Evaluating the Effectiveness of Young Male Mental Health Service in Residential Care - Case Study Example

Evaluating the Effectiveness of Young Male Mental Health Service in Residential Care in the UK Date: Abstract This evaluation was carried out to investigate the effectiveness of residential mental health care facilities for males in the UK. It is based on literature review. The literature sources were taken from the internet to form an evaluation of the effectiveness of the mental health care for males in UK. A discussion was then made in light of the literature review. A suggested evaluative research plan is also found in this article, which was made with help of information obtained during the literature review. It is hoped that this literature review and suggested research plan will come in useful for further studies related to this topic. Introduction: Mental Health: The WHO (2010) defines mental health as a state of well being in which a person is aware of his own potential and is able to cope with daily life situations. A mentally healthy person is an asset to the society, not a liability (WHO, 2010). A Mentally healthy person plays his role fully in the society. Taylor and James (1977) have outlined following characteristics of mental health: Ability to enjoy life Ability to Bounce back from Adversity Maintain Balance in life Flexibility Self actualization Following is a description of all the components of mental health: Ability to Enjoy Life: A mentally healthy person is able to enjoy life at the fullest. Such persons do not linger on small problems, rather they ignore problems and they enjoy small joys. They have a general positive attitude towards life and they don’t keep complaining (Holmes 2010). Bouncing Back from Adversity: Bouncing back from adversity is a major component and a symbol of positive mental health. If an unfavorable event occurs in their lives, mentally healthy people recover from it very soon and they do not indulge in self pity. They come back to their normal self very quickly (Holmes, 2010). Maintenance of balance in Life: Mentally healthy people lead balanced lives. They do not indulge to the limit in anything. All their choices and decisions in life are balanced. They neither over do anything, nor neglect anything too much. These are level minded people who control the course of their lives very much by themselves (Struzik, 1999). Flexibility: Mentally healthy people have flexible personalities. They have good adaptability skills. They usually readily adapt to changes in their lives and they have a positive attitude towards changes (Holmes 2010). Self Actualization: Self actualization refers to recognizing and reaching one’s maximum ability and potential. It is the highest point of Maslow’s Hierarchy pyramid. Mentally healthy people recognize what they are good at. They are aware of what they can achieve, and they go for it (Struzik 1999). Aims: The study aims at finding out major problems which young residents of mental health homes are facing. It aims at conducting a detailed literature review and forming an evaluation plan about the effectiveness of mental health institutes. Goals and Objectives: Goals and objectives of the current study are to highlight the problems being faced by young males living in mental health care institutes via reviewing the current literature, with reference to what they have already gone through. It is hoped that this study will come in useful for such facilities to improve their services in the future. Ethics: It is the duty of mental health care homes to assess and evaluate their patient services from time to time and to inform the authorities about them so that some action might be taken for improvement (APA, 2006). For ethical considerations in the current evaluation proposal, permission will have to be sought from the mental health care institute’s authority to interview the young males who were randomly selected. An informed consent will be taken from the subjects and then the data will be collected and analyzed. Limitations: Mental health care residencies in UK have a lot of limitations; (Mind, 2009) these include lack of well trained staff, a general lack of empathy among the staff, lack of proper resources to cater the special needs of its residents and lack of proper communication with the residents (Mind, 2009). These problems are even more enhanced when it comes to male patients. Males usually don’t contact social support systems such as residential mental health care programs unless and until they feel that now their situation is out of their control (Wolkind and Rushton, 1994, cited in Philips, 1999). This magnifies the problems because males in such institutions are usually less than females, but are more chronic logically since they are less expected to seek help. Following limitations also apply to this study: It is only a review of literature on already conducted researches on the similar topics. More detailed research must be conducted on the topic for further enlightenment. Literature Review: Mental health problems can affect the whole life of individuals (Rcinfo, 2010). Many studies as reviewed below, have been conducted in the past, investigating different issues related to mental health. Following is a review of some such studies: Franz and Barker (2009) conducted a study to identify different Barriers to Care