Mental Health Policy and Practice in Britain - Research Proposal Example

Table of Contents Research Proposal: Mental Health Policy and Practice in Britain in the Context of Minority Community Attitudes - Access and Treatment for the African Community 2 1.0 Introduction 2 1.1 Importance of the Study 3 2.0 Approach 4 2.1 Scope of the Study 4 2.2 Aims and Objectives 5 2.3 Research Hypothesis 6 2.4 Research Questions 6 2.5 Organisation of the Study 7 3.0 Literature Review 8 4.0 Methodology 10 5.0 Conclusion 11 6.0 Bibliography 12 Research Proposal: Mental Health Policy and Practice in Britain in the Context of Minority Community Attitudes - Access and Treatment for the African Community 1.0 Introduction Since 2000, several European Unions have undertaken a thorough examination of their mental health care system, evaluating the efficiency of the delivery paradigm, its accessibility to society and whether or not supply equally meets the demands of the variant groups within the society. With few exception, the studies demonstrated a clear differential between the accessibility of mental health care services to majority versus minority communities in addition to which, further investigations revealed that the mental health care system was inherently structured towards the confrontation and resolution of the problems particular to the majority community while rarely, if at all, those prevalent among minority ethnic groups (Ager et al., 2002; Campbell et al., 2006; Healy and McKee, 2004; Verhaak, 2004; Noredam, Mygind and Krasnik, 2005). In other words, the mental health care system within EU states is not designed to address the problems which may confront minority ethnic groups, on the one hand, and does not meet the demand of these groups for short-term and emergency mental health treatment, on the other (Verhaak, 2004; Noredam, Mygind and Krasnik, 2005; Rai-Atkins, et al., 2002). Britain is not an exception. According to the UK-based charity organisation, National Association for Mental Health, more popularly known as Mind, the country's African Caribbean community is largely deprived of the mental health care they need. Statistics indicate that the African Caribbean community is overrepresented in mental health care facilities, with there being an overwhelming tendency to diagnose members thereof as suffering from schizophrenia, depression or any of the numerous other mental health problem as require long-term treatment (Reid-Galloway, 2002). The implication here is not that bias among mental health care professionals leads to misdiagnosis but that the mental health care system is simply not, at present, equipped to respond to the immediate problems confronting members of this community and offer them the care they need prior to the compounding and escalation of the problem (Reid-Galloway, 2002; Tucker, 2002; Seedhouse, 2002; Rai-Atkins et al., 2002). As Reid-Galloway (2002) and Rai-Atkins et al. (2002) explain, members of this minority group confront a wide range of societal and occupational stress, whether as a consequence of racism or cultural alienation and subsequent social exclusion, which places them at high risk of mental health problems. The fact is, however, they are not receiving the requisite mental health care with the consequence being the escalation of the mental health problem, with the outcome being the earlier referenced over-representation in mental health care facilities (Reid-Galloway, 2002). 1.1 Importance of the Study The importance of the study immediately derives from the nature of the above-articulated problem. The African Caribbean community in Great Britain is, as a minority group, being effectively deprived of their right to quality mental health care as addresses their specific communal needs. Insofar as the research shall elucidate upon the referenced failure, its consequences and examine possible solutions and mental health policy reforms, it is deemed both important and valuable. 2.0 Approach As Creswell (2003) contends, it is contingent upon a researcher to clearly articulate the aims and objectives of his/her study and delineate its scope in order to avoid loss of focus. This is precisely what the current section aims towards. 2.1 Scope of the Study As may be inferred from a wide array of literature on mental health services in Great Britain, the system is beset with numerous problems. The most critical of these is, without doubt, the inherent inability of the system to fulfil current demand for services and to address the variant mental health problems which specific ethnic, age or socio-economic groups are susceptible to (Ensor and Cooper, 2004; Firth, 2004; Jacobsen, 2002; Glasby and Lester, 2005). An examination of the various challenges confronting the mental health care delivery system and its failures to address communal needs is, however, beyond the scope of the present study. Proceeding from within the confines of the earlier articulated problem, the dissertation will focus upon the examination of the mental health problem confronting the African