Impact of Social Policy on Mental Health in Australia - Article Example

Impact of social policy on mental health in Australia Introduction Sullivan, Chapman, & Mullen (2008) defines mental disorder or mental illness as a behavioural or psychological pattern which is generally associated with subjective distress or disability that occurs in a person and which is not a part of normal development and culture (Yelland, Sutherland, Wiebe, & Brown, 2009). Mental illness disrupts a person’s thinking, feeling, ability to relate to others, mood, and daily functioning. In Australia, one in five people experience a mental health problem or illness each year and 45% of people experience a mental health problem or illness at some point during their lifetime. It is estimated that 3.8% of Australians suffer from high psychological disorders with 6.7 % of the percentage being under 15 years of age and 9.5 % being between 15-17 years of age (Yelland et al. 2009). In addition, statistics show that more women suffer from metal disorders as compared to men. Mental illness is caused by a number of factors, which range from biological, psychological, environmental, and nutritional to lifestyle factors (Fiona, Carole & Ruth, 2010). Poor mental health can have adverse effect on the lives of individuals, resulting in loss of quality of life and devastating effects on family functioning, parenting effectiveness and childhood development (Michael, Matthew, Karen, Bernie, Stephen & Peter, 2010). Of recent, there has been a growing recognition of economic impacts of mental illness. In the mod 1990s Australia’s goals and targets positioned mental health as a new strategic direction with a focus on reduction of suicide rates and the effects of mental illness on the lives of people. The Australian social policies The mental health system in Australia is constantly changing and is highly influenced by social policies of the time. Major changes have been witnessed in social policies surrounding mental illness over the past 50 years. This has been influenced mainly by conceptualizations of mental illness and advancements in knowledge (Kim, Howard & Scott, 2008). Consequently, the social policies surrounding mental health are constantly evolving. In addition, social policies have considerably been influenced by the ideologies of the time and for many years, the idea of the welfare state prevailed. The welfare state entailed emerging views, which placed the focus and power within the average person (Yelland et al. 2009). Under this, governing bodies were in place to ensure the collective community sovereignty of a society, theoretically truly serving the people. Economic and capitalism power and persuasion have negatively influenced the maintenance of this ideology (Yelland et al. 2009). This has seen the governing bodies adopt neo-liberal ideologies and relinquishing the financial burden afforded by employing notions of the welfare state. The social policy of mental health is aimed at improving existing policies and forming new policies to deal with the treatment and prevention of mental illness (Sullivan, Chapman & Mullen, 2008). The social policy of mental health is continually evolving. Until 1960s, mental health policies were dictated and enforced by governing bodies of the society. From mid 1960s to early 1980s, mental health underwent a revolution and was characterized by the process of deinstitutionalization (Haslam, Jetten, Postmes & Haslam, 2008). The deinstitutionalization process involved a shift in the housing of people with mental ailments from traditional hospital based mental health facilities into community based care (Michael et al. 2010). The new policy stipulated that mentally ill persons should poorly be institutionalized if they require significantly high levels of treatment and supervision and ought to be discharged when this is no longer necessary. The deinstitutionalization of mental healthcare in Australia has been strengthened by various legislations. The first National Health Strategy in Australia was developed in 1992 with both a policy framework and an implementation plan (Fiona, Carole & Ruth, 2010). This was followed by a national community awareness program in 1994, which was aimed at reducing stigma and discrimination. The second National Mental Health Plan was launched in 1998. This was followed by the National Mental Health Promotion, Prevention and Early intervention action plan in 2000. This was aimed at enhancing social and emotional wellbeing among populations and individuals; reducing the incidence, prevalence and effects of mental problems and mental disorders; improving the range, quality and effectiveness of population health strategies to promote mental health; and to prevent and reduce the impact of mental health problems and mental disorders among Australian population (Fiona, Carole & Ruth, 2010). The National Mental Health Plan 2003-2008 built on previous two national plans to support mental health promotion at a national policy level (Yelland et al. 2009). This plan was aimed at promotion of mental health and prevention of mental health problems and mental illness; increasing service responsiveness; strengthening quality; and fostering research, innovation and sustainability on mental health (Jackson et al. 2009). Impact of social policy on service providers of mentally ill Deinstitutionalization policy of the mental healthcare in Australia has resulted in reduced stigmatization of people with mental illness in addition to reducing the financial burden on the government. However, this policy has led to reduction in the number of medical facilities to cater for people living with mental illness. The impact of deinstitutionalization policy in Australia on psychologists, nurses and social workers cannot be underestimated. Psychologists and social workers were the major advocates for deinstitutionalization of mental healthcare in Australia. The community health program wads set up by the Sax commission in Australia. This program introduced common wealth government funding in to health care for the first time. This