From: The place of public inquiries in shaping New Zealand's national mental health policy 1858–1996
INQUIRY | KEY RECOMMENDATIONS | IMPLEMENTATION |
---|---|---|
Select Committee (1858) | ||
Establish colonial lunatic asylum. | Accepted 1858 but not implemented. | |
Appoint commissioner to choose site. | Implemented 1858. | |
Obtain expert advice on asylum design and organisation. | Implemented 1858. | |
Adopt comprehensive and liberal treatment in asylum. | Accepted and applied variably by provinces. | |
Amend lunacy law. | Implemented 1858. | |
Revise lunacy law entirely. | Implemented 1867–8. | |
Joint Committee (1871) | ||
General government to ensure proper provision for lunatics where provision inadequate. | Limited to guidelines before 1876 and direct management of asylums afterwards. | |
Appoint specialist psychiatrist to supervise and control all asylums. | Implemented 1876. | |
Obtain more information before making decision about central asylum. | Implemented 1872–4. | |
Improve all asylums, especially Karori (Wellington). | Left to provincial governments. | |
Board of Health Committee (1957–60) | ||
Increase general hospital acute psychiatric beds in four main cities immediately. | Implemented progressively under hospital capital works programme. | |
Develop regional psychiatric units and outpatient clinics in 6 other cities. | Implemented – first unit opened 1963. Divisional outpatient services expanded as staffing permitted. | |
Establish staff in the units as per staff: patient ratios. | [Implemented]. | |
Establish child psychiatry units in four main centres when staff available. | Adopted but implemented through child health clinics. | |
Intensify specialist staff recruitment. | Ongoing implementation. | |
Second mental hospital staff to psychiatric units. | Implemented for first units then phased out. | |
Improve public attitudes towards mental illness. | Accepted. Intensified public relations with World Mental Health Year 1960. | |
Relax legal restrictions on patients' personal rights. | Implemented 1961. | |
Royal Commission (1972–3) | ||
First report | Continue mental health lead by way of allowance. | Adapted. |
Improve psychiatric hospital staffing to eliminate need for pay differential. | Accepted. | |
Set up independent study of poor working conditions that affect staff shortages. | Adapted then rejected 1975. | |
Review differential conditions of employment. | Implemented. | |
Review entry requirements to encourage recruitment of male psychiatric nurses. | Reviewed for more consideration. | |
Study extent of recruitment problem. | Adapted then rejected 1975. | |
Second report | Establish national Institute of Psychiatry. | Referred for consideration by key agencies. |
Advise those concerned without delay. | Implemented. | |
Third report | Undertake national survey of service needs of mentally handicapped patients in psychiatric hospitals. | Implemented 1973–4. |
Progressively move multiple-handicapped patients to general hospital care. | Deferred pending survey results. | |
Care for dual diagnosis or behaviourally disturbed mentally handicapped patients in general or psychiatric hospitals. | Deferred pending survey results. | |
Develop appropriate placements at home in foster home, community house or small special purpose institution. | Deferred pending survey results. | |
Discontinue practice of placing mentally handicapped patients in psychiatric hospitals. | Deferred pending survey results. | |
Transfer responsibility for mental handicap services from Health to Social Welfare Department. | Adapted for inter-departmental consultation. | |
Place moratorium on psychopaedic hospital development. | Implemented 1973. | |
Discontinue hospital model of care for mentally handicapped. | Addressed through national needs survey. | |
Actively promote measures to prevent mental handicap. | Required further investigation. | |
Teach medical students modern views on management of mental handicap. | Required further investigation. | |
Urgently support home care, IHC facilities, small homes and hostels under national plan. | Accepted in part but subject to needs survey results. | |
Ministerial Inquiry (1995–6) | Inquiry team should monitor implementation of its recommendations. | Rejected. |
Increase mental health funding between $125–140 M. over 5 years. | Adapted. | |
Ring-fence mental health funding. | Rejected. | |
Establish Mental Health Commission and National Advisory Board. | Adapted. | |
Request MHC to prepare national blueprint for mental health services. | Implemented 1998. |