Prejudice Towards Mental Health Problems - Essay Example

Prejudice towards mental health problems According to the figures given out by the Department of Health (2002), at any given point of time in the U.K, about 1.7 million parents with a mental illness will be in the process of caring for some 2.5 million children. According to Mayberry et al (2005), people who suffer from mental illness as well as their families, form a particularly vulnerable group who may often suffer from social isolation within their communities. Some of the reasons that have been advanced by Mayberry et al (2005) in support of this position include poor ante natal care that such victims of mental health problems may have received, the generally low socio-economic status of these persons which may make it difficult for them to seek medical assistance on a prompt basis, their generally low levels of educational achievement which may hinder their ability to realize that they are sick and seek help and finally the fewer social supports that they may receive. In one particular study that was conducted specifically on a Hispanic community in the United States, the level of access to mental health care services was assessed for this particular community.(Ruiz, 2002). The author of this study points out that despite the fact that the Hispanic community is on its way towards becoming the largest ethnic minority group in the United States, yet in terms of their access to mental health care services, they lag far behind other ethnic groups. Some of the factors that this author has identified for this lack of access to services includes the language and cultural barriers.(Ruiz, 1985). As a result of the inability to communicate symptoms effectively, clinical misunderstandings developed, since patients tended to speak more slowly and this was related to speech disturbances associated with anxiety. Moreover, cultural factors lead Hispanics to explain their psychiatric disorders as being caused by religious phenomena, which further leads to mis-diagnosis and inappropriate or insufficient levels of health care intervention. Moreover, the author also found that the number of Hispanic health care professions available to attend to the mental health needs of this community is also very low. (Ruiz, 1993). This is a problem for most members of minority communities anywhere, since the difficulties in language and cultural barriers with the inadequacy in availability of health care professionals from minority groups may contribute to the higher levels of problems minority communities face. Another reason for the differentials and prejudices faced by minority communities in terms of access to and receipt of health care is the low educational and socio-economic levels of these groups. Low educational levels lead to unemployment and low wages, as a result of which minority groups may have inadequate health insurance coverage and less of fringe benefits, which in turns leads to insufficient purchasing power and an inability to pay the deductibles on insurance services. All of these factors may limit access to health care services. Similar findings were also reported by Martinez and Carter-Pokras (2006) who state that barriers to receiving health services and information may span linguistic, financial, logistic, legal and cultural matters. These reasons were also found to be significant in a study that was conducted on mental health services in a London borough, where the needs and limitations in services to refugees and asylum seekers was addressed. (Misra, 2006). The author found that the main issues arising in provision of service to refugees and asylum seekers were language and cultural barriers and the difficulties in working through language interpreters in delivering therapy and longer consultation times. This resulted in a stretching of the demands on the already strained level of time and resources of mental health services and significantly reduced the level and quality of service available to deal with these minority groups. Ruiz(2002) also identifies ethnic and racial prejudices and discrimination as being among the reasons for inadequate and differential treatment meted out of mentally ill patients belonging to minority Hispanic groups. Since most Hispanics are uneducated and poor and are often recipients of welfare, discrimination by the health community is a factor that contributes to the prejudice that these minority groups experience. For example, one mental health care utilization study in the United States showed that Hispanic employees received 23 annual mental health visits while the white population received 31, with the discrimination arising clearly out of ethnic and discriminatory factors. (Sheffler and Miller 1991). A survey was conducted in UK of mental health social workers and the findings supported the conclusion that there is a high level of stress experienced by these social workers in dealing with mental health problems because of factors such as the need to work long hours, a too heavy workload, lack of participation in decision making and poor levels of social support, including poor management styles, all of which exacerbated the problems that these social workers experience din the workplace and which impacted negatively upon their working habits (Huxley et al, 2005). As a result of the stress and strain experienced by these social workers, there was also a consequent deterioration in the level of service that was dispensed to mentally ill patients and those requiring health care, especially from the minority groups. The study supported the finding that unless such social workers are valued by society, there are likely to be less people coming forward to provide services to mentally ill people and other members of the minority and poor public who may be in need of effective social care services in order to address their health problems within