Mental Health Priority Areas - Coursework Example

Mental Health Priority Areas Student’s Name: Grade Course: Tutor’s Name: Date: Introduction Mental health in Australia is a public health area that has attracted attention from policy formulators, health workers, and the society in general. Partly, the attention in the area is inspired by the serious nature of mental illnesses and the consequences they have on the sufferers, their carers and other people in the society. According to Groom, Hickie and Davenport (2003), the quality and nature of services given to mentally ill people can mean the difference between willing to live or die. Quoting the chairperson of the Australian Mental Health Consumer Network, Ms. Connor, Groom et al (2003) observe that neglect, rejection or ignorance to the plight of mental health consumers by mental healthcare service providers is sufficient enough reason for them to feel dejected to the point of committing suicide. To a mentally healthy person, such drastic consequences may seem unjustifiable especially because they seem to be caused by lack of empathy from the service providers; to the mental healthcare consumers however, the lack of empathy further complicates their struggles to find acceptance, support and understanding from the society. Australia has a mental health policy that is depicted as being among the best in the world (Groom et al., 2003). To the citizenry who have been subjected to the policy however, it failed to address some issues that were paramount to their well being. Such issues included variable service quality, restricted access, poor continuity of mental healthcare, insufficient support, and human right abuses during care (Groom et al., 2003). It is for such reasons that the Commonwealth Government identified five priority areas as needing the most attention in so far as the provision of mental health services was concerned. The first priority area addresses social inclusion and recovery of mentally ill persons, while the second priority area seeks to address matters pertaining to the prevention of mental illnesses and early intervention. The third priority area targets “service access, co-ordination, and continuity of care” while the fourth seeks to address matters pertaining to quality improvement and innovation in mental healthcare provision. The fifth and final priority area seeks to address matters of accountability. This essay will start by giving a brief introduction into all five priority areas. Two priority areas will then be chosen and the policy rationale, theoretical underpinnings and practice implications explored. The essay will also investigate the links that the two identified priority areas will have with the national Practice Standards for the Mental Health Workforce (2002), and the Revised National Standards for Mental Health Services (2010). The five priority areas i. Social inclusion and recovery Social inclusion and recovery has been identified as the first priority area that social stakeholders need to address. Here, it is expected that the community will better understand the significance of mental health and the consequences of mental illnesses. It is also expected that people with mental health problems will experience improvement in their interaction with the larger society especially when seeking employment, housing and health. Additionally, it is expected that healthcare service delivery will be more organised in order to ensure that the country coordinates care in all social and health domains. To help in the attainment of the outcomes identified under the “social inclusion and recovery” priority area, the National Mental Health Plan (NMHP) identified key actions that should be taken. They include the reduction of stigma through civic education, coordination of vocational, education and employment programs for people affected by mental illnesses, improvement of coordination between specialist mental health providers and the care givers, and the adoption of “a recovery oriented culture within the mental health services” (Commonwealth of Australia, 2009a, p. iv). Other actions that need to be taken include the development of integrated approaches among sectors such as aged care, community, justice and housing in order to reduce the social disadvantage risks that mentally ill people are exposed to. Finally under the first priority area, the NMHP report identifies the development and implementation of a “Social and emotional well being framework” for Aboriginal and Torres Strait Islanders as an action that should be taken if at all social inclusion and recovery from mental illnesses is to be attained. ii. Prevention and early intervention Prevention and early intervention is identified as the second key priority area whose desired outcomes include promoting an understanding and detection of mental-related problems. It is suggested that such an understanding will help people become more resilient to mental illnesses, or be able to cope with them better. The second desired outcome pertains to people becoming aware of mental illnesses early during its onset, and thus seeking treatment or support early. The third outcome seeks to draw attention to the relation that exists between mental illnesses and other social problems such as drug abuse, alcoholism, suicidal behaviour and physical health problems. The reasoning behind the third outcome is that people do not indulge in self-destructive habits just for the sake of it; often times there are underlying emotional and mental reasons to their behaviours. The recommended actions under the second priority area include working with schools, communities and workplaces in order to enhance mental health literacy, and by extension build resilience capacity. Secondly, the report recommends that early preventative and intervention programs should target children and their families. Other recommended actions include the development of customised mental healthcare services targeting vulnerable groups such as children who have suffered bodily, sexual or emotional abuse, improve support given to carers of mental ill patients, expand community-based mental health services targeting the youth, and “implement evidence based and cost-effective models of intervention for early psychosis in