for Primary Care Physicians Treating Patients with Alzheimer Disease. They concluded that the main problems were access to and communication with mental health specialists, poor reimbursement policies, and uneven geographic distribution of well trained staff in such facilities. The lack of such facilities clearly indicates that the mental health care services are not very effective. According to the World Health Organization (2009), there is gender bias in treatment of psychological disorders. There is a trend in doctors to diagnose depressive disorders in women, and not in men even if they show similar symptoms. There are also gender differences in who seeks help. Women are more likely to seek psychological help as compared to men (WHO, 2009). There is considerable amount of bias against people with mental health problems among the health service providers in UK. As cited in the ‘Science daily’, Dr Alex Mitchell and his team conducted a study in 2009 to investigate hindrances in access to proper mental health care services. They found out that in spite of more frequent medical visits, there is discrimination in the quality of psychological health services delivered to those with psychiatric illnesses and poor care than offered to those patients who have pre existing health problems. (Mitchell, 2009). In a study, Kovess (2007) found out that factors like age, education and social support also affect the seeking of professional mental health services .he also found out that often people with mental health problems contact a general practitioner instead of a psychologist for the resolution of these problems. This indicated the presence of bias among the service seekers against their own mental mental illness. Due to Gender roles assigned by the society, among patients with mental health problems, women are more likely to report as compared to men (Bader, 2009). In 2009 a research was conducted by Bader and Sinha. Their study was manifold and was conducted on an Iraqi sample. One of their many findings was that the interviewers seeking mental health services were twice as likely to be females. (Bader & Sindha, 2009). HARP conducted a DH funded study in 2003. Its purpose was to identify Bridges and Barriers into mental health of asylum seekers. They concluded that most of the male patients do not seek mental health or are very reluctant in doing so because their cultures assign them roles in which they are not expected to do so. (Harp, 2003). This shows that it is already difficult for most males to seek mental help. Logically it will also be difficult for them to complain about the poor condition of services provided to them. A study (as cited in Dr Anderson’s article) on ‘Quality of and access to health care services’ was conducted by HEALTH QUEST under the European Commission. This was aimed at analyzing the barriers of access to mainstream health care services for people at risk of social exclusion. Eight countries were studied in depth. They found out that there was a very complex situation in providing health care facilities to migrants. One issue was of multicultural setting. The migrants had communication issues. They couldn’t understand instructions or tell their problems properly. Second problem was that the professionals had no information of their medical history and also no way to attain it. So, along with bias, cultural issues like language and brought up style also pose a barrier in providing health care services. Sometimes the mental health providing facilities have so complicated procedures of admission, that the help seeker is discouraged automatically. (Croucher, 2007). The forms required to apply for mental health services are too long and inappropriately designed to be filled by mental health patients or their care takers. (Croucher, 2007). A study by Gordon Paul, conducted in 1988, cited in Neal & Davison (Ninth edition) suggests that even in the best residential mental health care homes, the Patients do not have optimum contact with therapists or psychologist. The clinical staff spends what is even less than one fourth of their total working hours with the patients. Suggested Evaluation Plan: Methodology The suggested methodology for this evaluation is Qualitative, through interview. Qualitative Research Methods: Qualitative research is a scientific research which attempts at understanding and seeking answers to a given problem of a local population. (Fhi, 2009). Qualitative research uses many data collection methods common of which are; Interviews, focus groups and Participant Observation. (Fhi, 2009). The data collection method used in the suggested research will be of semi structured interview. Semi Structured Interview: Since this is a qualitative study, it will employ qualitative methods of data collection. Best method for such a study is that of semi structured interviews, because such a schedule provides an opportunity to the interviewer to obtain maximum information of diverse nature out of the subject (CHSD, 2007). In semi structured interview, the interviewer makes an outline of some basic questions in form of a schedule and keeps that schedule with him/her while interviewing (CHSD, 2007). The sequence of questions might be altered during the interview according to the situation (Fhi, 2009). The interviewer has the freedom to add or subtract any questions from the schedule in