their financial abilities. On the basis of the above views from experts, it may therefore be concluded that some of the reasons for the prejudices that may be experienced by people suffering from mental health problems is the social isolation that they face from normal people who find it difficult to adjust to their special needs. Moreover, in many cases, the problem may lie in the difficulties experienced by those from minority groups in communicating effectively with health care professionals, while the lack of education and low socio economic status may be factors that contribute to a discriminatory attitude towards them. The perception that mentally ill people are not in full possession of their faculties could contribute further to the existing prejudices against them. Measures to tackle the prejudices: One of the significant legislative measures that have been mooted in recent times is the Mental Capacity Act of 2005. Section 2 of the Act states that a person lacks mental capacity if he/she is unable to make decisions; however the Act specifies that it is necessary and essential to act in the person’s best interests. (Irons, 2007) Moreover, acting in the best interests of a mentally incapacitated person is not restricted merely to clinical interests but also to social, moral and ethical factors and may serve to address in some measure the existing prejudices of health care professionals against the mentally disabled. In fact, as reported by the Royal College of Psychiatrists (2001), there is prejudice existing even within the medical community against mental illness. Within the medical profession, when doctors or health care professionals experience mental illness symptoms such as depression, they tend to hide the fact due to the discrimination that they face from the medical community. The Doctors Support Network has been set up to provide help for such victims of mental health disorders.(Miller, 2006). The stigma associated with mental health disorders can be particularly devastating for children, as found in a study where it was revealed that Americans exercise a higher degree of prejudice against the symptoms of mental health disorders such as depression in children, as compared to adults.(Perry et al, 2007). In order to cope effectively with the problems arising out of such prejudice, it is necessary to modify the attitude of the public towards mental illness, in order to eliminate the wrong perception that mentally ill people are always dangerous. There must be more efforts made among local communities to correct such wrong impressions among members of the public through anti-stigma and educational programs within the community. One of the important public measures that has been introduced in this regard is the Newpin Service that has been introduced within the UK, which helps to provide center based, structured support for parents and their children who are under five years of age, where mental health problems have been identified (Lederrer and McHugh, 2006). The theoretical foundations of this program are based upon the attachment theory and it seeks to build and foster the levels of attachment between mentally disabled children and their parents. By generating confidence in parents on their ability to handle the problems being faced by their children, there is potential to reduce future costs associated with behavioral difficulties in children. The National Service Framework for Mental Health also aims to promote mental health and reduce the discrimination and the social exclusion that are associated with mental health problems (Lederer and McHugh, 2006). The FWA Newpin model project is also very effective in addressing the problems of refugees and asylum seekers. These individuals often suffer from mental health problems due to the traumatic experiences they have gone through while being displaced from their respective countries, therefore their relationships with others and their notions of the future are affected and distorted. As a result, the Newpin model which focuses on the promotion of attachment between the mentally disturbed person and those in his/her environment is effective in addressing the underlying causes of mental ill health. Most of the negative perceptions about mentally ill patients is the result of media images propagated through films which reveal these individuals as dangerously disturbed, psychotic individuals, who are a potent threat to normal people. The strong of murders, tragedies and suicides that are associated with mental health service users and in particular, in the case of mentally ill schizophrenic patients, has resulted in the media presentation of mentally ill patients as dangerous psychotic individuals who are a liability on the community and therefore non deserving of support. Therefore, the same media must be utilized to help in reversing this wrong impression. Through the dissemination of public service messages on television or through educational films that demonstrate the problems faced by mentally ill people and their need for support from the community, a great deal may be done to reverse the damages that have been done through the media to the image of mentally ill people. Rather than focusing on a few aberrant instances of mentally ill people who have harmed themselves and others, it is better to focus upon the problems, prejudices and discrimination faced by these people and their need to be rehabilitated into the community. The prevailing attitude of the public about mentally ill people tends to be one of avoidance due to the prevailing wrong attitudes about them. There is a general trend to the policy of NIMBY – Not in my back yard, whereby the community does not want to be associated with the need to care for mentally ill people, but would rather see them safely locked away in institutions where they would apparently not be a danger to others. This is largely