young people to provide broader national coverage” (Commonwealth of Australia, 2009a, p. v). Additionally, suicide prevention was identified as a valid action that states, territories and commonwealth governments should take through a preventative framework that identifies people who stand a high risk of suicide, and presenting them with the support needed to dissuade them from suicidal thoughts. iii. Service access, coordination and continuity of care “Service access, coordination and continuity of care” is a priority area that seeks to necessitate mental healthcare outcomes that include the improvement of access to proper care, continuity of the same, and reduction of mental illness relapse. Through this priority area, the plan formulators hoped to attain an adequate service provision based on population-based planning. Finally, it was hoped that the government and service providers would work jointly to streamline access to mental healthcare services through minimising duplication of services and promoting efficient and effective use of the same (Commonwealth of Australia, 2009a). To realise the outcomes identified under the third priority area, the following actions were recommended: first, it was indicated that a service planning framework would need to be set up in order to identify the “range of mental health services” that would be targeted, and identify the innovative funding models needed to support them. Secondly, the establishment of partnerships that would bring together consumers, carers, service providers and other stakeholders was identified as a necessary action for purposes of co-developing local and acceptable solutions. Thirdly, the improvement of communication channels was identified as a necessary step especially if specialist service providers were to support caregivers. Additionally, effective flow of information was identified as one of the ways through which the community can understand mental illnesses and hence deal with negative stigma. The fourth action under the third priority area was identified as working with “emergency and community services to develop protocols” which would provide guidance and support to transitions that would occur between service sectors and other jurisdictions. Another action was identified as improving linkages and coordination among caregivers in order to enable them identify mental health problems, improve referral for patients and improve treatment for the same. It was also noted that developing and implementing systems that were accessible, visible and culturally relevant to people was an essential action relating to the third priority area. Finally, the adoption of “cooperative and innovative service models” was identified as a necessary action in providing improved target services, and addressing existing services gaps that hindered the delivery of basic mental healthcare (Commonwealth of Australia, 2009a, p. vi). iv. Quality improvement and innovation Three main outcomes were identified under the “quality improvement and innovation” priority area. They include communities having access to information about service delivery and service outcomes in different regions; mental health laws meeting agreed principles, and supporting the transfer of “civil and forensic patients between jurisdictions” (Commonwealth of Australia, 2009a, p. vii). The third outcome under the fourth priority area seeks to encourage leaders to support research and the dissemination of findings, and other workforce development initiatives in order to promote innovative mental healthcare models. Reviewing the “mental health statement of rights and responsibilities” is the main action identified in the fourth priority, and under it, other actions such as amending legislation related to mental health, defining standardised roles and competencies for mental clinical workforce, employing more carers, and ensuring accreditation and reporting systems are in place are also identified. v. Accountability - measuring and reporting progress The main outcome under the “accountability” priority area was identified that the public could use to “make informed judgements about the extent of mental health reform in Australia, including the progress of the fourth plan and has confidence in the information available to make these judgement” (Commonwealth of Australia, 2009a, p. viii). Recommended actions under the fifth mental health priority area include: establishing a national reporting framework that offers a comprehensive, regular and timely progress reports to stakeholders who may need such information; building a system that will enhance accountability in service delivery; developing information data banks for mental health - thus providing a foundation for accurate reporting and accountability; and finally, evaluating “the Fourth National Mental Health Plan” rigorously (Commonwealth of Australia, 2009a, p. viii). Analysis of “social inclusion & recovery” and “prevention and early intervention” priority areas Putting the “social inclusion and recovery” priority area into perspective Policy rationale The Australian social inclusion policy aims at “making all Australians feel valued and have the opportunity to participate fully in [the] society” (Australian Government, 2011, p. “what is social inclusion?”). Notably, Australians can only have the capabilities and opportunities envisaged by their government if they have access to the resources and opportunities available in their society indiscriminately. For such a thing to happen however, they would need to learn (either through education or training), work, engage with other members of the society, and have a voice in their respective communities in a manner that can affect how decisions on matters that affect them are made (Australian Government, 2011). The social inclusion agenda outside the mental health debate has attracted much attention. In 2009 for example, the government published inspirational principles for the same, which identified the reduction of social-economical disadvantages as the first principle. The government proposed that by ensuring that all people can access good health and education among other social services, the gap between diverse social, economic and cultural groups in the country would be narrowed, hence