Sir: Accredited accommodation: an alternative to in-patient care in rural north Powys (Readhead et al, Psychiatric Bulletin, July 2002, 26, 264-265).
Although separated by historical period, civilisation and culture, it is interesting to compare this scheme to a similar one in a developing country. The ‘Aro village’ in Nigeria is set in a semi-rural culture, and operated by the Department of Psychiatry, University of Ibadan. It was pioneered by Professor Adeoye Lambo, an eminent psychiatrist who later became the Deputy-Director of The World Health Organization. This initiative was the very first attempt in community psychiatry in Nigeria (Boroffka & Olatawura, 1976).
As in the case of the north Powys project, Aro village was adapted from the already existing infrastructure of a village community. It offered a social model of care and a rich rehabilitation resource.
Community confidence in the scheme was achieved through liaison between the psychiatrists and the community leaders, a delicate balance between traditionalists and Western psychiatry, a relationship based on trust and the prospect of mutual benefits from the project. In return, the Aro village witnessed infrastructural developments and on-site health clinics. Among other research interests, the project was the subject of an international research collaboration by Leighton et al, 1963.
In a self-funded health economy, patients and their families paid for lodging in the village. The period of stay was longer, at times it ran into years, and some patients relocated to live permanently in the village.
Finally, the benefits were not couched in terms of econometrics, but in the confidence of the rural community to embrace the, then, alien Western psychiatry.