Responding to External Environment of Mental Health Services - Essay Example

?Responding to the External Environment of Mental Health Services in the UK I. Introduction Governments worldwide are being called upon to tighten spending for public services. The call comes as a direct result of government budget deficits and the perceived correlation between government budget deficits and vulnerability of societies with large budget deficits and crises. The concern has become extremely important as the United States’ sub-prime crisis evolved into a world financial crisis. The UK is one of the countries that have been affected by the world crisis. Partly as a response to the crisis and partly because of a concern for efficiency and judicious use of public funds, the UK government implemented austerity measures in public spending and in spending for mental health services in particular. Mental health is “a state of well being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (World Health Organization 2004, citing its earlier work in 2001). Despite the importance of mental health and a claim by Chantrill (2013) that the UK health budget has increased, Healthcare Today (2012) reported that UK government spending for mental health dropped by 1% in 2011-2012. According to Healthcare Today (2012, 2nd paragraph), “expenditure on mental health for the elderly was particularly affected, decreasing by 3.1% to ?2.83 billion.” II. External Policy Environment and Mental Health in the UK Given an external policy environment of austerity and yet providing the mental health services at high quality, several policy thrusts have been articulated. One of the policy thrust is indicated in the document, Working our way to better mental health: A framework for action, produced in 2007. The document recognizes that “poor mental health is very common” in the United Kingdom (Burnham & Cooper 2007, p. 7). In the estimate of the Secretaries of the Department for Work Pensions and the Department of Health, “at any one time, one in three of our working-age population may be experiencing some kind of distress or mental health condition such as depression” (Burnham & Cooper 2007, p. 8). This is significantly large and is basically saying that mental health problems are highly prevalent in the working age population. Worst, the document pointed out that “mental ill-health is now the most common reason for claiming health-related benefits and 86 percent remain on the benefits for more than three months” (Burnham & Cooper 2007, p. 8). Burnham & Cooper (2007) that evidence show that the longer people are out of work because of mental ill-health, the less likely they have a chance of returning back to work. This indicates that policy must be designed to allow people with ill mental health to return to work as soon as possible, provided that support mechanisms are in created such that therapy continues while a person is at work. Related to this, the National Mental Health Development Unit (2009a) emphasized that work is good for people with mental problems. It also pointed out that “people with mental health conditions can and do work, with many thousands of people with mental health conditions working in a broad range of roles” (National Mental Health Development Unit 2009a, p. 4). Thus, the key message of the National Mental Health Development Unit (2009a) material is that “work is good for mental health and is central to recovery for people with mental health conditions” (p. 4). Meanwhile, McDaid (2008) pointed out that although death rate from suicide in the United Kingdom went down by at least 20% in 2010, the problem is still bad because “1 in 10 children and young people aged 5-16 had a clinically recognizable mental disorder” (p. 1). Further, 14% of the population of the United Kingdom “have or had chronic anxiety or depression, and 12% say that they are undergoing medical treatment for this reason.” To facilitate the quick recovery of people affected by various types of mental illnesses, one of the policy reforms that the United Kingdom has undertaken in recent years is the adoption of community-supervised treatment based on the Mental Health Act of 2007 (McDaid 2008). Complementary to the policy, The Department of Work and Pensions (2009b) highlighted the need for better employment support for people with mental health conditions. III. Framework for Advancing Health Service Reforms Wheelen and Hunger (2012) informed us that in executing any management decision, it is important to scan the external environment of the organization for external variables that can affect management decisions. Analyzing the external environment is useful for identifying threats as well opportunities that can arise. Policy can be a source of opportunities as well as threats. In the external environment we have identified, it is clear that although austerity constitute a threat to government funding of programs for mental health, we can attribute to the same policy, the current movement to emphasize on continuity of work for persons with mental health problems, the emphasis on preventive measures and mental health services in workplaces and schools. Thus, while there are threats produced by the external environment, the same policy environment produced opportunities. IV. Recommendations Given the external environment and framework for advancing health reforms, several measures can be advanced. Although I am psychiatrist working in the private sector in the United Kingdom, it is my professional interest to promote mental health both in the private and the private sectors. In my view, there are at least six measures that can be advanced to promote mental health. Some of the measures can be adopted by the private sector while others can be adopted by government. First, private voluntary organizations must be tapped for donations as well as creating mental health services programs to supplement government initiatives and services in mental health. Second, to the extent feasible, mental health services program should be redirected to emphasize on the preventive rather than on the curative aspects of mental health and private voluntary organization must be mobilized to provide services in this area. This may mean, for example, that counseling services should be initiated in the localities. Government, for example, can focused on training and accreditation of counseling groups, professionals and volunteers rather than actually funding the