This essay will examine and evaluate various relevant perspectives in understanding the concept of mental health and ill health. Review theory and evidence to demonstrate an understanding of multidisciplinary approaches to meeting mental health needs. The essay will demonstrate a critical appraisal/understanding of the diverse nature of determinants to mental health and well being and explore contemporary issues in mental health care. Drawing on research, legislation and policy frameworks. There are many definitions of what mental health is but a common definition of mental is: “Mental health is the emotional resilience which enables us to enjoy life and to survive pain, disappointment and sadness. It is a positive sense of well-being and an underlying belief in our own and others’, dignity and worth “HEA 1996 (cited in Tilford & Cattan 2006). Kakar (1984) also defined mental health as a label which encompasses different perspectives and concerns, such as the lack of incapacitating symptoms, incorporation of psychological functioning, effective conduct of personal and social life, feelings of ethical and spiritual wellbeing.
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There are numerous mental health illness conditions that contribute and influence an individual’s mental health. For instance, depression, anxiety, eating disorders, addictive behaviours and schizophrenia, which happen to be a very common mental health issues, these conditions can result to outcomes that makes it hard individuals to be dynamic in society this includes feeling segregated, unable to communicate, personal relationships and work life. Definitions of stress of mental health are influenced by a cultures values system. How individuals define what is healthy depends very much on individuals value orientations.
Substance misuse is usual rather than exceptional amongst people with mental health problems’ (DOH 2002) May affect between 30 to 70%
of those presenting to health and social care settings (Crome et al. 2009)
At the same time, approximately 50% of patients in drug & alcohol services have a mental health problem (Rethink 2007)
First-episode psychosis: A sample of 168 young people showed that 37%
of the sample reported drug use, drug misuse and alcohol misuse (Cantwell et al. 1999).
Estimating the commonness of mental health issues is challenging for various reasons: underfunding, the hidden nature of mental health issues and the variation in demonstrative practices across the nation. Mental health problems are extremely common: One in four adults experience mental illness at some point during their lifetime and one in six experience symptoms at any one time – making mental illness the largest single cause of disability in our society. (Department of Health, 2011). Economic costs £105 billion, much of which is accountable through “lost productivity” as well becoming an important contributor to the overall burden of disease surpassing heart disease (Department of Health, 2012 p.3 JCPMH 2013). One in five mothers suffers from depression, anxiety or in some cases psychosis during pregnancy or in the first year after childbirth. Roughly 9 out of 10 adults wo suffer with a metal health problem ca be supported in primary care. “Primary care services provide the first point of contact in the healthcare system, acting as the ‘front door’ of the NHS. Primary care includes general practice, community pharmacy, dental, and optometry (eye health) services” (England NHS,2015). Suicide happened to be the seconding leading cause of maternal death, after cardiovascular disease. Mental health is a public health issue because of rising rates of suicide for examples In 2014 in Britain the highest suicide rate was among men aged 45 to 59 at 23.9 deaths per 100.000 with male suicide being significantly higher than female, rising rates of depression: female rates of depression are higher than in males and increase in mental health problems in children inclusive of eating disorders (ONS.2016).
Individuals with mental health problems often state that the social stigma attached to mental ill health and the discrimination they experience can make their challenges worse and make it harder to recuperate (Mental Health, 2016). Discrimination is the prejudicial and /or distinguishing treatment of an indvidual based on their actual or perceived membership in a certain group or category, discrimination includes restricting members of one group from opportunities or privileges that are available to another group leading to the exclusion of the indvidual or entities based on logical or irrational decision making (Equality Act, 2010). In line with Equality Act (2010) protected characteristics are: race, gender reassignment, age, sexual orientation, religion or belief, disability and sex.
Mental health issues are as yet encompassed by prejudice, distress and obliviousness, notwithstanding the fact that 1 in 4 adults have encountered them. Many individuals who experience mental health problems recover fully or are able to manage them especially if they get help early on. Nearly nine out of 10 people with mental health problems say that stigma and discrimination have a negative effect on their lives. Mental health stigma operates in society and it is taken on by individuals and is attributed by health professionals. They are many ways that can possibly improve mental health, strengthening communities: increasing social support, social inclusion and participation, improving community safety, development of health and social care which support mental health and investing in social capital. Reducing structural barriers to mental health; initiatives to reduce discrimination and inequalities across to housing, employment and education. The World Health organisation defines health inequality as “differences in health status or in the distribution of health determinants between different population groups”.
“A multidisciplinary team is a group of health care workers who are members of different disciplines (professions e.g. Psychiatrists, Social Workers, etc.), each providing specific services to the patient. The team members independently treat various issues a patient may have, focusing on the issues in which they specialise” (Health Service Executive, 2018). A key quality of multidisciplinary teams is that the joined ability of a range of mental health professionals is utilised to convey consistent, comprehensive care to individuals. The conveyance of mental health treatment and care by multidisciplinary teams has created in parallel with the demise of huge psychiatric intuitions (Leff et al.,2000). Since the 1950’s mental health care has moved from the psychological medical clinic to community-based care. This development was the aftereffect od enhancements in in pharmacological medications along with social, political and economics trends. These included expanding accentuation on human rights, comprehension of the inconvenient impacts of systematisation, the association of family and administration client associations, esteem for cash, and the impact of the helpful network development. The development of network-based consideration has been to a great extent down to earth, mirroring a clinical view that 'the necessities of the seriously rationally sick can once in a while be met by a solitary individual' (Burns and Lloyd 2004; Onyett, 1992).
