Managing Madness by Dyck Erika; Deighton Alexander; Lafave Hugh

Author:Dyck, Erika; Deighton, Alexander; Lafave, Hugh
Language: eng
Format: epub
Publisher: University of Manitoba Press
Published: 2017-09-19T16:00:00+00:00

Tearing Down the Walls

Beginning in the early 1960s, a small group pioneered the transformation to community care starting from the base of improved institutional care. Key figures shared an ideology that viewed large psychiatric hospitals as undesirable, in spite of any reforms taking place within them or efforts by Griff McKerracher and others to redistribute mental health care in smaller clinics throughout Saskatchewan. This group saw an expanded role for general medicine and the transfer of some of the care for persons with psychiatric disorders to general practitioners and community hospitals. They believed that all patients referred to a mental hospital should first be seen in their home communities by a team of professionals trained in assessment and able to provide much of the care required in those communities.

The then radical idea that community programs could replace mental hospitals developed in the context of regionalization of health and education services. Regional catchment areas were created, and it became feasible to deliver mental health services on a regional basis. This permitted the province to establish community mental health services according to zones or regions and then direct personnel to fill services in each health region.

McKerracher, in his capacity as head of the Department of Psychiatry at the University of Saskatchewan, had successfully treated mentally ill patients in the psychiatric unit of the University Hospital.51 He was one of the few people of that era who believed that most mental illnesses could be managed in the community with less recourse to psychiatric units in local general hospitals. He also thought that he could not attract enough psychiatrists to Saskatchewan to fill the need, but he believed that family practitioners could be trained to provide most services delivered by psychiatrists. As well, with support from Dr. Sam Lawson and Dr. Charles Jillings, he set up training programs for psychiatric nurses and nursing assistants at Weyburn and North Battleford. Not only did these programs serve to improve the standard of care in the mental hospitals, but also they created a workforce later retrained to become integral parts of interdisciplinary community teams.

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