Transcript PURSUING WELLNESS THROUGH MENTAL HEALTH SYSTEMS …

PURSUING WELLNESS –
PART 2
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PSYC 377 Week 1
GROUP WORK – WHAT ARE THE ISSUES
WITH MENTAL HEALTH SERVICES
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Five stakeholders:
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4.
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Clients/Patients/Survivors and users of mental health
services
Clients’ family members
Clinicians
Administrators
Policy makers
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CLIENTS/PATIENTS/SURVIVORS AND USERS
OF MENTAL HEALTH SERVICES:
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Stigma:
Cluster of negative attitudes and prejudicial beliefs
 Fearful of negative evaluation or criticism
 Immigrants are unwilling to reiceve help from mainstream services
due to stigma
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Health-related quality of life:
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Medication and resulting weight gain and vitality
Competence of service providers:
Inadequate
 Insufficient
 No comprehension of traditional methods such as consultation with
a traditional healer
 Cultural awareness :
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Somalian women and church activity
Non-English speaking clients
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CLIENTS’ FAMILY MEMBERS
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Stigma:
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Difficulties accessing services such as respite
Forced to give up custody to obtain mental health services
Services not equipped to deal with their grief
Culture of blaming them for problems
Competence of service providers:
Inadequate
 Insufficient
 No comprehension of traditional methods such as
consultation with a traditional healer
 Even though the families play an important role in health
care decisions of patients and their adherence/compliance to
treatment, they are excluded from sessions
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CLINICIANS
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Responsible for delivering, coordinating or monitoring services
Increasing severity of symptoms
Increasing complexity of clients’ health and mental health problems
(hypertension coupled with depression and substance abuse)
Medicine adherence – willingness to follow a medication plan:
Side-effects (weight gain, sexual dysfunction, diabetes)
 Constipation, dry mouth, blurred vision, severe movement disorders
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Difficulties due to having to deal with treatment plans incorporating
numerous health and mental health providers –a gency policy
might not realize the importance of underlying health issues
Co-morbidity:
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Substance abuse and mental health condition,
Hypertension and depression
Depression and cornoray artery disease
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ADMINISTRATORS
Structural and fiscal organization
 Human and economic costs associated with fragmented
mental health system
 Human cost:
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Untreated mental illness would result in indivudals seeking
more expensive medical care earlier than they would
(individuals diagnosed with severe mental illness had higher
rates of emergency room visists)
 Early treatments for symptoms might also increase lifetime
costs of maintaining stability over time (people with
schizopherenia recieveing early treatment live longer and
require continuing living with economic dependency longer)
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ADMINISTRATORS
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Economic cost:
Cost containment- distribution of mental health services is
restricted to a capitated budget (‘managed care’) and
services that are most necessary are provided only
 Fragmented service systems and cost-containment practices
restrict access to care for example children with depression
tend to use emergency services more and children with
ADHD use medical services twice the amount of other
children
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POLICY MAKERS
Mental health policy : ‘an organized set of values,
principles, and objectives for improving mental health
and reducing the burden of mental disorders in a
population‘ (WHO, 2004)
 Mental health policy is shaped by historical, scientific
developments and efforts of policy makers and
politicians working on behalf of individuals, families and
communities
 Policy makers do not have time to gather evidence and
information
 Their position is difficult because they speak for their
constituents but also for the government
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HOW DO YOU BRING ABOUT MENTAL
HEALTH REFORM
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Health promotion:
Planned activities that are
educational resulting in
philosphical shift for example redefining focus of their work
 political resulting in policy reform using data from World
Health Report, Health People and Insitute of Medince
reports
 organizational accomodating integrated practice model for
example attention to co-occuring illnesses (substance use
and mental illness / HIV, shizophrenia and employment)
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