due to the negative images in the media, whereby mentally ill people are perceived as a danger to themselves and to the community they live in. They are therefore perceived to be in need of rigid supervision within an institutionalized environment such as a psychiatric facility. However as Heller et al ( 1996) have pointed out, it is necessary to reverse this impression of “otherness” that is associated with mentally ill people, and to promote understanding within the community for these people, so that they are allow to live and function within the community as members who are well received among their family and friends, rather than being forced to be locked away in an institutionalized environment. Heller et al (1996) have suggested that mentally ill people need to be rehabilitated within the community itself in accordance with the K257 policy, where strategies must be devised in order to take care of these people within the community itself. The introduction of family support as mooted through programs such as the FMA Newpin is therefore likely to be an excellent step in the achievement of the long term goals of rehabilitation of mentally ill people within the community. In most cases, these people are in need of medication and care to effectively control their symptoms and where the incidence of the symptoms are mild, these individuals may also be rehabilitated into the community and function effectively within it. Most mentally ill people fall into the category where they may suffer from symptoms such as mild depression rather than suffering from hard core murderous instincts as portrayed in media images and films. Therefore, it is very essential for proper education among the public, on the true nature of mental illness, rather than the exaggerated picture of them that people obtain from the media images and stereotypes propagated through film and media images. By allowing such individuals to be rehabilitated within the community, the process of recovery may be facilitated, while also reducing the substantial costs associated with mental health programs. Community rehabilitation of mentally ill people will also take off the strain that falls upon mental health professionals and social workers in dealing with the problems. With the pressure on public resources and the difficulties associated with assignment of funds for dealing with mental health problems, it is better that such patients are allowed to function within the community. Such a policy may also help to redress the linguistic and cultural difficulties that are also associated with the treatment of mental illness, since individuals who can receive the necessary support from within their own community will be able to more effectively deal with the problems without the barrier of linguistic and cultural differences. Educating the public and disseminating information about mental illness and the need to deal compassionately with these people will help to address the unreasonable prejudices that exist against these people within the community. Through the provision of a supportive community framework, it becomes possible for most members of the public to realize that they also have a role to play in assisting mentally ill people, since the images propagated in the media may be largely unfair to mentally ill people. References: * Department of Health, 2002. “Womens Mental Health: Into the Mainstream. Strategic Development of Mental Health Care for Women”. London: Department of Health. * Heller, Reynolds, Gomm, Muston and Pattison, 1996. “Mental Health Matters: a reader.” Basingstoke: Macmillan * Huxley, Peter, Evans, Sherrill, Gately, Claire, Webber, Martin, Mears, Alex, Pajak, Sarah, Kendall, Tim, Medina, Jibby and Katona, Cornelius, 2005. “Stress and Pressures in mental health Social Work: The worker speaks.” British Journal of Social Work, 35: 1063-1079. * Irons, Ashley, 2007. “Impact of the mental Capacity Act of 2005” The Mental health review, 12(1): 37-41 * Lederer, Jacqui and McHugh, Marian, 2006. “FWA Newpin – working with parents with Mental Health problems and their young children.” The Mental Health Review, 11(4): 23-28 * Martinez, Iveris L and Carter-Pokras, Olivia, 2006. “Assessing health concerns and barriers in a heterogenous Latino community.” Journal of Health care for the Poor and Undeserved.” 17(4):899-910 * Miller, Liz, 2006. “Doctors’ Support Network.” The Mental Health Review, 11(3): 41-44 * Mayberry D, Ling L, Szakacs E et al, 2005. “Children of parents with a mental illness. Perspectives on need”. Australian ejournal for the Advancement of Mental Health 234. * Misra, Tania, 2006. “Addressing Mental health needs of asylum seekers and refugees in a London borough: developing a service model.” Primary health care Research and Development, 7:249-256 * Perry, Brea L, Pescosolido, Bernice A, Martin, Jack K, McLeod, Jane D and Jensen, Peter S, 2007. “Comparison of Public Attributions, Attitudes and Stigma in regard to Depression among children and adults.” Psychiatric Services, 58(5): 632 * Royal College of Psychiatrists, Royal College of Physicians in London & British Medical Association, 2001. “Mental Illness: Stigmatisation and Discrimination within the Medical Profession.” London: Royal College of Psychiatrists, Royal College of Physicians in London & British Medical Association. * Ruiz. Pedro, 2002. “Hispanic access to health/mental health services.” Psychiatric Quarterly, 73 (2): 85-93 * Ruiz, Pedro, 1993. “Access to health care for uninsured Hispanics: Policy recommendations.” Hospital and Community Psychiatry, 44: 958-962 * Ruiz, Pedro, 1985. “Cultural barriers to effective medical care among Hispanic American patients.” Annual Review of Medicine, 36: 63-71 * Sheffler, R.M. and Miller, A.B., 1991. “Differences in mental health service utilization among ethnic sub populations.” International Journal of Law and Psychiatry, 14: 363-376 Read More