Australian National Mental Health Care - Literature review Example

Running head: Australian National Mental Health Care Plan 2009 Name Course Lecturer Date Introduction The public policy process is usually continuous, iterative, incremental, inherently political, as well as subject to recurrent reviews. As such, it should be positioned appropriately enough to deal with practically identified needs within a society. This is by creating a structure and basis on which the authorities fund and plan operations meant for addressing the problem. Thus, it is imperative for the public policy process to be evidence-based. Developing and implementing evidence-based policies requires that the process is based on practical and empirical input from the realistic scenario as well as the stakeholders. However, more often than not, this rhetoric is hardly matched with the reality so that there is rare integration of evidence into the policy, both in its development and implementation. This paper is an analysis of the Australian National Mental Health Care Plan 2009, ‘The Plan’. The Plan is formulated in view of guiding the reforms and key actions identified in the National Mental Health Policy (2008). In a nutshell, the Plan has five key priority areas. These include enhancing social inclusion and recovery of mentally ill persons, prevention, care access and continuity, quality in innovation and improvement and accountability. It identifies these areas as being core in improving mental health care in the country. As such, this is a national plan, to be implemented even in territorial and governments. The paper is a case study of the Plan identifying various aspects of the Plan related to its target problems, stakeholders, procedures and processes and its effectiveness. More aptly, the paper evaluates its effectiveness in dealing with a practical need and problem within the Australian society. Case Study of the Plan According to Bowen & Sainsbury (2005), public policy making is a complex process and oftenly a daunting task for authorities. The complexity results from the interplay of various stakeholders and competing forces. Essentially, it must appreciate how the people, interest groups, politics and process relate, as well as the central role of evidence as the common focus of these stakeholders and forces. Evidence should also be provided as a rationale for the needs identified. The Plan is established on a backdrop that one in five Australians suffer from a mental illness annually and that there are more expectations from the governments, nationally and regionally. This number reflects the wide range between mild and severe illnesses for both childhood and adulthood. This translates into high economic costs and burden to families, communities, health care systems and governments. In addition, the statistics of persons requiring mental health care brings a challenge to the appropriation of mental health care due to fast changing global, national and local environments. According to Coveney (2010), health care environmental changes are second nature for many health care groups and management necessitating policy plans. As such, the Plan envisions a flexible approach to addressing the challenges in care access, quality and accountability. By addressing the five priority areas, the Plan collectively envisions systematic improvements in mental health care access and delivery. Coveney (2010) suggest three approaches to policy analysis: ‘What’s the problem approach, governmentality approach and policy cycle. The What’s the Problem approach was suggested by Carol Bacchi focusing on problems identified within a policy. This explores the rationality of problems addressed in the policy from various conceptualizations as well as the underlying assumptions leading to the conceptualization and representation. In the Plan, the five priority areas are the problems identified by the governments in view of implementation of the 2008 national policy. The Plan identifies mentally ill persons as suffering from social exclusion with reference to employment, housing, income and health. As such, there scenario is one of inequities in the access to social services relative to other citizens. These inequities are in the backdrop of acknowledging the rights and needs of all Australians regardless of social environment outcomes. According to Australian Nursing Federation (2009), factors in the social environment are outstanding determinants in primary health care access and quality. Secondly, there is need for prevention and early intervention of the illnesses. This need addresses preventative actions required to reduce the prevalence of the illnesses, and their impacts. Thirdly, the Plan addresses the need for continuity in care and service access while at number four, it acknowledges continued improvement and innovation. Fifthly, and most importantly, there lacks adequate accountability with reference to progress achieved. According to Townsend, it is vital for the Australian government to address professional and community concerns over access difficulties, quality care, funding and accountability and social exclusion of mentally ill persons (Townsend, et al., 2006). Health care planning and delivery has been, over time, characterised by issues of lack of equity. There are persistent differences between citizens due to varying situational factors. The mentally ill, receiving the focus in the Plan has equal rights as others in need of health care and other social services. By establishing the Plan in the context of rights and social inclusions, the Plan identifies the denial of rights of these people and seeks to protect them. Rights and service equity are some of the key principles upon which the Plan is scheduled. This derives from the National Policy which schedules rights and responsibilities for mental health care consumers. In Jones (2009), literature