Theoretical Underpinnings and Practice Implications of the National Health Priority Areas - Coursework Example

Academic Essay for Mental Health Introduction The National Health Priority Areas (NHPA) Initiative is a corroborative effort between the State, Commonwealth and Territory governments and draws on expertise from the non-government institutions. It aims to bring a policy emphasis to areas that are identified as bearing the greatest danger in terms of disease in the community and for which it is possible to intervene and reduce the burden greatly. Combined, the national priority areas represent about 70 per cent of the burden of illness and injury that currently affect the Australian community. There are six key priority areas namely Cancer Control, Cardiovascular Health, Mental Health, Injury Prevention and Control, Asthma and Diabetes Mellitus. The NHPA scheme seeks to improve the wellbeing and health of the Australian population through reducing the burden of sickness, lowering health inequalities, increasing access to health services and quality care across the field of health, and fostering partnership between all sectors (Dewar, 2000). This paper focuses on two of the National Health Priority Areas that relate to the Revised National Standards for Mental Health Services and the National Practice Standards for the Mental Health Workforce. The areas discussed in this regard are Injury Prevention and Control and Mental Health. Injury Prevention and Control is considered a National Health Priority Area in Australia primarily because injury is one of the major causes of death in people aged below 45 in the country. Similarly, mental health and particularly depression is a National Health Priority Area because it is linked to most of the other National Health Priority Areas in one way or another. Thus under Mental Health, the paper focuses specifically on depression. The key focal points of the paper are the policy rationale, theoretical underpinnings and practice implications of each of the two selected areas. Injury Prevention and Control Policy Rationale Injury Prevention and Control is a National Health Priority Area in Australia because injury is the major cause of death in people aged below 45. It is also a leading cause of morbidity, mortality and permanent disability in Australia. Significantly therefore, injury is a source of health care costs in the country (Australian Institute of Health and Welfare (AIHW), 2011). According to the Australian Institute of Health and Welfare (2011), nearly 7.4 per cent of all deaths occurring in Australia between 2005 and 2006 resulted from an injury or a related cause of injury. Additionally, injury accounted for more than 1 in 20 of all hospitalisations in Australia between 2007 and 2008, with almost 426,000 cases of hospitalisation due to injury. As a National Health Priority Area, Injury Prevention and Control is directly related to the Revised National Standards for Mental Health Services and the National Practice Standards for the Mental Health Workforce because injuries cause a wide range of physical, psychological and cognitive disabilities that seriously affect the quality of life that individuals and their families lead (AIHW, 2011). In fact, section 10.4.5 of the Revised National Standards for Mental Health Services (2010) addresses this issue by noting that one of the instances when a mental health service conducts a review of a consumer’s treatment, care and recovery plan is when the consumer “is at significant risk of injury to themself or another person” (Commonwealth of Australia, 2010, p. 25). At the same time, the 4th Standard of the National Practice Standards for the Mental Health Workforce (2002) states that mental health professionals have knowledge about mental health problems as well as mental disorders, and apply this knowledge on all aspects of their work. Importantly, the Standard identifies brain injury and trauma as some of the areas of mental health that mental health professionals demonstrate an understanding of (Commonwealth of Australia, 2002). Theoretical Underpinnings Although injury can be devastating to human life, it can be prevented or avoided. As the Department of Ageing (2009) notes, most physical injuries, whether intended or accidental, can be prevented by recognising their causes and removing them, or reducing people’s chances of being exposed to them. The Australian Institute of Health and Welfare (2011) supports this phenomenon by pointing out that there are significant opportunities for lessening the burden of injury by putting in place prevention strategies. In the same scope, the National Injury Prevention and Safety Promotion Plan 2004-2014 states that the environments in which people live are the ones that determine the possible injury risks and the opportunities for preventing these injuries (National Public Health Partnership (NPHP), 2005). The physical environment encompasses things such as vehicles, roads, buildings, and the general settings in which people live, work and play. These can be improved through better planning and design. The opportunities that enhance knowledge about safety include factors such as education and employment which improve people’s socio-economic environment and thereby protect them from harmful environments (NPHP, 2005). Thus, bearing in mind that injuries can be prevented, Injury