The Lunacy Commission was set up following the 1845 Lunacy Act. This Government appointed group of lawyers and doctors oversaw the conditions of the asylums in England and Wales. Appointed commissioners would visit the hospitals twice a year their main objective was to ensure that the hospitals ran safely and efficiently particularly in regards to treatments. The reports raised concerns particularly with Patients being certified insane, suicide prevention and excessive force when restraining/subduing those in the asylum. The report highlighted that a good amount of furniture had been provided for the use of inmates.
The government took over the building of asylums eliminating private enterprise.
The government passed legislation to regulate activities in 1845 and 1853 Hospitals were also registered for the first time. In 1890 the Lunacy act of 1890 was passed in response to public concerns that some patients were being wrongfully detained particularly women who had very little rights, women who were wealthy could fall victim to financial abuse through private arrangements her husband could have his wife certified insane and locked away clearing the way for himself to inherit any financial benefits. Although great strides were made protecting the rights of inmate’s privacy was minimal there was usually 50 inmates to any one ward, privacy was minimal, unit wings were closed to patients with each ward/wing being placed under lock and key.
1961 is considered as the year attitudes towards for institutionalized mental healthcare was changing. Enoch Powell had been appointed health secretary in 1960 and was given the task of reforming the nations crumbling health services, including the Mental Hospitals. During the conservative party conference in March 1961, Powell criticized the asylums.
He spoke of the transition to community based care, the horror that asylums inflicted on patients, Enoch Powell proposed a radical vision towards community health care, not only reducing costs to the state (Powell envisioned 15,000 fewer psychiatrists) and reducing psychiatric beds by 50%. Powell’s next point was regarding those he described as the ‘sub-normal’, and the requirement to assess their needs and develop a more concise understanding of the issues faced in managing and caring for those individuals. Powell also advocated community services and better co-operation between local authorities and medical staff. Powell believed that services should be more flexibility in regards to the services offered and the services should be more person-centered fitting the services to suit the induvial needs and rights.
Under the 1990 National Health Service and Community Care Act any adult aged 18 or over who is eligible for and requires services from their local authority have the right to have their needs assessed and be fully involved in the arrangement of services advocates also can play a vital role in ensuring their opinion is respected, and any plan is implemented to enable individuals to live as independently as possible the community care act of 1990 emphasized the importance enabling and tailoring support and services around the needs of individuals. Assessments are reviewed every year, unless there is change of circumstances or the individual or local authority feel another review would be beneficial.
Importance of Human Rights approach to care
The human rights approach within care allows support workers to “realize the potential” of service users, highlighting the importance holistic care and taking a holistic approach to care it emphasizes the importance of taking someone’s emotional, physical, spiritual needs of an individual. Although a support worker may care for the physical needs of a patient due to any physical disability, such as assisting with washing or preparing meals a human rights approach advocates the importance of taking into consideration dietary requirements such as the individual being a vegetarian or observing religious traditions such as a Muslim or Jewish service user not consuming pork. The service provider would also not discriminate against any service user because of their religion, sexual orientation or any criminal convictions. This allows services to feel comfortable with services available and can raise complaints or seek support without fear of reprisals or intimation, this not only promotes the individual’s dignity but also their human rights.
Underlying principles of Human Rights
The underlying principles of human rights particularly in relation to care can be broken down into the acronym PANEL.
- Participation: Service users should as far as possible participate in the review of their care especially when their needs are being assessed and services are being allocated to offer the appropriate support that the individual requires.
- Accountability: Services are held accountable by governmental appointed agencies such the care inspectorate in Scotland Set up by Scottish Government, and accountable to ministers, they ensure assure and protect everyone that uses these services. Using the person-centered approach to care and having a holistic view of care allows the service users understand what is expected of them when they receive support and services.
- Non-Discrimination: The service provider would also not discriminate against any service user because of their religion, sexual orientation or any criminal convictions.
- Empowerment: Services should empower the individual to make their own choices, such as how they dress, plan activities that suit their individual tastes and choices emphasizing individuality and choices.
- Legality: Service providers/Employees follow the law and strictly enforce the recommendations ensuring the safety of service users and employees are strictly adhered to reporting any cases of assault, abuse or offences.
My Practice’s Human Rights approach
Enablement: I assist the service user to make and achieve their goals but they don’t do it for them they encourage them to fulfil them themselves with the support needed. It is important that the care worker works in partnership with a range of integrated services, such as occupational therapist, to assist in meeting the service user’s needs. I will try to uphold the service user’s independence and encourage them to achieve their goals. I ensure that I encourage the service user whilst supporting them rather than doing it for them.
Non-Discrimination: Service users have the right to live in an environment free from harassment and discrimination so it is important that the care worker considers all factors so that all their spiritual, cultural and religious needs are met. Service users have the right to complain without being discriminated against if they have not received the care that they are entitled to or if they have been discriminated against. I aim to treat the service user with equality and diversity. I will ensure that I do not discriminate against any of the service users and I will embrace the diversity of the service user’s disabilities, sexual orientation and religious beliefs and focus on their induvial needs rather than their lifestyle.
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