Mental Illness Pros And Cons

The definition of mental illness or a psychological disorder refers to the distress, impairment and atypical behaviour of an individual over a period of time. This definition has changed throughout history. The different definitions have caused much controversy in the views and treatment of the mentally ill. These views and treatments have been both disgusting and caring (Barlow & Durand, 2016). Events, such as the institutionalisation and deinstitutionalisation of mentally ill patients have had important effects on the development of mental illness as a phenomenon as a whole.
Institutionalisation and deinstitutionalisation are forever evolving concepts. They can both have negative and positive connotations and both are very important when
evaluating certain situations involving either one, or both.
Institutionalisation looks at political control and social oppression. It is a social process where structured policies, programmes and practices are enforced to create legitimacy in society. The process of institutionalisation is held in place by society and can sometimes end up being taken for granted and achieve a law like status. Institutionalisation is also referred to as a way of infusing value to activities and structures in the mental health sector. This then leads to an emergence of an orderly and stable pattern of institutionalised mental health care, out of disorderly patterns of deinstitutionalised mental health care (Shen & Snowden, 2014).
When looking at institutionalisation in psychiatry it has been a constantly changing definition. During the 1950s, the life of psychiatric patients was seen only in institutions. These were seen as more like prisons than hospitals for the mentally ill. Psychiatric institutions created a closed system that kept the patients apart from the outside world and therefore a patient’s life was dictated by the institutional schedule. The staff would physically, emotionally and socially abuse the patients which would lead to a loss of self and the gain of the stigma attached to being a psychiatric patient. This, in turn, led the stripping of the patients’ social roles and to their dependency on the institutions and the staff. These terrible conditions of institutions and the high costs involved brought about deinstitutionalisation and the establishment of community based care. There is also a more positive connotation linked to institutionalisation, in which the institution just wants to care for and help the patient, but somehow, along the way, this changes into something more dark. Today, it is said that the need for institutionalised care is becoming more prevalent because these community based care foundations are beginning to be connected to the negative connotation of the traditional view of institutionalisation. Therefore we can conclude that the term institutionalisation is an ever changing concept (Chow & Priebe, 2013).
Deinstitutionalisation refers to policies that mandate shifts from institutionalised practice of caring to care by the community. It is dependent on funding, politics and opinions of health care professionals. The biggest opponents to deinstitutionalisation are psychiatrists and psychiatric nurses. This is not only because their business would decrease, but also because they fear for the patients’ safety and treatment. Most funding for the deinstitutionalisation process would come more from government through tax payers and less out of the patients’ and their family’s pockets. Deinstitutionalisation is starting to happen worldwide, mostly in first world countries. It can be defined as the process of moving the care of mental health patients from an institutional caring environment into a community based caring environment. This has both positive and negative effects on the patients and significant other involved (Shen & Snowden, 2014).
This process is easier said than done. For deinstitutionalisation to be a success there needs to be adequate funding in place for the community alternatives (Dvoskin, Bopp & Dvoskin, 2011). There is a lack of coordination between closing down institutions and building up community based care. Governments are downsizing institutions before the communities are ready to receive patients. This has resulted in the transfer of mentally ill patients to nursing homes, community hospitals, households, prisons and assisted housing. This is also known as trans-institutionalisation (Shen & Snowden, 2014). Deinstitutionalisation caused a rise in homelessness and criminalisation of people with severe mental illness (Barlow & Durand 2016).
Deinstitutionalisation occurs when the costs of care in institutions become too intense and therefore leaves insufficient support and provision for current, future and discharged patients.
There are many needs that were never considered when governments decided to deinstitutionalise, for example: housing, employment and social integration and support and treatment of patients focuses on those who have less severe mental illnesses. Recently, those countries that have already started to implement deinstitutionalisation have begun to consider all these factors to ensure the correct treatment of mentally ill patients. There are both pros and cons to this process. The cons are that there seems to be an increase in homelessness in places where deinstitutionalisation has occurred, as well as an increase of criminalisation of those with mental health issues and those with mental health issues seem to be dying earlier than the average person. Another issue with this process is that people are expecting a quick fix or inexpensive solution to mental health issues and therefore, it is difficult to gain support and funding from the people in the communities. The pros of this process are that if it is done right there are multiple rehabs programmes, support groups, clinical and housing that lead to results of patients being able to live better lives (Dvoskin, Bopp & Dvoskin,
2011).
There seems to be a need for re-institutionalisation as the community health and care services were not competently equipped to deal with the influx of mentally ill patients (Shen & Snowden, 2014).
These two factors are both very important in the treatment and view of the mentally ill over time.