Prevention and Control was considered as one of the National Health Priority Areas from the outset of the initiative of priority areas. Injury Prevention and Control was approved as a National Health Priority Area by the Health Ministers of Australia in 1986 in appreciation of the national burden of injury. Along the same line, the Department of Health and Ageing seeks to reduce the prevalence, mortality and morbidity associated with all forms of injury across age groups, and falls in indigenous people of age 55 and over and non-indigenous people aged 65 years and over (Australian Government Department of Health and Ageing, 2009). To facilitate this, information is gathered through evidence based research as well as analysis of injury related incidents conducted by the National Injury Surveillance Unit of the Australian Institute of Health and Welfare, the National Poisons Register and the National Coroners Information System under the support of the Australian Government Department of Health and Ageing (Australian Government Department of Health and Ageing, 2009). In Queensland for instance, the Chief Health Officer Report of 2006 showed that there are four groups of people that are most adversely affected by injuries. These are children, older people, men, and the Aboriginal and Torres Strait Islander peoples. In this region, falls and their impact are the major cause of injury that leads to hospitalisation and this costs the heath system twofold as much as road traffic accidents. In the year 2007, 12.4 per cent of the people in Queensland were aged over 65 years (Queensland Government, 2009). Although these statistics are not representative of the entire Australian population, they emphasise the need to take preventive measures to avoid falls among people aged over 65 years. They also inform all stakeholders of the need to take care of all age groups and all environments to ensure that safety measures are implemented everywhere to reduce injuries. This will ultimately reduce the costs of treatment of injuries. In effect, many interventions have been designed to prevent and control injuries by ensuring the safety of different environments. This forms the basis of the practice implications for Injury Prevention and Control as discussed next. Practice Implications for Injury Prevention and Control According to the Australian Government Department of Health and Ageing (2009), a number of injury prevention plans have been implemented or are currently underway. These include the National Injury Prevention and Safety Promotion Plan of 2004 to 2014, the National Falls Prevention for Older People Plan of 2004 onwards, and The National Aboriginal and Torres Strait Islander Safety Promotion Strategy. Under the National Injury Prevention and Safety Promotion Plan of 2004 to 2014, there is evidence that a disproportionate burden of injury is borne by populations that live outside urban centres. This burden heightens with remoteness such that the highest rates of serious injury occur among residents of the most remote areas (Queensland Government, 2009). The vision of the National Injury Prevention and Safety Promotion Plan is to ensure that governments work together with the private sector and communities to make certain that Australians have the greatest opportunity to live in an environment that is safe and free from the consequences of injuries. The plan also involves the health sector as it aims to adopt a greater partnership role on schemes and plans that have prevention of injury and promotion of safety as the priority areas and which can work collaboratively in the dissemination of information, resources and opportunities to avert injuries (such as suicide prevention, road safety, product safety; and occupational health and safety) (NPHP, 2005). This is in tandem with section 2.6 of the Revised National Standards for Mental Health Services which states that mental health services should meet their legal occupational health and safety requirements in order to offer safe workplaces and environments. The National Practice Standards for the Mental Health Workforce also envisage this requirement through the role of occupational therapists who help avert injuries in different work environments. The National Falls Prevention for Older People Plan aims to promote working strategically and collectively to reduce the burden and effect of falls and fall related injuries among older populations in Australia (Australian Government Department of Health and Ageing, 2009). This is a notable effort considering that injuries among people in the country have been a pervasive problem. The National Aboriginal and Torres Strait Islander Safety Promotion Strategy was developed to offer a wide-ranging strategic framework of preventing injuries among Aboriginal and Torres Strait Islander peoples (Australian Government Department of Health and Ageing, 2009). This is another laudable problem-specific approach as it has been aforementioned in this paper that Aboriginal and Torres Strait Islander peoples are among the high-risk groups with reference to injuries. Mental Health: Depression Policy Rationale Mental health is the capability of individuals and groups of people to relate with one another and the environment, in a manner that enhances subjective wellbeing, the most favourable development as well as the use of cognitive, affective and