Caribbean community in Great Britain and whether or not the health care delivery paradigm facilitates access to this group on the one hand, and addresses their specified needs on the other. The aforementioned assessment shall necessitate a review of the operative mental health care policies in the UK. It should be noted that since the study's scope, as articulated in the preceding paragraph, intends to overview the status of the African Caribbean community in relation to this particular problem, the exigencies of collecting relevant primary data from community members are inarguable. The likelihood of satisfactorily doing so, however, given time constraints and the size of the community, is slim. Consequently, the research shall focus upon policy analysis and on the critique of published literature. Within the context of the stated, therefore, and in order to avoid the drawbacks of collecting non-representative primary data as would yield lopsided results and lend to erroneous conclusions, the scope of the research is limited to secondary data collection and policy analysis. 2.2 Aims and Objectives Within the contextual parameters of the articulated study scope, the dissertations proposed objectives are as follows: An explication of the current mental health care delivery paradigm and policies in the UK as a means of identifying the source of its inherent inability to meet the demands of the African Caribbean community; An examination of the occupational, societal and cultural mental health risk factors confronting Britain's African Caribbean community and how the mental health care system may most effectively and efficiently address them; An articulation of the consequence of the failure of the operative health care delivery paradigm and system upon the African Caribbean community and how current overrepresentation in long-term mental health care facilities is an immediate outcome of the mentioned failure; An exploration of the requisite policy and structural reforms as would resolve the defined problem. 2.3 Research Hypothesis The operative mental health care structure and delivery paradigms, concomitant with the policies foregrounding it, are inherently geared towards the service of a homogenous population and, accordingly, are incapable of meeting the specified communal needs of Britain's African Caribbean community, with the consequence being their greater susceptibility to critical mental health problems, culminating in their overrepresentation in long-term mental health care centres and programmes. 2.4 Research Questions The dissertation's proposed research questions are immediately informed by the earlier mentioned objectives and hypothesis: To what extent do the current mental health care policies constrain the ability of the system to address the particular communal needs of Britain's ethnic minority groups Why do minority groups, such as the African Caribbean, tend towards greater susceptibility to mental health problems than the majority communities How and why has the mental health care system failed to address Britain's African Caribbean community's mental health care needs How may policy and structural reforms correct the defined problem 2.5 Organisation of the Study The dissertation shall be divided into five chapters. The first chapter shall define the research problem, investigate its background, outline the scope of the study while elucidating upon its limitations. The second chapter, or Methodology,' shall articulate the dissertation's research questions, hypothesis, theoretical approach and data collection methodology, further explicating the ethics governing secondary data collection, analysis and usage. The third chapter, the literature review, shall overview a select, but representative number of published studies and researches on mental health policy in Great Britain, the system's operational and delivery paradigms and, most importantly, shall critically review research on the mental health problems confronting the country's African Caribbean community, concomitant with a review on the literature pertaining to the failure, and reasons thereof, of the system to address and resolve these problems. The fourth chapter, or Discussion and Results,' shall expound upon the secondary data collected and earlier presented, with the purpose being the provision of direct responses to the articulated research questions and the proposal of possible solutions to the articulated problem. The fifth chapter shall conclude the study. 