led to many psychologists, social workers and some psychiatric nurses getting new employment in community health program funded under the new scheme. However, many psychologists were ill equipped to work in community program due to their training in psychometric assessment and psychopathology (Fiona, Carole & Ruth, 2010). The knowledge was irrelevant because psychometric assessment of patients was to be done in asylums to facilitate their placement in long-term program. However, the long-term hospitalization of mentally ill patients had been abolished by deinstitutionalization policy. As a result of this policy, many psychologists awakened to the fact that they needed skills in counselling, community development and advocacy to help people adjust to community life after being discharged from hospital. Social workers who attempted to place people in accommodation after discharge from hospital were confronted with the lack of services and appropriate support for people living with mental illness in the community (Yelland et al. 2009). Owing to lack of support services for people leaving psychiatric care, some psychologists and social workers started some of the current non-government services providing accommodation, family support and retraining for employment. Social workers and psychologists who were initially working in psychiatric hospitals set up support groups for particular groups. For instance, Margaret Lukes a social worker with the NSW Mental Health association started the first support group for relatives of people living with mental illness in NSW in the mid 1970s. Another organization, ADARDS, was set up by Jill Faddy a psychologist at Callan Park Hospital in Sydney and Di Griffin a social worker at Gladesville Hospital. This new organization was instrumental in lobbying for many of the changes to care and treat people living with dementia. Impact of social policy on mentally ill The current policy that relates to admission of people with mental illness has changed in that a mentally ill has to be admitted, treated and then be discharged as quickly as possible. This policy is aimed at a more moral form of treatment and the potential for significant financial merit. This follows the concept of community mental health. This deinstitutionalization and the shift to community treatment were found to work initially but a faction of the previously institutionalized population could not be reintegrated into society. These patients were mainly those suffering from chronic mental illness that had been institutionalized for a prolonged period and had almost no friends and family in the outside community (Fiona, Carole & Ruth, 2010). This situation is still being experienced presently because there is a portion of the population who has been identified to be community treatment resistant who are not able to gain treatment within the system (Yelland et al. 2009). Even though under this policy of deinstitutionalization the government and NGOs provide some support for people existing within the community, the welfare responsibility for these patients falls mainly on their family members and friends. For those who have no friends or family members, they often find themselves in cheap housing, in inadequate nursing homes or homeless. This implies that the current social policy on mental health is not effective mainly because of poor funding and inadequate staffing. If the policy could address these two issues then the policy of deinstitutionalization could have been a success. The current policy has led to few people receiving adequate treatment from the system while a large number of mentally ill persons are not getting adequate treatment (Brotherston, Lee, Smith, Dobson, & Outram, 2003). The main causes for such people missing treatment are financial, ideological and legal reasons. The Australian mental health system is shifting to health care delivery being seen as a profitable business where different levels of health care are projected as optional. This has resulted in provision of mental health services by a collection of institutions. Consequently, there is affiliation of facilities within either public or private sectors and significant lack of collaboration between the two. In addition, financial gains from deinstitutionalization have not been channelled toward provision of adequate facilities to cater for mental illness. Thus, there are inadequate facilities for taking care of mentally ill persons. Impact of social policy on community living with mentally ill Due to institutionalization policy and legislations that followed the implementation of this policy, Australian community is more aware of mental health than ever before (Brotherston, Lee, Smith, Dobson, & Outram, 2003). This is because most legislation advocated for the support of community awareness campaigns to improve mental health literacy, increase help seeking behaviour and promotion of positive mental health (Fiona, Carole & Ruth, 2010). This policy has also reduced stigmatization of people living mental illness among the community due to engagement of a range of community settings including workplaces and schools in mental health promotion activities to increase awareness and organization capacity to build resilience, reduce risk factors and increasing protective factors (Yelland et al. 2009). These initiatives are aimed at ensuring that consumers are supported to seek and obtain care when they become unwell and that mental health problems and illness do not reach crisis point before appropriate care is received. Deinstitutionalization policy in Australia encourages the implementation of a stepped system of care with community mental health services at the centre of the care system. It provides a range of supported accommodation, community rehabilitation, and intermediate, acute and secure care options that is supported by a comprehensive community mental health care system and clear links to primary health care and other community services. Media is utilized by many people world wide as a means for gaining and analysing information regarding the