Primary Mental Health Care - Essay Example

Primary Mental Health Care The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. So, if a person is not mentally healthy, the topmost care has to be arranged for evaluation of the reason of such illness with all the possible solution and action taken for the purpose with proper methods. A considerable amount of research in the field of prevention and promotion in mental health has been reported during recent years, but most of this research has come from the developed countries with very little from the developing countries (WHO 2002) but the patients in the need of mental health are spread though all the countries and percentage of such persons in the developing and under-developing countries are much supplementary in comparison with the developed countries. So, the need of steps to be taken for the benefit of mental patients at the international level is on high demand to attain a healthy society which is formed by a healthy person. According to WHO (2002) “in order to attain health, improvement of the mental health of individuals is essential” and “this is all the more important because mental disorders are responsible for a high degree of burden due to illness.” Owing to this growing burden of mental disorders, it is essential that effective preventive and promotional measures be taken in mental health to reduce the impact of mental disorders on the individual and society (WHO 2002). At the hour, the need for mental health protocols with a high level standard formulated by expert committee to be developed by an international organization to promote and upgrade the living condition of mental health patients is on high demand. Once the knowledge base for standardized evidence-based programmes has been identified, governments will need to be urged to formulate and integrate policies and programmes related to prevention and promotion in mental health, according to their specific needs (WHO 2002) as the persons who are at the verge of relapse of mental health are very much pathetic due to their recent recovery from the disorder. They have much more prone to go back into their previous mental condition as any newly recovered disease has more intention to regain if proper and ample amount of care is not taken for the prevention and cure. A case study unemployed workers from Jane-Llopis et. at. 2005 will make the situation clear. Case study: the Winning New Jobs Program – promoting re-employment and mental health: The Winning New Jobs Program was developed in the United States to help unemployed workers effectively seek re-employment and cope with the multiple challenges of unemployment and job search (Caplan et al. 1989; Price et al. 1992; Price & Vinokur 1995). The program is based on theories of active learning process, social modelling, gradual exposure to acquiring skills, practice through role-playing, and inoculation against setbacks. Over one week, five intensive half-day workshops are held. The workshops focus on identifying effective job search strategies, improving participants’ job search skills, increasing self-esteem and confidence, and motivating participants to persist in job search activities. Two trainers deliver the program to groups of 12–20 people. The intervention is designed to achieve its goals by creating supportive environments and relationships between trainers and participants and among participants. The program has been evaluated in replicated randomised trials involving thousands of unemployed workers and their partners in the quality of re-employment, increased self-esteem and decreased psychological distress and depressive symptoms over two years, particularly among those with a higher risk for depression (Price et al. 1992). In addition, the program has been shown to inoculate workers against the adverse effects of subsequent job loss because workers gain an enhanced sense of mastery over the challenges of job search (Price 2003). If the reason of the mental disorder is not known and the diagnostic measure cannot be identified for the person but he/she has gained such disorder, then measure are to be taken to reduce the impact of the disorder. It is obvious that “a person may suffer from the signs and symptoms of a mental illness and be dysfunctional, without fulfilling the required criteria to be diagnosed within a diagnostic system. Preventive strategies are usually directed against risk factors, hence need to be implemented at specific periods before the onset of the disorder in order to be maximally effective. However, once the disorder has developed, it is still possible to reduce its severity, course, duration, and associated disability by taking preventive measures throughout the course of the disorder” (WHO 2002). On of the most important and useful therapy for the treatment of mental health patient is Bibiliotherapy, the use of reading of books for a particular person according to his/her situation in life. Studying the mental health history of the patients, proper analysis is done as to give what types of book of what standard of reading so that the mental condition may relate to his situation in life and he/she has some emotional effect on mind and heart by reading such