The delivery of mental health treatment and care by multidisciplinary teams has established in parallel with the destruction of enormous psychiatric institutions (Leff et al.,2000). Since the 1950s psychological well being care has moved from the mental health hospital to community-based care. This development was the result of enhancements in pharmacological treatments alongside key social, political and economic trends. The development of community-based care has been to a great extent down to business, mirroring a clinical view that ‘the needs of severely mentally ill can rarely be met by a single individual’ (Burns and Lloyd 2004). A key quality of multidisciplinary groups is that the consolidated skill of a scope of mental health professionals is utilised to convey consistent, comprehensive care to the indvidual. The research evidence supports multidisciplinary team working as the most effective means of delivering a comprehensive mental health service to individuals with mental health issues, particularly those with long term mental health issues (Tyrer, 1998).
Multidisciplinary teams pass on numerous advantages to both service users and the mental health professionals working on the team, for instance continuity of care, working on the team, for example continuity of care, the capacity to take a thorough compressive perspective on the service user’s needs, the accessibility of a scope of aptitudes, and shared help and education. As indicated to Moss (1994) multidisciplinary groups working in the network empowers the accompanying three key capacities to be accessible to support clients: proceeding with proactive consideration of those with long haul genuine psychological well-being issues 24-hour access to data and backing, intercession and treatment previously and during emergencies, and a sorted out reaction to demands for assistance from essential consideration.
WHO (2016) defines health inequality as differences in health status or in the distribution of health determinants between different population groups. Lower SES (Socio –economic status) is associated with lower life expectancy, higher overall mortality rates and higher rates infant and prenatal mortality. Moreover, low SES is associated with each of the 14 major cause-of death categories in the International Classification of Diseases as well as many other health outcomes” (Rogers & Pilgrim 2010, p.48).
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The World Health Organisations have stated that individuals who are socially deprived and hindered have over the span of their lifetimes much higher levels of major psychological instability and inadequate access to care. When thinking about this factor in connection to mental health illness, there are different factor that are different factors that are significant for instance, gender, age and race. For understanding determinants causing imbalance in both mental and physical health. There are information’s that considers the impact of early life conditions and how they may affect wellbeing in later life. Social class permits just a halfway picture. The Black Report 1980 explains inequality of physical and mental health from four perspectives; artefact explanations – inequalities are a product of the way statistics are presented and challenge their existence. New methods using longitudinal census data and linking to death certification and cancer registration refuted a statistical bias. Selection explanations – examines impact of chronic illness in early life and how this may perpetuate into adulthood (Power et al 1996). Cultural/behavioural explanations – looks at lifestyle and health-related behaviour, for example how smoking, obesity, lack of exercise, lead to inequalities. Materialist explanations – poverty and lack of opportunity, a person’s socio-economic position leads to poorer health (cited in Rogers & Pilgrim 2014p:23).
Research unequivocally shows that the more unfortunate an individual the more in danger they are od developing a mental health issue. In any case, there is verity for instance affective disorders are believed to be spread equitably over the class separate though as solid connection exists among schizophrenia and lower classes. Individuals in poverty have to battle more and bear more worry from higher crime rates, less fortunate crowded living conditions, traffic, commotion and so forth. Indication from patient follow up indicates those with a diagnosis of schizophrenia have a better prognosis if they have employment opportunities (Warner 2003).
A negative frames of mind of mental Health and mental Illness don't simply vanish medium-term, the authenticity where certain enactments and acts are incorporated to keep people from being separated these include: Mental Health Act 1983-2007, Mental Capacity Act 2005, Human Rights Act 1998 and Equality Act 2010, without the utilisation of these demonstrations and enactments in cutting edge society openings for work would not be ensured, poor lodging and advantages won't be drawn closer in the right way
Rogers and Pilgrim (2010) indicate poverty an important factor when bearing in mind the connection between social class and mental health as it polarises the social control component of psychiatry. Poverty is significant when considering precipitators factors in distress. The elements may incorporate collaborations with different types of abuse for example racism. The dominant approaches to understanding and treating mental health problems is entrenched in the biomedical model. “Illness viewed as objective and physical and upholds and reinforces the notion that any intervention will be culturally neutral and therefore appropriate to use as a model for all cultures” (Burr & Chapman 1998). The Health Care Commission, Mental Health Act Commission and NIMHE/CSIP (2005) found mental hospital admission rates were 3 times the average for black men and double for black women. A determination of schizophrenia is multiple times increasingly normal in Black African Caribbean's, multiple times almost certain in Black Africans and over multiple times progressively basic in non-British whites. Potential causes discussed are absence of social fitness on the half of psychological wellness experts, who misread signs and read practices wrongly. Additionally, Black individuals bound to endure destitution and stressors related. “Research conducted by the Social Care Institute for Excellence points to importance of awareness that BME service users often do not seek help early because of a lack of trust in services. So more likely to leave until crisis point and detained under Mental Health Act 1989” (Green, Pugh and Roberts 2008 cited in Greaves 2010).