accordance with the course of dialogue with the subject (Fhi, 2009). If the interviewer feels during the conversation that the subject is reluctant in answering a certain question he can omit that question from his schedule (Fhi, 2009). Contrastingly, if the interviewer feels that the subject is more willing to talk about a certain issue; he can add more questions related to that (Fhi, 2009). The aim of the interviewer in semi structured interview is to obtain maximum information from the subject and the interviewer has the authority to change his flexible interview schedule accordingly (CHSD, 2007). Semi structures interview is a very suitable method of data collection for this research since it attempts at exploring the topic (CHSD, 2007). The researcher is not looking for any specific answers; rather an attempt is being made to find out whatever there is to know about the effectiveness of mental health care residential institutes for males, and to have an insight of service user perspective (CHSD, 2007). Procedure: (Applying Qualitative research method in the current, suggested research). A sample of males seeking mental health care in the UK must be drawn. These males will then be interviewed. The interviews will be semi structured in nature and a suggested sample semi structured interview form is attached in the appendix. The age group should be between 14 and 20 years since the target sample is youth. The interviews should explore the different facilities and services at the residential health care systems for males to give a complete picture of effectiveness of the systems. Results: The results will be compiled and presented in an organized manner after a careful analysis of all the interviews obtained in the study. Expected Findings: In light of literature review, following are the possible expected findings and a result of this evaluation: 1. Patients might report that they are not allowed to see the psychiatrist frequently. 2. Patients may complain that the psycho therapy sessions they receive are too few. 3. Bias and rudeness on behalf of staff might be reported. 4. Complains about the general hygiene of residential mental health care facilities might be expected. (These are not real, only the expected findings devised as mentioned above, in light of the literature review). Discussion: Service provided to young males in mental health care institutions in UK is not as good as it is expected to be. “We have seen many cases where the provision of health care to asylum seekers has fallen significantly short of what would be accepted as a minimum standard of care under international human rights standard” (Joint Committee on human rights: evidence. P.173) Mental health is a very vast term and residential mental health care professionals need to focus on all the aspects of mental health (Mind, 2009). Residents in such institutes require proper guidance and counseling. They will not benefit from the facility if a professional is not available for them most of the time. Some patients who are not native face language issues. Such residencies should hire proper professionals and possibly an interpreter for such patients. (Mind, 2009). Bias among the staff was also highlighted in the literature review. If the professional mental health staff will be biased against people having mental health issues, then there is little chance for a life time betterment of patients (Kovess, 2007). Such young males are already subjected to a lot of bias and criticism that can have a lasting effect on their lives. They deserve a bias free environment at least inside the facility (Kovess, 2007). One good thing about the mental health care institute that was made knowledgeable during the literature review is that the professionals over there arrange meetings with the patient’s relatives and care takers from time to time to educate them about mental health issues that their dear ones are facing (HARP, 2003). Suggestions: In the light of Literature review and discussion, following suggestions are made for the institutes: 1. More professionals should be hired for the facility and subjects should have free access to professional help. 2. The facility should be lighted properly and should be colorfully decorated for good impact of the residents. 3. The staff hired should be unbiased. 4. A doctor should be hired and should visit weekly to check the medical condition of the subjects. 5. General hygiene of the institute should be improved. 6. Some recreational activities must be introduced and if possible, some technical education should be imparted to the subjects during their stay in the facility. 7. Some nature field trips should be arranged for the subjects, this will have a very positive impact on the mental health of subjects. 8. Proper psychotherapy sessions should be conducted in the residency. Following are some suggestions for further research on the topic: 1. Mental health institutes in the main city area should also be researched on and findings should be compared to these findings. 