The development of mental health services in the Wellington region 1945 - 1978

Abstract

This thesis is a socio-historical study which describes and analyses the development of mental health services in the Wellington region from 1945- 1978. It traces the developments in the services from 1945 when they consisted of Porirua Hospital, Observation wards and outpatient clinics in Wellington Hospital and a community group called "Aftercare". These services formed part of the Department of Mental Hospitals. Their overall administration was carried out by the Head Office of this Department whose rules and economic policies dominated activities within the services. The treatments used in the mental health services, the daily activities of the patients and staff, as well as the community's awareness of psychiatric illness and the services available are all discussed in relation to the period 1945-1950s. A number of changes took place in the 1950s; these included new administrative policies and the introduction of new drug therapy (the phenothiazines in 1955). These changes brought about considerable developments in patients living conditions and standards of care; admission and discharge rates were also affected. Considerable staffing problems occurred during this period, affecting both the recruitment and retention of staff. Within the wider community changes in the public attitude began to happen. In the 1960s the greater public interest in mental health together with wider public knowledge about the conditions at Porirua Hospital produced considerable change in the mental health services. The governments response to public awareness of the overcrowding, inadequate sanitary facilities, dirty kitchens and numerous other appalling conditions at the Mental Hospitals was to transfer the administration of Psychiatric Hospitals to Hospital Board control. This occurred in 1972. The transfer of administrative control produced a great deal of change. General hospital psychiatric units were developed and expanded. Wellington obtained a psychiatric unit in 1974. It provided inpatient, outpatient and daycare facilities. Further developments included community mental health facilities, Wellington's "Hillview" being an example of this. The events involved in the development of the services from 1945-1978 are analysed from an organisational perspective. The focus in the analysis is on the structure and process of the mental health service organisation.