They are many ways that can possibly improve mental health, strengthen communities: increasing social support, social inclusion and participation, improving community safety, development of health and social care which support mental health and investing in social capital. Reducing structural barriers to mental health; initiatives to reduce discrimination and inequalities across to housing, employment and education.
The psychiatric perspective is an approach that understands that mental health and ill health is underpinned by the bio medical mode which the dominant medical discourse in western psychiatry. Psychiatry is concerned with the diagnosing mental ill health, prognosis the course of illness, the aetiology possible cause and the prescribing and recommending a treatment approach with aim to cure or tackle symptoms. Be that as it may, there is a lot od variety between psychiatrists regarding to what is been said previously. One bringing together idea is the solid concern with diagnosis and biological beliefs and approaches to treatment. Without a doubt psychiatry as become the dominant perspective within contemporary mental health services (Rogers, A and Pilgrim, D 2014).
Pilgrim & Rogers believe the 21st century notion of mental health policy is related to legal arrangements, policy directives and service investment (cited in Glasby & Lester 2010). The World Health Organisation states that health policy refers to decisions, plans and actions that are undertaken to achieve specific health care goals within a society. An explicit health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the shorts and medium term. It outlines priorates and the expected roles of different groups; and it builds consensus and informs people.
The Mental Health policy has truly developed since the late 1990s. Beginning with Modernizing Mental Health Services in 1998, which was trailed by the National Service Framework for Mental Health in 1999, progressive strategies have attempted to create psychological well-being administration arrangement, and to fabricate an equality of regard between emotional well-being and physical wellbeing. According to Pilgrim and Rogers mental health policy means “any society’s attempts to promote mental health and to ameliorate mental health problems. It includes legislative arrangements and politically prescribed forms of professional duty and service response” (Pilgrim, 2014 p.139). consideration of Mental Health Policy is best placed within a historical overview due to the fact that any comparison of policy and overtime enables individuals to grasp a picture of how different governments have driven policies and also enables individuals to have snapshot of the socio economic and political context at a given time. Department of Health have a goal of achieving better access to mental health services by 2020 which includes: treatment within six weeks for 75% of people referred to the Improving Access to Psychological Therapies programme, with 95% of individuals being treated within 18 weeks. As Well treatment within two weeks for more than 50% of individuals experiencing a first episode of psychosis, additionally a 30 million targeted investment will help individuals in crisis to access effective support in more acute hospitals (Department of Health p.4,2014).
The Suicide Prevention Strategy for England 2012 has two key objectives which are: a decrease in the suicide rate in the general population in England and an improved support for those bereaved or affected by suicide. The strategy also identifies six key areas of action which include: decreasing the risk of suicide in key high-risk groups, adapting methods to develop mental health in specific groups, lowering access to the means of suicide, delivering better information and support to those grieving or affected by suicide, supporting the media in delivering sensitive approaches to suicide and suicidal behaviour and also supporting research, data collection and monitoring (Department of Health, 2012).
Overall, mental health should be spoken about to many individuals due to the fact that many people end up dying everyday due to the mental health state. Many people would say that not a lot of people have a great understanding of understanding because it is not spoken often which is a shame because statistics level of suicide to mental health is very high. Public health is concerned with improving the health of the population as opposed to treating individuals. Key themes in public health include addressing the root causes of illness, tackling the inequalities which are at the heart of large variations in health and promoting public participation (Marmot Review 2010). Every indvidual is unique and also the factors causing mental illness. It is estimated that individuals living in poor financial conditions are increasingly inclined to the basic mental issue. This is additionally compounded by joblessness, poor instruction status and other budgetary impediments. The most widely recognized psychological instability in UK today is tension. It represents influencing 9.2% of the absolute population. They're no uncertainty that values are a most important rule practically speaking which is then used to attempt issues of Mental Health and Mental Illnesses. Next in line is sorrow influencing one out of 200 youngsters under the age gathering of 12 years (Voelker, 1999). Acknowledgment of Mental Health conditions turned out to be progressively standard in current society; individuals' frames of mind and practices changed since consciousness of the issue through web-based social networking and backing of multidisciplinary groups utilisation of giving data. Improved mental health and wellbeing is linked with a variety of better results for individuals of all ages and backgrounds. These include better physical health and life expectancy, better educational achievement, enhanced skills, decreased health risk behaviours such as smoking and alcohol misuse, reduced risk of mental health problems and suicide, better employment rates and productivity, lowered anti- social behaviour and criminality and greater levels of social interaction and participation (NHS,2016).
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- Department of Health (2001) The Journey to Recovery. London
- DoH (2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages. London
- DoH (2012) No health without mental health: implementation framework. HM Government Equality Act (2010) [Online] (Accessed October 2019) Available at http://www.legislation.gov.uk/ukpga/2010/15/contents
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