Mental health not for privatization

How many of you have seen a movie where a mental health institution and/or a patient plays a central role in it? What about a movie about an escaped mental institution patient who has an assortment of officials after them – the tough official who thinks only of the threat the person might/not pose; the medical officer or social worker aware of the patients history and is more interested in their safety; the police officer who is responsible for apprehending (if that is the appropriate word in this context)the patient?

Very often I wonder how accurate Hollywood portrayals of these institutions are. The people who run them are swathed in regulations that place all sorts of restrictions on what they can/not do. Did the Members of Parliament or the Ministers of the Crown in the case of New Zealand, whilst writing or reviewing legislation, ever think to visit a couple of these places to try to understand issues from the perspective of staff and management?

What I cannot possibly see is how anyone will gain ethically from privatizing mental health services, which I believe the recent contracting out of mental health services is a first step towards. A dollar driven mental health sector is at risk of patient and staff exploitation. It sends the wrong signals to the community at large about how they should view the patients and the institutions that house them. Although through advanced economics it might be possible to place a dollar figure on the value of our mental health services, is it actually appropriate to try?

When I look at mental health institutions, I see a critical part of the health infrastructure too valuable to be played with by profiteers. I see the institution that will hopefully provide a safe environment for those with issues that mean that it is not safe for them to be in public. I see the institutions that are supposed to hold those who might committed criminal offences, but were mentally incapable of comprehending what they were doing, and thus not able to stand trial or stood trial and were found not guilty by reason of insanity. I also see a sector of health that is grossly misunderstood, constantly subject to criticism by arm chair critics.

Mental health patients are quite varied in their behaviour. Some can be incredibly productive in terms of their day to day output in that they might for example be writing a story and churn out several pages a day. Some might have suffered a brain injury that never healed. Others might be too unstable to leave a visitor alone with them. However they behave and whatever the cause of their mental state – post traumatic stress disorder; narcotics overdose – they are human beings and have the same right to be treated with dignity and respect as any other health sector patient.

And yet we hear of people falling through the cracks so often that one can only wonder about the state of this much maligned and yet very important sector of N.Z. medicine. Monetizing its performance expectations – which I am fairly sure that is what this Government wants to do – will not solve the problems. It will not stop someone being Hannibal Lecter. Nor will N.Z. society be better for it.


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