2. If possible, the care takers of patients should also be interviewed. Conclusion: In light of literature review and above discussion, it can be concluded that despite providing mental health care and facilities to young males, mental health care residential homes need to be improved. Hiring of professional, un-biased staff is required (Kovess, 2007). Availability of and access to well trained psychologists and psychotherapists is a must (Mind, 2009). Young males are more open to therapy as compared to medication, so counseling sessions should be encouraged (HARP, 2003). Some residential mental health care centers do not fulfill the needs of the patients. They should increase their funding to meet the basic needs of the residents. On the whole it can be said that these institutes have both, merits and demerits. Some issues like biased attitude, availability of professionals, enough psychotherapy sessions and physical requirements in such facilities need to be addressed. References: Anderson E. Stanciole, Manfred Huber; 2009. Access to health care for migrants. Policy Brief. (Internet). Available at: http://www.euro.centre.org/data/1254748286_82982.pdf. (Accessed: 20 may 2009) APA 2006. Psychiatric services.(Online). Available at: http://psychservices.psychiatryonline.org/cgi/content/full/57/4/552 (Accessed 29 June 2010). Bader F, Sinha R; 2009. Psycho-Social health in displaced Iraqis’. Pubmed. (online). Available at : http://www.ncbi.nlm.nih.gov/pubmed/19806555. (Accessed: 20 may 2010) CHSD, 2010. Qualitative research methods. Information Bulletin.(Online).Vol I. available at: http://chsd.uow.edu.au/Publications/2007_pubs/care_planning_info_bulletin_1.pdf (Accessed 20 May 2010). Croucher, G. 2007. The challenge of helping asylum seekers. ASPA Conference. (Internet). Available at: http://docs.google.com/viewer?a=v&q=cache:tdsC0kpPXDAJ:arts.monash.edu.au/psi/news-and-events/apsa/refereed-papers/au-nz-politics/croucher. (Accessed: 20 May 2010) Delphine,S & Viviane,K 2007. Motivating Factors for Mental Health. BMC Public Health. (Online). Available at: http://www.medscape.com/viewarticle/563591. (Accessed: 20 May 2010) Fraz, C.E & Barker, J.C 2009. When help becomes a hinderence. American Journal of Geriatic Psychology.(online).Abstract from Geriatic Psychiatry Database. Available at: http://journals.lww.com/ajgponline/Abstract/publishahead/When_Help_Becomes_a_Hindrance__Mental_Health.99920.aspx. (Accessed 20 may 2010) Fhi. 2009. Qualitative Research Methods. (Online). Available at: http://www.fhi.org/NR/rdonlyres/etl7vogszehu5s4stpzb3tyqlpp7rojv4waq37elpbyei3tgmc4ty6dunbccfzxtaj2rvbaubzmz4f/overview1.pdf (Accessed 12 July 2010). HARP, 2003. DH. (Internet) Available at: http://www.networks.nhs.uk/uploads/06/03/refugeeconf/lane.ppt (Accessed 20 May 2010). Holmes, L 2010. What is Mental Health. (Online). Available at: http://mentalhealth.about.com/cs/stressmanagement/a/whatismental.htm (Accessed: 29 June 2010). Joint Comitee on Human Rights.Provision of health care 10th report of session 2006-2007. (Internet) Available at: http://books.google.com.pk/books?id=p_m-YfqqPmsC&pg=PA173&dq=problems+faced+by+mental+health+care+seekers&hl=en&ei=2KD1S5ycGMufrAeNgIX3Cg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC4Q6AEwAA#v=onepage&q=problems%20faced%20by%20mental%20health%20care%20seekers&f=fals(Accessed: 20 may 2010) Kovess, V 2007. Differences in Lifetime Use of Services for Mental Health Problems in Six European Countries. (internet). February 1st 2007. Available at: http://psychservices.psychiatryonline.org/cgi/content/full/58/2/213. (Accessed: 14 July 2010). Mind 2009.Young people and mental health. (Internet). Available at: http://www.mind.org.uk/help/people_groups_and_communities/children_young_people_and_mental_health (Accessed 29 June 2010). Mitchell, A 2009. ‘People With Mental Health Problems Receive Inadequate Medical Care’. Science Daily. (internet).June 4, 2009. Available at: http://www.sciencedaily.com/releases/2009/06/090602083721.htm (Accessed: 20 May 2010) Neal & Davison 1997. Abnormal Psychology. (Ninth Edition). Available at: www.wiley.com/college/davison (Accessed: 21 may 2010) Philips, J 1999. Meeting the psychiatric need of children in foster care. (internet). Available at: http://pb.rcpsych.org/cgi/reprint/21/10/609.pdf. (Accessed 14 july 2010). Rcpsych 2003. Mental health. (Online). Available at: http://www.rcpsych.ac.uk/files/pdfversion/cr112.pdf (Accessed: 29 June 2010). Struzik, I 1999. Self Actualization as predictor of Mental Health. (Online). Available at: http://www.questia.com/googleScholar.qst;jsessionid=Mq6JYLJv7DQ2KX4GQj9HkGzWTl26TthF5xrGqwHsQyGhK10vD17q!-289140146!1566849592?docId=5001829727 (Accessed 29 june 2010). Taylor & James 1977. Secret of life album. (Internet). Available at: http://mentalhealth.about.com/cs/stressmanagement/a/whatismental.htm (Accessed 21 May 2010) WHO, 2010. Gender disparities and mental health: The Facts. World Health Organization.(online). Available at: http://www.who.int/mental_health/prevention/genderwomen/en/ (Accessed: 20 May 2010) Appendix: Example of a semi structured Interview schedule: Name:_____________ Institute:________________ Psychiatrist’s Name:_____________ How long have you been here? Where is your Family? How did you come here? Was it easy for you? Are you happy here? Are you facing any difficulties here? Would you prefer to be home? Do you find it easy to talk to the in charge here? Do they listen what you say? Do you think your condition is improving here? Etc…. The interviewer can write some basic questions, then he/she can devise more questions at the spot to steer the conversation with the subject so as to obtain whatever information is being seeked. Read More