counseling organizations, professionals and volunteers although government may provide the skeletal or basic personnel. Those that can be tapped to provide free or inexpensive counseling services include the religious organizations, civic groups and business organizations oriented to charity. Third, health insurance companies should be tapped to cover or expand its coverage of mental health services that can be covered by the health insurance policies. Government can tap the health insurance companies through regulations and encouragement. To identify what the insurance companies can cover, a study must be conducted what the insurance companies currently cover and what they may be able to cover. Fourth, government through regulation may require that offices and workplaces must see to it that offices with a certain sizes like 150 personnel, for example, are provided with psychiatrists or psychiatric services. In implementing or finalizing this recommendation, however, a study must be conducted. The study must carefully study what firms can afford as well as the needs associated with a large workforce. Fifth, government can require all offices and workplaces with certain sizes like 50 personnel, for example, to have mental health programs instituted in their offices. To ensure that offices and workplaces will have the capability for instituting mental health programs, government can also require that offices and workplaces attend seminars on mental health and techniques for formulating simple and practical mental health programs in the workplaces and offices. Sixth, schools and educational institutions should be required to have a mental health programs in place and schools of certain sizes should hire or retain a psychiatrist in their workforce. That schools must have mental health services is something not new; Weist and Murray (2007) reported that there have been significant advances in schools with regard to the promotion of mental health. However, what seems to be missing is for policy to explicitly define that schools have the responsibility of promoting mental health among children or students enrolled in their schools, regardless of whether the schools are private or public. Related to the task of promoting mental health in school, the Department of Children, Schools and Families (2008) emphasized that ample evidence exist that programs targeted for promoting mental health in schools work. It is likely that the six recommendations advanced in this work do not exhaust the measures that are possible to implement to keep government costs low in providing mental health services even as the quality of health services are either maintained or even upgraded. The mental health workers in the field and science probably have the answers on how costs can be kept as low as possible while maintaining or even upgrading the quality of mental health services. Thus, complementary to the six recommendations forwarded herein, government must continuously sponsor public consultations with agenda of eliciting suggestions and recommendations on how public services can be upgraded while keeping the costs low. Meanwhile, in managing my work at the clinic where I work, I believe that one good interpretation of the policy environment is that the focus or emphasis of my professional work and that of my colleagues in our clinic should be on the following. First, my professional practice and that of my office can increase our emphasis on prevention of mental illnesses. This can be done by sponsoring preventive seminars or lectures. I can increase the volume of my work on helping organizations and offices prevent or cope with mental ailments or even set up mental health promotion programs in offices and workplaces. Second, my professional practice and that of my office can be more oriented on allowing patients to work as soon as working becomes possible and this would imply that the stress of work must be on designing services that can be done after work or, preferably, during work hours. As I see it, the major point highlighted by the external policy environment is that the emphasis of mental service delivery must be on providing the mental service while the patient is at work. This is a major change in the external environment resulting from a policy change. Finally or thirdly, I have to work closer with insurance companies covering mental health services and our clinic must do the same. As an immediate measure, we have to identify the insurance companies covering mental health services. In conclusion, while policy in the external environment produces constraints, opportunities are also created. The opportunities created can be exploited as soon as an organization modifies its mission based on changes in the external environment. References Burnham, A. and Cooper, Y., 2009. Working our way to better mental health: A framework for better mental health. London: The Stationery Office. Chantrill, C., 2013. Public spending details for 2013. Available in http://www.ukpublicspending.co.uk/uk_health_care_spending_10.html (Accessed 25 January 2013). Department for Children, Schools and Families, 2008. Targeted mental health in schools project. Nottingham: DCSF Publications. Department for Work and Pensions, 2009. Realizing ambitions: Better employment support for people with a mental health condition. London: Department for Work and Pensions. Healthcare Today, 8 August 2012. Mental health expenditure falls for the first time in 10 years. Available at: http://www.healthcare-today.co.uk/news/mental-health-expenditure-falls-for-the-first-time-in-10-years/22486/ (Accessed 25 January 2013). McDaid, D., 2008. Mental Health Briefing Sheets: Facts and Activities in Member States. Available at http://ec.europa.eu/health/ph_determinants/life_style/mental/docs/UK.pdf (Accessed 25 January 2013). National Mental Health Development Unit, 2009a. Work, recovery & inclusion. London: National Mental Health Development Unit, National Health Service. National Mental Health Development Unit, 2009b. The Commissioning Friend for Mental Health Services. London: National Mental Health Development Unit, National Health Service. Weist, M. and Murray, M. (eds.), 2007. Advances in school mental health promotion. Stafford: The Clifford Beers Foundation. Wheelen, T. and Hunger, J.D., 2012. Strategic management and business policy. 13th ed. Pearson. World Health Organization, 2004. Promoting mental health. Geneva: World Health Organization. Read More