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Table 1 Implementation of General Mental Health Inquiry Recommendations, 1858–1996

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.