indicates that equity is vital in development and incorporates entrenchment of equal chances for all and equal concern for their needs. However, there is always a gap between the implications of the meaning equity and reality in planning and implementation. As such, disadvantaged persons will often access poorer services (Whiteland, 2000). In view of this, the Plan approaches the issues of rights from a wide spectrum so that mental health care is equitably accessible across all demographics. The context refers to all age groups, communities, areas, as well as diversity of culture, social orientation and experiences. In delivering the equity of chance and access, the plan acknowledges the importance of partnerships with various cross-sectoral stakeholders. This is emphasised in priority area 3 which focuses on delivering care and service interventions to the mentally ill. As such, the stakeholders identified in this juncture are carers, consumers, funders and service providers. Apart from these stakeholders being involved in delivery and continuity of support, they form the key element with reference to accountability. The stakeholders comprise a complex mix with as complex diversity of interests thereby requiring the diversified engagement and accountability (Friedman & Miles 2006). Whereas the Plan does not elucidate the specific contrasting in the complex mix of stakeholders, it is emphatic on their common interests. Mental health care consumers are the most important stakeholders, with this group comprising the common interests of other stakeholders. This conforms to normative stakeholder theory which entrenches establishing common good of a society amongst contrasting interests. The Plan is an implementation strategy for the 2008 National Policy. The Policy entrenches the introduction of a new approach to mental health care, thereby underlining key policy directions. These directions are differentiated in the priority areas for which the Plan stipulates desired outcomes, indicators, strategies and target group. Policies are effective to the extent that there is planned implementation, monitoring and evaluation. Literature refers to this as function allocation which establishes a relationship between desired outcomes on one side, and resources of all types, techniques, responsibilities and processed on the other (Malone & Heasly, 2008). For each priority area, there are outcomes, indicators and shared responsibilities to various target groups and stakeholders. For instance, priority area 5 revolves around accountability and monitoring. The desired outcome is a public which is well informed about services performance and progress of the National Policy. As such, the key actions include development of a regular national reporting system, developing delivery system that is accountable, developing mental health information to empower reporting and accountability, and performing continuous evaluation of Plan’s progress. For these outcomes, the plan tasks the health sector as the main actor, in relations to other sectors. This requires a cross-portfolio implementation which is a multi-level approach involving both the policy level and its implementation by health care providers. In addition, it is effective to the extent that it addresses the challenges and that there is monitoring (Biggs & Helms, 2007). As such, it is evidence-based and targets to meet social, technical and budgetary indicators (Graham, 2011). In the opinion of this critique, the Plan is set for effectiveness although it does not necessarily have precise statistical indicators. Its indicators and benchmarks may be used as a basis for the more precise results. In conclusion, this paper has presented a case study analysis of the Australian National Mental Health Care Plan 2009. The Plan is an implementation strategy of the 2008 National Policy mental health care. It identifies the social and economic challenges emanating from people with mental illness in Australia from both a national and regional outlook. As such, it sets forth five priority areas under which it delineates specific challenges, desired outcomes, activities, strategies, processes, responsibilities, target groups and stakeholders. The stakeholder mix is complex. However, the Plan addresses them from the point of view of the common element: consumers. By so doing, the strategies represent an effective function allocation focusing on the commonality of interests thus converge the diverse interests. A policy is effective to the extent that it is evidence-based thus dealing with a real challenge and it identifies strategies and procedures by which to achieve established standards. References Australian Nursing Federation, (2009). Primary health care in Australia: A nursing and midwifery consensus view, Rozelle: Australian Nursing Federation. Biggs, S. & Helms, L. B., (2007). The practice of American public policymaking. Armonk: ME Sharpe. Bowen, S. Z. A. & Sainsbury, P., (2005). What evidence informs government population health policy? Lessons from early childhood intervention policy in Australia. NSW Public Health Bulletin, 16(11-12), pp. 180-184. Coveney, J., (2010). Analyzing Public health policy: Three approaches. Health promotion practice, 11(4), pp. 515-521. Friedman, A. L. & Miles, S., (2006). Stakeholders: Theory and practice. New York: Oxford University Press. Graham, R., (2011). Complexity, institutions and public policy : agile decision-making in a turbulent world. Cheltenham: Edward Elgar. Malone, T. & Heasly, C. C., (2008). Function Allocation: Policy, Practice, Procedures, & Process. Naval Engineers Journal, 115(2), pp. 49-62. Townsend, C. et al., (2006). Stakeholder concerns about Australia's mental health care system. Australian Health Review, 30(2), pp. 158-163. Whiteland, M., (2000). The concepts and principle of equity and health, Copenhagen: World Health Organization. Read More