promoting social inclusion (Australian Government, 2009). Relating the social inclusion policy to mental health, the policy envisages a situation where the mentally ill would be at par with other people in the society on economic, social, political and cultural aspects (Schneider & Bramley, 2008). For this to become a reality however, some prevailing imbalances would need to be rectified. For example, the power imbalance between service providers and service consumers and their carers would need to be remedied by giving service consumers more decision-making leeway concerning their own care, and availing efficient information to the carers through improved communication channels. The government and the society at large would also need to find effective ways of fighting stigma, which unfortunately is ingrained in the attitudes that the “healthy” population has towards mentally ill people (Thornicroft, 2006). Overall, although the social inclusion policy seems good on paper, the government will need to effectively address how the same can be done in five key areas, which include employment, education, housing, social and community participation, and healthcare provision. Theoretical underpinnings The inclusion of “social inclusion and recovery” as the mental health priority area by the Australian government has several theoretical foundations. The social identity theory is one such area, which posits that how people perceive themselves is shaped by their membership to existing social groups. Hence, a person’s sense of self-image is to a great extent determined by their social identification towards a certain group. If for example a person who was socialised to believe that mentally ill people become a burden to their carers, friends and the society at large acquire the illness at some point in their life, their esteem goes down since they believe they are now part of the “mentally-ill” group. They therefore acquire negative self-image traits, which affect their confidence and self-esteem, and consequently, their chance of recovery lowers (Schneider & Bramley, 2008). Allport’s contact hypothesis can also be use to describe the rationale behind the “social inclusion and recovery” priority area. The theory posits that societies have “in” and “out” social groups. Since the social groups perceive each other differently, the theory posits that enhancing interaction between the two groups through direct contact would create familiarity, hence giving each group a chance to disconfirm stereotypes. Once the stereotypes are disconfirmed, greater social inclusion is likely to happen through long-lasting, meaningful and pleasant interaction between members of the two groups (Pettigrew and Troop, 2006). Practice implications The “social inclusion and remedy” priority area will no doubt affect how mental healthcare providers work. This is especially relevant considering that treatment is only part of the social inclusion agenda. Other factors that healthcare workers would need to consider include social networks, housing, and employment that the healthcare consumers have. As Schneider and Bramley (2008) observe, this is likely to pose a threat to the professional identities of mental healthcare providers. Social inclusion may also require the healthcare providers to have skills in areas like conflict resolution and community development, and this may pose a professional dilemma to them since they do not usually receive training in such areas during their healthcare-focused courses (Schneider & Bramley, 2008). Putting “prevention and early intervention” into perspective Policy rationale The policy rationale behind the second priority area seems to be pegged on the fact that the most policies formulated in different sectors ends up impacting on mental health (Commonwealth of Australia, 2009b). This is especially so considering that all aspects in life have extricable interlinks that make any decisions made in one sector to have implications in other sectors. By prioritising prevention of mental illnesses and early intervention, the Australian Government sought to identify the core areas that could be used to prevent the occurrence of disadvantages that lead to mental illnesses. One of the envisaged strategies that can be used to reduce social-economic and cultural disadvantages that affect mental health negatively is the provision of effective support to vulnerable groups in order to prevent disadvantages from becoming entrenched in their social “in” groups (Australian Government, 2011, p. 3). Through prevention and early detection, there is a likelihood that the disabilities and dependency associated with mental disorders and illnesses would greatly decline (Commonwealth of Australia, 2002). Theoretical underpinnings The “prevention and early intervention” priority area has its root in the medical model, which posits that specific behavioural or health issues can be deterred from happening in the first place; and if not, early intervention measures can be used to reduce the harm associated with specific emerging or already initiated “risky” behaviours or practices (Mallett, n.d). Within the medical model, preventative strategies can be implemented through mainstream or universal services such as hospitals, health centres and schools. Such preventative strategies target the broader society (Mallett, n.d.). Following the medical model, the early intervention strategies are implemented on individuals or groups who have already started exhibiting signs of mental ill health, or those people whose family histories place them as an at-risk category. In the early stages of implementing early intervention strategies, the targeted people may not be categorised as mentally ill (Goren & Mallick, 2007). Hence, early intervention is more targeted at providing help to people or populations which are identified as being at an increased risk of mental illnesses (Mallett, n.d.). Implication on practice Wilson, Bushnell and Caputi (2011) hold the opinion that “prevention and early intervention” can promote help-negation, where those people who have mental illnesses believe that they can overcome their mental health issues alone without seeking professional help. To counter such tendencies therefore, Wilson et al (2011) propose