relational competencies. Various types of social, biological, environmental and psychological factors can affect the mental health of an individual. Consequently, people can develop indications and behaviours that are distressing to themselves or other people, and interfere with their social performance and capacity to handle daily life. These indications and behaviours may necessitate treatment or rehabilitation, and even hospitalisation (AIHW, 2011). In regard to the Australian population, mental health status encompasses several wide ranging themes such as culture and identity, inter-group dynamics, and the general feeling of positive wellbeing. According to AIHW (1999), both social-emotional ill health and psychiatric illnesses can result from racism, oppression, economic factors, environmental circumstances, grief, trauma, stress, cultural genocide, loss, poor physical health and psychological processes. In particular reference to Aboriginal peoples and Torres Strait Islanders, the issue of metal health must be discussed in the wider view of physical, emotional and social wellbeing. Mental health is part of the NHPA scheme because it is one of the major causal agents of non-fatal burden of disease and injury in Australia. For instance, the National Survey of Meta Health conducted in 2007 approximated that one in five Australians of age between 16 and 85 was affected by one or more of the common mental illnesses in the 12 months prior to the survey. These conditions were mood disorders (like depression), substance use disorders and anxiety disorders. Another one quarter of those surveyed, while not affected by one of these disorders in the past 12 months, had done so at some point in the past. Hence, 45 per cent of the respondents had experienced a mental condition in their lifetime. This implies 7,286,600 Australians aged between 16 and 85 (AIHW, 2011), As seen above, depression one of the key mental disorders, and according to AIHW (2011), it is the initial focus of the NHPA initiative in mental health. Theoretical Underpinnings of Depression Depression is a mood ailment characterised by feelings of unhappiness, loss of interest or delight in almost all activities, feelings of hopelessness and thoughts of suicide or self blame. The condition is commonly associated with a range of health risk behaviours, illicit drug use, tobacco use, misuse of alcohol, eating disorders and obesity. In recognition of the high prevalence of the condition, and the associated human, social and economic costs as well as the public health implication in Australia, the National Health Priority Action Council (NHPAC) in collaboration with the National Mental Health Working Group (NMHWG) regarded depression as an issue requiring a particular focus under the NHPA. Depression was the most frequently managed mental health-related condition between 2008 and 2009, accounting for 34.3 per cent of all health-related problems taken care of and 2.8 per cent of all health conditions managed (AIWH, 2011). As seen above, management of depression has been well highlighted by the NHPAC and the NMHWG. The condition is also well highlighted in the Revised National Standards for Mental Health Services where one of the key principles is the requirement that mental health services should promote an optimal quality of life for individuals with mental health problems as well as mental illnesses (Commonwealth of Australia, 2010). The National Practice Standards for the Mental Health Workforce also stipulate that mental health professionals should demonstrate an ability to provide collaborative treatment and support with other providers of service and with drug and alcohol among other issues (Commonwealth of Australia, 2002). Depression is a major issue because it can also be linked to nearly all the other National Priority Areas. First is Cardiovascular Health, whereby studies have shown that there is a considerable prevalence of depression in people diagnosed with cardiovascular disease. Depression is also known to predict future cardiac prevalence in people with coronary heart artery disease (AIHW, 1999). The second item is Diabetes, whereby a number of studies reviewed by the Australian Institute of Health and Welfare have shown that pre-existing depression is associated with a higher risk of developing diabetes and comorbid depression that is linked with poorer diabetic control (AIHW, 1999). The third area is Cancer, whereby a review of literature conducted by AIHW (1999) shows that many people undergoing medical treatment for cancer have a psychiatric disorder, usually characterised by depressive symptoms. Practice Implications for Depression The Australian Institute of Health and Welfare designed an intervention programme for depression which comprises prevention, early intervention, treatment and management which aims to maximise mental health outcomes in line with the Revised National Standards for Mental Health Services and the National Practice Standards for the Mental Health Workforce. There is also a mental health promotion programme that aims to protect, support and sustain the mental wellbeing of the Australian population by raising protective factors that result in positive outcomes. Prevention and early intervention measures focus fundamentally on recognition and timely management of the risk factors that increase people’s susceptibility to