books and in the long run of the process the mental condition may change up to recovery level. M.S. Chellamuthu Trust & Research Foundation 1992 has found out the advantages of such therapy as follows: It is more acceptable to more people and more people will stick to it. More immediate effects than some (particularly antidepressant) medication. No rebound effect (when symptoms return) when treatment comes to an end Tendency to continued improvement over time because people have more information and learn new skills. Lower relapse rates (e.g., reasons as above) No appreciable adverse side effects. No adverse reaction with medication or other forms of treatment. No significant contraindications of when not to use bibiliotherapy, given sufficient literacy and interest, No danger of an overdose Safe in pregnancy!!! The other Advantages of this Therapy are that it assists to stimulate the patrons budding self assurance and boldness. It assembles up a soaring spirits and enhances such qualities as personality, and self-admiration. This therapy also facilitates the patients to obtain updated knowledge there by mounting hope in the psyche. Assembly of twice or thrice a week is done for the persons recognized for this therapy to provide appropriate books for learning and recovery from the disorders. Research in the field shows that self help with book has great impact on the patients with improvement at very high level. According to Darongkamas (2009) “2001 Dept. of Health Policy Research Programme said that most studies reported a significant benefit from self–help materials and that it was “probably safer” if their use was supported by a health-care professional. They suggested that self-help interventions could be a very useful first step in a stepped care approach. There is good evidence for the effectiveness of self help. The level of effectiveness depends on the quality of the book. Effectiveness depends on the person’s motivation and if s/he actively reads and enthusiastically engages, as well as having sufficient literacy abilities. “However, total adherence to a complete programme is not necessary for the person to gain some significant beneficial effect”. The books which are based on self help may well be used for preventive measure for the patients with appropriate topics of literature and motivational matters which have great impact on the heart and psyche of the people. WHO’s World Health Report 2001, which focuses on mental health, also laid stress on prevention and promotion programmes in mental health. It outlined certain interventions that have been found beneficial in this field and called for enhanced research in this area. The need for the use of bibiliotherapy cannot be denied in this preventive measures of the mental health patients. Another way of conceptualising prevention strategies is based on a risk-benefit point of view, i.e. the risk to an individual of getting a disease against the cost, risk, and discomfort of the preventive strategy (Gordon, 1987). The following three categories of primary prevention have been identified, one Universal prevention that targets the general public or a whole population group. Second Selective prevention which targets individuals or subgroups of the population whose risk of developing a mental disorder is significantly higher than that of the rest of the population. And third Indicated prevention which targets persons at high-risk for mental disorders. Secondary prevention refers to interventions undertaken to reduce the prevalence, i.e. all specific treatment-related strategies, and tertiary prevention would include interventions that reduce disability and all forms of rehabilitation as well as prevention of relapses of the illness (WHO 2002). WHO’s World Health Report 2001 shows that the need is to “generate, review and compile evidence for prevention and promotion in mental health; develop appropriate strategies and programmes; facilitate partnerships and collaboration” But if the mental patients are to be treated in long run effectively with a barrier to the process of relapse of such patients, the need for good specialized training to health care professionals is on the sky-scraping requirement. So, in the view of Jané-Llopis (2005) cares have to be taken to “ raise the awareness of primary health care professionals of the reach and burden of mental ill health;” they should be also aware “of primary health care professionals of the relation between physical ill health and mental ill health; “ and should “provide primary health care professionals with a set of skills, tools and strategies based on problem solving skills for mental health promotion and mental disorder prevention to use with patients suffering from emotional symptoms and those who are at risk.” In the 54th World Health Assembly in 2001, Health Ministers from Member States who participated in a Ministerial Round Table Conference on Mental Health, discussed the integration of mental health into primary care and education of the public on mental health. The Ministers identified means by which WHO could provide technical support to countries at global/regional levels. They suggested that WHO “should document effectiveness of interventions