Mental Health Policy in Britain: A Critical Introduction by Anne Rogers

By Anne Rogers

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In 1984 there were 5,045 admissions to authorised private mental nursing homes, and in 1990 there were 4,943 (Faulkner 1992). However, as discussed below, occupancy of private residential (not nursing) homes has dramatically increased. The changing pattern of bed use needs to be seen in the context of the services available for people when they are not in hospital. This takes us to our next section. 2 Community mental health facilities These include residential and day care, community mental health centres and crisis intervention services.

Given the confusion about the purpose of psychiatry and whom it is serving (see above), what is to be investigated by health economists? Is it the improvement in the quality of life of patients or of their relatives? What if these are at odds with one another? What if some interventions are highly effective at suppressing disruptive conduct but have profoundly disabling and distressing effects on their recipients? Whose word is privileged about improvement following an intervention? Is it the word of the patient, or their relatives, or their treating professionals?

We return to these questions in Chapters 7, 9 and 10. The picture of disadvantage also explains, to some extent, why some mental health service recipients become politicised about their oppression and campaign to abolish or reform psychiatry and reverse social exclusion (see Chapter 9). Conclusion This first chapter has introduced a variety of interests in the field of mental health. Competing stakeholder perspectives are more common here than elsewhere. For example, whilst medical knowledge in general is contested by academic sociologists, only a few specific areas of medical practice have evoked a passionate and articulate lay critique, one such area being women's health (particularly about obstetric care) and the other, mental health.

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