depression. Symptoms of depression may be arrested through recognition and response to the presence of risk factors. Preventive strategies can be targeted collectively at the general public or selectively at individuals or various groups that have a higher chance of developing depressive disorders. Interventions meant for particular groups can be aimed at high-risk individuals, for instance people with existing symptoms of depression. Early recognition of the symptoms of depression as well as first episodes of disorder and the provision of evidence-based interventions are the major issues considered in treatment interventions (AIHW, 1999, AIWH, 2011). The National Health Priority Areas Report of 1998 outlines some of the roles that health professionals can play with reference to promotion of mental health, prevention of depression, as well as early intervention. These roles are also outlined in the Revised National Standards for Mental Health Services and the National Practice Standards for the Mental Health Workforce. Mental health promotion is meant to contribute generally to improving mental health and wellbeing, which therefore indirectly prevents depression. The activities involved seek to ameliorate people’s knowledge and skills and increase their ability to deal with challenging situations. These include community awareness campaigns that relate to known risk factors at the community level such as social isolation, unemployment and certain types of stress (AIHW, 1999; AIWH, 2011). Preventive strategies require identification of risk and the protective factors that affect the development of disorders. They also need effective methods of lowering risk factors and promoting protective factors, as well identification of those risks. Importantly, they need a significant level of funding and systems to enable the implementers to carry out the prevention activities (AIHW, 1999; AIWH, 2011). Conclusion In conclusion, Injury Prevention and Control and Mental Health are vital components of the National Health Priority Areas initiative. As it has been shown in this paper, both areas, if unmonitored, impose a huge health burden to Australia. As detailed in the paper, injury is the major cause of death in people aged below 45; and Mental Health, in particular depression, affects nearly all the other constituents of the National Health Priority Areas initiative. The implication is that if attention is not paid to these areas, they will continue ailing the health of many Australians and hence affect the wellbeing of the workforce as well as other segments of the society. But as National Health Priority Areas, the issues discussed are being addressed well from different segments of the Australian society. For instance, many studies have been done to show the impact of injury. Consequently, measures have been put in place to prevent and deal with effect of injuries. The National Injury Prevention and Safety Promotion Plan of 2004 to 2014 is one of such strategies. Others include the National Falls Prevention for Older People Plan of 2004 onwards, and The National Aboriginal and Torres Strait Islander Safety Promotion Strategy. These strategies crucially target the high-risk groups and hence they are problem-specific. Depression has been highlighted as an area that affects other National Priority Areas such as Cardiovascular Health, Diabetes and Cancer. To deal with the problem of depression, the Australian Institute of Health and Welfare through the Australian Government designed an intervention programme that comprises prevention, early intervention, treatment and management. This aims to maximise mental health outcomes in line with the Revised National Standards for Mental Health Services and the National Practice Standards for the Mental Health Workforce. References AIHW (1999). “National Health Priority Areas Report: Mental health 1998.” AIHW Cat. No. PHE 13. HEALTH and AIHW, Canberra. AIHW (2011). “Injury prevention and control.” Retrieved 25 October 2011, from http://www.aihw.gov.au/injury-prevention-and-control-health-priority-area/ Australian Government Department of Health and Ageing (2009). “Injury Prevention.” Retrieved 25 October 2011, http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-injury-index.htm Commonwealth of Australia (2002).”National Practice Standards for the Mental Health Workforce.” Retrieved 25 October 2011, from http://www.health.gov.au/internet/main/publishing.nsf/content/2ED5E3CD955D5FAACA25722F007B402C/$File/workstds.pdf Commonwealth of Australia (2010). “National Standards for Mental Health Services.” Retrieved 25 October 2011, from http://www.health.gov.au/internet/main/publishing.nsf/content/DA71C0838BA6411BCA2577A0001AAC32/$File/servst10v2.pdf Dewar, J. (2000). “The National Health Priority Areas Initiative.” Social Policy Group, Parliament of Australian. 27 June 2000. Retrieved 25 October 2011, from http://www.aph.gov.au/library/Pubs/cib/1999-2000/2000cib18.htm National Public Health Partnership (NPHP). (2005). National Injury Prevention and Safety Promotion Plan 2004-2014. Canberra: NPHP. Retrieved 25 October 2011, from http://www.nphp.gov.au/publications/sipp/nipspp.pdf Queensland Government (2009).“Strategic Directions for Injury Prevention and Safety Promotion 2009-2012.” Brisbane: Queensland Government. http://www.health.qld.gov.au/ph/documents/pdu/phstratdir_injury.pdf Read More