Deinstitutionalisation is not only downsizing or even closing psychiatric hospitals, but undertaking a complex process of removing the ideology and power of the institution by putting the person first – with his/her subjectivity, needs, life story, significant relationships, social networks, social capital – above the institution.
In order to do that, it is necessary to remove the power of institutions over people with mental health problems. This requires a shift of resources from hospitals to a range of community based services founded on the whole life needs of the person. This approach opens pathways of care and programmes that integrate social and health responses and actions. Deinstitutionalisation is therefore a whole change of systems, thinking and practice, that aims at overcoming the old psychiatric ideology while creating a new way of supporting community mental health and supporting the self determination,resilience and strengths of people with mental health problems.
A person with a mental health problem has the same basic human needs as all of us. Recognising the whole person is the way to develop and lead a life that is full of purpose, interest, recognition, contribution, value and reward. People with a mental health problem are seeking a whole life comprising of these needs and aspirations. Enabling people to have a whole life opportunity and assisting them in their recovery and wellbeing requires full access to health, educational opportunities, vocational training schemes, work, volunteering, social networks, sport and leisure, art and culture and faith and religion.
The IMHCN Whole Life approach promotes this by applying a Whole Systems methodology in the design, planning and implementation of a comprehensive integrated mental health system. The Whole system has to have an agreed common purpose and objectives negotiated and owned by all community stakeholders. In this way the components of the System are interdependent with each other and have themselves a well defined contribution to the Whole System. The Whole is the most important objective and not each component on their own.
This approach actively benefits from a local communities human, economic, social and cultural resources. All communities have the potential to provide significant opportunities for individuals and families to continue or regain a whole life in all its domains. Ensuring the active participation of organisations and individuals from communities in designing and implementing a whole life whole system strategy lies at the core of the success of this approach.