with special reference to prevention, treatment and patient satisfaction.” Prevention is concerned with avoiding disease while promotion is about improving health and well being. By identifying the positive aspects of mental health, one can highlight or target the areas to promote and the goals to be attained. It is important to target the positive aspects of mental health, together with targeting the illness. Preventive and promotional elements can be present within the same programme and hold different meanings for two groups of the targeted population. Thus, the two approaches may sometimes involve similar activities but produce different outcomes. For example, a mental health promotion intervention that is aimed at increasing well being in a community may have the effect of decreasing the incidence of mental disorders. Mental health promotion efforts have sometimes been advocated, because they are believed to reduce vulnerability to a disorder and sometimes as an end in itself without the potential to prevent a disorder (WHO 2002). In the long run of identification and support to the mental health patients, the needs and requirements for their well being to live a healthy and people-contacted social life with the main stream personal in the society, the need to take steps for spreading the awareness to the people is not only for the legendary organizations in the world like WHO but also for the common people who are in the vicinity of such retarded persons. The common people have to take care to spread the message to the world. However, WHO has taken initiative measure to give ample amount of effort and research in this field for up gradation and prevention of mental health patients. Various measure and protocols of international level has been provided to reach the aim of the need. The reports and finding of the organization is very much helpful in the formulation of the protocols and rules to make it possible to reach to the common people of need of the society. The call for high thinking to eradicate fully (or at least reduce) the problems of mental health care is not to be decelerated here but to be elevated to such an extent that the bad effects are minimized to extremely low level. References: Caplan, RD, Vinokur, AD, Price, RH & Van Ryn, M 1989, Job seeking, reemployment, and mental health: a randomized field experiment in coping with job loss, Journal of Applied Psychology, 74, 5, pp 759-769. Darongkamas, J 2009, Self help book prescription scheme (bibliotherapy) for primary care, Ms., Consultant Clinical Psychologist, Park House. Phone: 01543 431576, viewed May 11, 2009, http://72.14.235.132/search?q=cache:pp3uzSEyJ4MJ:www.staffordshirementalhealth.info/ftp/document/pdf/jd%2520SELF%2520HELP%2520BOOK%2520PRESCRIPTION%2520SCHEME%2520hubbub%252005042.doc+Consensus+opinion+from+research+evidence+is+that+both+pharmacological/medication+and+psychological+treatments+are+effective%3B+broadly&cd=1&hl=en&ct=clnk&gl=in&client=firefox-a Gordon R 1987 An operational classification of disease prevention. In: Steinberg JA, Silverman MM, eds. Prevention of Mental Disorders. Rockville,MD,Department of Health and Human Services, 1987: pp.20-26. Jané-Llopis, E, PhD & Prof. Hosman C, PhD 2005, Integrating mental health promotion interventions into countries’ policies, practice and mental health care system (the IMHPA Project), Final Report to the European Commission, DG SANCO/G October 25th, 2005, Department of Clinical Psychology, Radboud University Nijmegen , Montessorilaan 3, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands, Tel: + 31 24 361 26 67, Fax: + 31 24 361 55 94, Email: Llopis@psych.ru.n Keleher, H & Armstrong, R 2005, Evidence-based mental health promotion resource, Report for the Department of Human Services and VicHealth, Melbourne. M.S. Chellamuthu Trust & Research Foundation 1992, Bibliotherapy, A Psychosocial Rehabilitation Center”viewed May 9, 2009, http://www.msctrust.org/Bibliotherapy.asp Price, R, Van Ryn, M & Vinokur, A 1992, Impact of a preventive job search intervention on the likelihood of depression among the unemployed, Journal of Health and Social Behaviour, 33, pp 158-167. Public Health Group, 2006 Evidence-based mental health promotion resource Victorian Government Department of Human Services, Melbourne, Victoria, February 2006 State of Victoria, Department of Human Services, ISBN 0 7311 6228 5, Authorised by the State Government of Victoria, 555 Collins St, Melbourne. Also published on www.dhs.vic.gov.au/healthpromotion/ WHO (World Health Organization) 1986. Ottawa charter for health promotion, World Health Organization, Avenue Appia 20, CH-1211, Geneva 27, Switzerland. WHO (World Health Organization) 2002, Prevention and promotion in mental health. Mental Health: Evidence and Research Department of Mental Health and Substance Dependence, World Health Organization, Avenue Appia 20, CH-1211, Geneva 27, Switzerland Tel: + 4122 791 36 25, Fax: + 4122 791 41 60, Email: saxenas@who.int Source for Case Study Based on: (Jane-Llopis, J, Barry, M, Hosman, C & Patel, V 2005, ‘Mental health promotion works: a review’, IUHPE – Promotion and Education, vol. 2, pp. 9–25. 72 Evidence-based mental health promotion resource) Read More