that clinicians, carers and other mental health stakeholders should use innovative approaches to encourage help-seeking behaviour among the populace. Relating priority areas with the revised Standards for Mental Health Services (2010), and the National Practice Standards for the Mental Health Workforce (2002) The Standards for Mental Health Services (2010) contain 10 standards which state the ideal conditions that mental healthcare services should be offered to consumers. Of significance to the first priority area, i.e. “social inclusion and recovery” is the tenth standard, which addresses how delivery of care should be done in order to support recovery, access, entry, assessment and review, treatment and support, and exit and entry. It is especially notable that social inclusion has been identified as one of the ways through which recovery can be supported through protecting consumers from discrimination and advocating for their rights as citizens of the country who deserve to be treated fairly (Australian Government, 2010, p. 21). In the National Practice Standards for Mental Health Workforce (2002), social inclusion is indirectly addressed in the “integration and partnership” standard, where it is stated that “people with mental health problems and mental disorders [may also] require access to stable housing, home support, recreation, employment, education and social networks” (Commonwealth of Australia, 2002, p. 28). Such statements are indicative of the points underscored in the “social inclusion and recovery” priority area, where the importance of mentally ill people participating in social, economic or cultural activities, without facing discrimination is stressed. The Standards for Mental Health Services (2010) has also addressed matters that are closely related to the second priority area, i.e. “prevention and early detection”. In particular, the fifth standard addresses matters that relate to the promotion of mental health and prevention of mental illnesses or problems. In the National Practice Standards for the Mental Health Workforce (2002), the “prevention and early detection” priority area is addressed in two different principles, which are: “promotion and prevention”, and “early detection and intervention”. In the first principle, the promotion and development of “environments that optimise mental health and wellbeing among populations, individuals and families in order to prevent mental health problems and mental disorders” is identified as a key area that mental health professional should deal with. In the second principle, the role of mental health workers in encouraging early detection, and following this up with the necessary intervention measures is underscored. In conclusion, it is worth noting that the mental health priority areas can be supported both in policy and in theory. As seen in this essay, the two priority areas identified for discussion have considerable implications to practice; however, the implications are not projected as being too much to the extent that they would overwhelm the mental health professionals or service providers. This essay has also established that the two priority areas have links with the National Practice Standards for the Mental Health Workforce (2002), and the Revised National Standards for Mental Health Services (2010). Such links provide evidence that the priority areas are not just random targets set by the Australian Government, but are well-thought ideas, which if implemented can revolutionise mental health service delivery. The theoretical underpinnings and policy rationale behind the priority areas are indicative of the fact that perhaps most of the sought-after mental health solutions are to be found in the outlined desirable actions. Although some of the priority areas such as social inclusion may take years to be fully realised, implementing them in the soonest possible time is the only way the mental health service consumers, their carers, the mental health professionals and other stakeholders can determine if indeed they can deliver the sought-after solutions. References Australian Government. (2010). “National Standards for Mental Health Services”. National Mental Health Strategy. Retrieved 06 November 2010, from www.health.gov.au/internet/main/publishing.nsf/.../servst10v2.pdf Australian Government. (2011). “Social Inclusion- What is social inclusion”. Retrieved November 06, 2011 http://www.socialinclusion.gov.au/about/what-social-inclusion Commonwealth of Australia (2002). “National Practice Standards for the Mental Health Workforce”. 1-73. Commonwealth of Australia (2009a). “Fourth National Mental Health Plan - An Agenda for Collaborative Government Action in Mental Health 2009-2014.” Retrieved 05 October 2011, from www.health.gov.au/internet/main/publishing.nsf/.../plan09v2.pdf Commonwealth of Australia (2009b). “National Mental Health Policy 2008.” Retrieved 07 November 2011, from http://www.health.gov.au/internet/main/publishing.nsf/content/532CBE92A8323E03CA25756E001203BF/$File/finpol08.pdf Goren, N. & Mallick, J. (2007). “Prevention and early intervention of coexisting mental health and substance use issues”. Drug Info clearing House-Issues Paper, 3, 1-11. Groom, G., Hickie, I. & Davenport, T. (2003). “Out of Hospital out of Mind!” A Report Detailing Mental Health Services in Australia in 2002 and Community Priorities for National Mental Health Policy for 2003-2008. Canberra: Mental Health Council of Australia, 2003. 1-84. Mallett, S. (n.d). “Youth homelessness prevention and early intervention: a brief historical overview of key frameworks in Australia”. Retrieved 07 November 2011, from http://www.chp.org.au/parity/articles/results.chtml?filename_num=00354 Pettigrew, T. F. & Troop, L. R. (2006). “A meta-analytic test of intergroup contact theory.” Journal of Personality and Social Psychology, 90, 751-738. Schneider, J. & Bramley, C. (2008). “Towards social inclusion in mental health”. Advances in Psychiatric Treatment, 14, 131-138. Thornicroft, G. (2006). Shunned: Discrimination against people with mental illness. Oxford University Press. Wilson, C., Bushnell, J.A., & Caputi, P. (2011). “Early access and help-seeking: practice implications and new initiatives”. Early Intervention in Psychiatry, 5(s1): 34-39. Read More