Discussion along these lines among professionals in various disciplines and among the parents and voluntary agencies who assist the mentally handicapped has received tacit support from many quarters, not least from the medical profession and from the specialist nursing services. The more practical argument that large scale institutions are essively costly, both in the capital resources needed rovide them, and in the per capita running costs is a persuasive element in discussions with regional health authorities and social service departments. Schemes such as those described below indicate about 42 per cent reduction in revenue cost compared with institutional care. The case for comprehensive, locally-based residential services for the mentally handicapped was given a further boost in March 1980 when a project paper by the Kings Fund Centre was published arguing the case most lucidly on grounds both of economy and of quality of service. At a more emotive level recent television news and documentary pieces have illustrated that it was possible in the past for people with the most mild inadequacies to be incarcerated in large mental institutions for decades, only to be discovered by some progressive consultant and launched into a perfectly adequate lifestyle in independent housing within the community.