3.0 Literature Review The mental health care profession in the UK is structurally incapable of meeting the variant demands of the society's multitudinous ethnic groups, each of whom has its own specified problems (Laurance, 2003). Having been designed to operate within the bounds of a relatively homogenous society, the ever-evolving culturally and ethnically dynamic nature of British society is largely, if not entirely, ignored. Within the matrix of a demographically and ethnically fluid social structure, the mental health care system has remained static, culminating in a systemic inability to address societal mental health care needs (Ridsdale, 1998; Burton, 1998; Laurance, 2003). Concurring with the above assessment of the state of Britain's mental health care system, numerous mental health scholars, practitioners and social workers have expressed concern regarding the effect of the stated on minority groups. The majority of these groups are exposed to a number of societal, cultural and occupational risk factors which renders them more vulnerable than most to the development of mental health problems. Be it the young, the adolescent, the adult, the middle-aged or the geriatric, Britain's ethnic group members are confronted with discrimination, are excluded from mainstream society, are generally unemployed and poor and, in numerous cases, have to contend with having to live in a society whose cultural rules they do not understand and whose language they barely comprehend. The aforementioned contributes to the development of numerous mental heath problems, from depression to schizophrenia to sociopathology (Bowes and Dar, 2000; Bowes and Sim, 2005; Campbell et al., 2006; Chandola et al., 2004; Mold, 2005). Britain's African Caribbean community has suffered, and continues to, the consequences of the mental health care system's innate inability to address minority community needs. Research on the mental health state of this particular ethnic group has reached the unanimous consensus that the country's operative mental health care delivery paradigm does not meet the demands of this group and is not equipped to deal with their immediate, and often urgent, psychological problems (Laurance, 2003; Rai-Atkins et al., 2002; Reid-Galloway, 2002; Hatloy, 2002). In the absence of immediate access to mental health care and, more specifically, a health care system which understands the particular risk factors to mental health they are confronted with, problems are allowed to fester and develop into conditions which require long-term, often inpatient, treatment (Reid-Galloway, 2002; Hatloy, 2002; Rai-Atkins, et al., 2003). It is within the context of the articulated failure that the overrepresentation of African Caribbeans in Britain's mental health care centres, programmes and institutions must be understood. There exists a wealth of literature on the imperatives of reforming the operative mental health care delivery system and paradigm to better address and resolve the mental health care issues particular to minority communities (Kalman, 2004; Greenberg, 2005; Baldwin, 2004; Rai-Atkins et al., 2002; Ridsdale, 1998). Proposals for reform have ranged from the adoption of community nursing services within areas of minority group clusters (Baldwin, 2004), to the adoption of occupational mental health services (Greenberg et al., 2005; Kalman, 2004), and to the complete overhaul of the current system and the policies foregrounding it (Laurance, 2003; Seedhouse, 2002). Controversy and debate, as may be inferred, characterise the discussion on solutions but consensus surrounds arguments pertaining to both the presence of a problem and its nature. 4.0 Methodology The methodology will be immediately informed by the nature of the articulated research problem, and shall be framed by the study's selected objectives, hypothesis and research questions. To this end, the dissertation shall adopt a mixed methodological approach, bearing in mind Creswell's (2003) advice against imposing a stringently defined and specified methodology upon any given study, insofar as doing so may limit exploration of alternate viewpoints and perspectives. Consequently, the theoretical framework shall combine between such policy analysis theory as conceptual theory, causal theory, theory of knowing and normative theory. While the research shall be entirely desk-based and data shall be drawn from published literature, clearly defined ethics guidelines must be followed. As Creswell (2003) notes, researchers tend to presume that the ethics of data-collection, presentation and analysis pertain only to primary data ad quantitative analysis. However, this is not true. Secondary data collection and analysis must unfold within equally well-defined and stringent ethical guidelines, such as impose upon the researcher the exigencies of reviewing authorial qualifications and integrity, prior to the selection of the literature for review, analysing the authority of the references cited by each and every piece of literature included in the research and, above all, accurately and objectively presenting that literature and reviewing arguments on both side of the issue (Creswell, 2003). These ethical requirements shall form an integral part of the research methodology and shall, indeed, determine the methodological parameters. 