In Australia it is widely accepted that having a home is a right not a luxury. But what constitutes as a home? For some severe mental illness consumers their understanding of home may have developed into an image of white walls, brown clipboards, blue gowns and electric beds- a hospital.
The Mental Health and Drug & Alcohol Office NSW Ministry of Health recognises that this is problematic and in June 2014 begun developing a Pathways to Community Living Initiative to address this issue.
The program seeks to offer community living housing to approximately 380 high care, long-term consumers. This is a preferred alternative to providing housing in an acute setting at a mental health hospital.
The project was established through the strategic plan for mental health. It calls for consumers to be assimilated into the community, rather than being kept in hospitals, as it is recognised that hospital environments should be a last resort. Jonathon Harms, CEO of New South Wales ARAFMI and policy developer of the project said:
“It should be more like physical health treatment. If you break your leg they give you surgery and then the 6 weeks of healing takes place back at your home. That’s the way hospitals should function. Sometimes if it’s more severely broken, or if your arm is broken too, then you may need a bit more help for a while because you actually need help to feed yourself and stuff like that.
“But the idea is there is an acute period when you’re very unwell, then you’re given appropriate, intensive assistance and then put back into the community.”
The community living complexes will have different levels of support available, depending on the needs of the patient. This could range from a person being checked on by a health care professional once a day, to the extreme end of the spectrum, where staff is constantly on standby.
Jonathon made note that an important aspect of the initiative is that it seeks to provide consumers with a sense of independence from carers (50-60% of which are the person’s parents).
“For a lot of young people that might have a significant psycho-social mental health disability, or other related issues as well, they don’t want to live with their parents their whole lives.
“We want to create small groups of homes rather than group homes. Some people may unfortunately be so unwell and high risk that they need to be maintained in a locked facility the whole time, but generally that requires years of abuse and failure by the system to get someone that sick.”
Community living environments are also cost friendly. Acute hospital beds are expensive, estimated to cost $900 per patient, per night. Therefore, hospital housing is largely economically unsustainable for long-term patients, who would benefit from transitioning into alternative, community living spaces. Freeing acute hospital spaces for short-term patients would also create a smoother transition into recovery for many people.
One concern Jonathon has is that as majority of the 380 residents taking part in this initiative will be elderly, there could be a contest to avoid of funding the new supports between the aged-care and mental health departments:
“For a variety of reasons aged-care doesn’t do mental health for people with sufficiently acute needs. They tend to think that’s the mental health sector’s problem and mental health thinks that older people are the aged care sector’s problem, so there’s this avoidance of responsibility.
“I always like to say that it’s a complete myth to suggest that we’d find savings is if we worked out which level of government is responsible for what in health and related services. What we’d actually do is present both state and federal governments with a large bill that they wouldn’t be able to avoid anymore, rather than passing the buck between each other. Because really there’s duplication in the paperwork but not the services as far as we can see in mental health and other health related sectors.”
This project has already begun being put into action and the relocation of the 380 patients is striving to be completed by June 2016.
By Ellie Hills
