Part 6: Rehab and Reality.

Community Rehabilitation - The Modern Way..

Rehabilitation generally refers to helping an individual learn or regain those skills required for more independent living. In Mental Health it is a process of working with people to help them regain control of their lives which psychiatric illness (and sometimes institutionalisation), has taken away.

Andy knew a lot about de-institutionalisation. It had been the buzzword when he had trained in the 1980s. At nine syllables long it was one of the longest words he knew. And he also knew you'd be counting them out on your fingers as he completed the end of the sentence. See..nine.

The eighties had been a time of revolution in psychiatric - sorry, Mental Health care. The language was changing, the asylums were closing and erstwhile patients were being discharged into commmunity care and this was consideredf a very good thing.

Any mental health nursing student worth his or her salt disparaged long-term psychiatric inpatient care and any psychiatric luddites (read: backwater staff) who dared to ever support it. We loudly championed deinstitutionalisation! throughout our assignments. Just as three decades later any self-respecting student would ferociously ejaculate the mantra of the new Recovery Model, whilst scrutinising seasoned clinicians for any signs of dissension from The New Order.

Andy mused that the streets were once again awash with babies and bathwater..

In theory the idea of getting people out of the psychiatric hospitals and into environments promoting choice and freedom had been a decent one. For centuries people had been labelled as 'mad' and 'insane' and locked away from society's gaze (out of eye, out-of-mind) in distant institutions. Now it was time to return them to the loving communities from whence they came, who would of course embrace then with open arms..

And Random House was one such place. An environment where the previously incarcerated would be able to learn to reintegrate into polite society, to shop, get haircuts, drink beer and wank openly. Except of course the people - the locals - didn't want them there for some reason. It had been a time of fine hypocrisies indeed. A time of "Yes, these people should be back in the community where they belong" but "I don't want them near me."

Andy and his kind had fought the good fight to get people with mental illness accepted into the community. An important stock-in-trade part of the job had been to advocate for the cause. Of course, he mused, there were client advocates to do that now..

"Hey cheer up Nurse Andy!" said a bright apparition standing at the office door. "Wot you got to be so down in the dumps about?"

Andy looked up at Catty, a lifelong Bipolar (amongst other things) sufferer whom he had looked after on-and-off for nearly twenty years. Catty grinned back maniacally through a mask of Max Factor's finest.

"Come and give us a hug Andy Pandy! I heard you was on tonight. You doin' the night shift again..? We've got sandwiches for supper tonight and I've been cleaning my room up with the day staff. Come and have a look.."

Snapped from his reverie, Andy got up and returned the hug, "It's good to see you too.."

You can take the person out of the institution..



Other Links

Further writings on a theme..

I See Dead People

And there it is. The table. A table with the white sheet over it. Slightly familiar ripples in the cloth hint at what might lie below..   [link]


However, contrary to popular belief, the operation was not only used on psychiatric patients..   [link]

Gallows Humour

The nurses and doctors just sit down, but the patient puts a newspaper down first and then sits down..   [link]

Drayton Olde Lodge

In June 1469, King Edward IV rode from Norwich to Walsingham and cast a lofty eye across the ruined lodge..   [link]

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