5.0 Conclusion As may be inferred from the above, the dissertation intends to focus upon the mental health problems confronting the African Caribbean community and expound upon the extent to which the current paradigm has contributed to the escalation and prevalence of the stated problems. In testing the hypothesis and responding to the selected research questions, the study shall undertake a thorough mental health policy analysis, in an effort to identify policy shortcomings and required reforms. In the final analysis, the value of the proposed dissertation will lie in its clarification of the multi-dimensional nature of the problem and in the subsequent proposal of possible solutions. 6.0 Bibliography Ager, A. et al. (2002). Community contact and mental health among socially isolated refugees.' Journal of Refugee Studies, 15(1), 71-80. Retrieved March 1, 2006 from Oxford Journals. Baldwin, R. (2004). Does a nurse-led mental health liaison service for older people reduce psychiatric morbidity in acute general medical wards A randomised controlled trial.' Age and Ageing, 33(5), 472-478. Retrieved March 1, 2006 from Oxford Journals. Bowes, A.M. and N.S. Dar (2000). Researching Social Care for Minority Older Ethnic People: Implications for Some Scottish Research.' British Journal of Social Work, 30, 305-321. Retrieved March 1, 2006 from Oxford Journals. Bowes, A.M. and D. Sim (2005). Advocacy for black and minority ethnic communities: Understanding and expectations.' British Journal of Social Works, 1-17. Retrieved March 1, 2006 from Oxford Journals. Burton, M. (1998). Psychotherapy Counselling and Primary Mental Health Care: Assessment for Brief or Longer-Term Treatment. London: John Wiley and Sons Ltd. Campbell, J. et al. (2006). International perspectives on the use of community treatment orders: Implications for mental health social workers.' British Journal of Social Work, 18(1), 1-18. Retrieved March 1, 2006 from Oxford Journals. Chandola, T. et al. (2004). Does conflict between home and work explain the effect of multiple roles on mental health A comparative study of Finland, Japan and the UK.' International Journal of Epidemiology, 33, 884-893. Retrieved March 1, 2006 from Oxford Journals. Creswell, J.W. (2003). Research Design: Qualitative, Quantitative and Mixed Method Approaches. California: Sage Publications. Ensor, T. and S. Cooper (2004). Overcoming barriers to health service access: Influencing the demand side.' Health Policy and Planning, 18(2), 69-79. Retrieved March 1, 2006 from Oxford Journals. Firth, M.T. (2004). Non-statutory mental heath social work in primary care: A chance for renewal' British Journal of Social Work, 34, 143-165. Retrieved March 1, 2006 from Oxford Journals. Glasby, J. and H. Lester (2005). On the inside: A narrative review of mental health inpatient services.' British Journal of Social Work, 35, 863-879. Retrieved March 1, 2006 from Oxford Journals. Greenberg, N. et al. (2005). Does having an occupational mental health service make any difference' Occupational Medicine, 55, 549-551. Retrieved March 1, 2006 from Oxford Journals. Hatloy, I. (2002). Statistics 3: Race, culture and mental health.' Mind Information Unit. Retrieved March 2, 2006 from http://www.mind.org.uk/Information/Factsheets/Statistics/Statistics+3.htm Healy, J. and M. McKee (2004). Accessing Health Care: Responding To Diversity. Oxford: Oxford University Press. Jacobsen, L. (2002). Tackling teenage turmoil: Primary care recognition and management of mental health during adolescence.' Family Practice, 19(4), 401-409. Retrieved March 1, 2006 from Oxford Journals. Kalman, C. (2004). Report of a system for diagnosis, categorizing and recording occupational mental health.' Occupational Medicine, 54, 464-468. Retrieved March 1, 2006 from Oxford Journals. Laurance, J. (2003). Pure madness: How Fear Drives the Mental Health System. London: Routledge. Mold, F. et al. (2005). Minority ethnic elders in care homes: A review of the literature.' Age and Ageing, 34(2), 107-113. Retrieved March 1, 2006 from Oxford Journals. Noredam, M., A. Mygind and A. Krasnik. (2005). Access to health care for asylum seekers in the European Union - A comparative study of country policies.' European Journal of Public Health, 9(1), 1-5. Retrieved March 1, 2006 from Oxford Journals. Rai-Atkins, A. et al. (2002). Best Practice in Mental Health: Advocacy for African Caribbean and South-East Asian Communities. Bristol: The Polity Press. Reid-Galloway, C. (2002). The African Caribbean community and mental health in Britain.' Mind Information Unit. Retrieved March 1, 2006 from http://www.mind.org.uk/Information/Factsheets/Diversity/The+African+Caribbean+Community+and+Mental+Health.htm Ridsdale, L. (1998). Evidence-Based Practice in Primary Care. London: Churchill-Livingston. Seedhouse, D. (2002). Total Health Promotion: Mental Health, Rational Needs and the Quest for Autonomy. London: John Wiley and Sons Ltd. Tucker, C.M. (2002). Expanding pediatric psychology beyond hospital walls to meet the health care needs of minority ethnic children.' Journal of Pediatric Psychology, 27(4), 315-323. Retrieved March 1, 2006 from Oxford Journals. Verhaak, P.F.M. (2004). Demand and supply for psychological help in general practice in different European countries.' European Journal of Public Health, 14, 134-140. Read More