world. Media has been found to play a significant role in shaping how society views people with mental illness (Brotherston, Lee, Smith, Dobson, & Outram, 2003). For a prolonged period, people living with mental illness have endured substantial stigmatization and discrimination and this was mainly fuelled by perceptions within the media. However, following implementation of deinstitutionalization policy and accompanied legislations, media has changed drastically to influence the community positively (Yelland et al. 2009). This has helped in reducing instances of stigmatization of people living with mental illness. Studies indicate that most media firms no longer portray mental illness in the negative way: they take either a neutral position or a positive one (Fritze, Blashki, Burke & Wiseman, 2008). Thus stigmatization towards the mentally ill within the media is not apparent as it used to be in the past before the implementation of deinstitutionalization policy and accompanying legislations. The media have portrayed the Australian government in the negative light in reference to their approach to the mental health system within Australia. Studies indicate that the Australian media is quite disparaged with the approach of the government to mental health and does not perpetuate the conservative neo liberal ideas that are in existence currently within the government (Berry, Bowen & Kjellstrom, 2009). The media has helped to highlight problems facing the current deinstitutionalization policy, which has seen the government relinquish major funding toward mental health. Some of the problems highlighted by Australian media in the mental health system include inadequate facilities and treatment options and inability of people living with mental illness to receive treatments and get assistance due to financial problems and inability to access treatment options. In spite these positive results of deinstitutionalization policy to the community; it has brought great economic strain among the community supporting such people living withy mental illness since a substantial amount of burden for those suffering from mental illness is being shifted to the individual and then subsequently the family (Fritze et al. 2008). The reduction of government funding has implied that the community has to meet all the costs of taking care of their loved one (Brotherston, Lee, Smith, Dobson, & Outram, 2003). In addition, no adequate facilities and services are available to the community to take their patients. Lack of funding or rather inadequate funding imply that few service providers are available in the community to pro vide essential services to people living with mental illness (Griffiths & Gillies, 2006). As a consequence the community is expected to provide such services which most of them are not trained in taking care of people living with mental illness within the community imply that some community members have had to leave their employment to take care of their loved ones (Yelland et al. 2009). This has increased the financial constraints on such families, which in most case will not be able to finance medical costs for their relative living with a mental illness. Conclusion A mental disorder or mental illness is a behavioural or psychological pattern, which is generally associated with subjective distress or disability that occurs in a person and which is not a part of normal development and culture. The mental health system in Australia is constantly changing and is highly influenced by social policies of the time. The social policy of mental health is aimed at improving existing policies and forming new policies to deal with the treatment and prevention of mental illness. From mid 1960s to early 1980s, mental health underwent a revolution and was characterized by the process of deinstitutionalization. The deinstitutionalization process involved a shift in the housing of people with mental ailments from traditional hospital based mental health facilities into community based care. The new policy stipulated that mentally ill persons should poorly be institutionalized if they require significantly high levels of treatment and supervision and ought to be discharged when this is no longer necessary. Deinstitutionalization policy of the mental healthcare in Australia has resulted in reduced stigmatization of people with mental illness in addition to reducing the financial burden on the government. However, this policy has led to reduction in the number of medical facilities to cater for people living with mental illness. The current policy has led to few people receiving adequate treatment from the system while a large number of mentally ill persons are not getting adequate treatment. Due to institutionalization policy and legislations that followed the implementation of this policy, Australian community is more aware of mental health than ever before. This is because most legislation advocated for the support of community awareness campaigns to improve mental health literacy, increase help seeking behaviour and promotion of positive mental health. In spite these positive results of deinstitutionalization policy to the community; it has brought great economic strain among the community supporting such people living withy mental illness since a substantial amount of burden for those suffering from mental illness is being shifted to the individual and then subsequently the family. The current policy could be improved if the government increases funding to the mental healthcare to ensures that various options of treatment and adequate facilities are available and accessible to all people living with mental illness within Australia. References Berry, H., Bowen, K., & Kjellstrom, T. (2009). Climate change and mental health: a causal pathways framework. International Journal of Public Health, 55(2), 123-132 Brotherston, R., Lee, C., Smith, N., Dobson, A., & Outram, S. (2003) Women and mental health in Australia: selected findings of the Australian Longitudinal Study on Women’s Health. : Australia. 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