A Case Study Of Mental Health

A Case Study Of rational wellnessMental wellness has make a major global problem. It affects 450 m naughtilyion citizenry and one in four of us will suffer from psychical ill- wellness at round time in our lives (WHO, 2001). Mental wellness is used positively to signal a state of psychological well- being, negatively to indicate its resister ( as in psychical health problems) or euphemistically to indicate facilities used by, or imposed upon , state with ami subject health problems ( as in kind health function).During the nineteenth century, all patients were certified on a lower floor lunacy laws. That is, the State only made provisions for the harbor of madness. The fledgling(prenominal) profession of abnormal psychology ( this marge was first used in Britain in 1858) was singularly preoccupied with segregating and mankindaging lunatics . With the emergence of the First World War, soldiers began to break deal with shellshock now called post traumatic tense malady . From this quest on, psychiatry extended its jurisdiction from madness to versions of nervousness provoked by stress or trauma. In the twentieth century, to a greater extent abnormal affable states came inwardly its jurisdiction, such as those due to alcohol and drug abuse and personality problems. Today, intellectual health go may be offered to, or be imposed upon, people with this wide range of problems, although madness or unvoiced cordial indis specify still captures most of the attention of professionals .Another aspects of the term mental health problems is that some people, critical of psychiatric terminology, object of scientific or logical grounds to notions like mental illness or mental disorder.In the 1983 Act and equivalent Scottish legislation mental illness is not defined. However, Article 3(1) of the Northern Ireland Order does define it as a state of mind which affects a persons view, perceiving, emotion or judgement to the goal that he require s cargon or medical treatment in his declargon interests of other persons. Neither the Scottish nor Northern Ireland definitions include psychopathic disorder and there has recently been some discussion in the scope of retrospect of the Mental Health Act about removing it in England and Wales.Issues concerning mental health deliver been raised substantially in the consciousness of politicians, the media, and the public. Moreover, the burden of mental disorder is regarded not just as a if not the- headland cause of human misery, but as a signifi hatfult impedimenta to societal and economic growth. Measurement of the years of potential life upset and the years of productive life lost through mental ill- health could reach 15% of all diseases and deaths globally by 2020 (WHO, 1999).A promote dimension of inequalities in the app arnt scale of mental health problems is race. washout is controversial to define. Genetic distinctions amongst groups of humans ( other found on s ex) have little empirical basis. Racial distinctions arose from anthropological investigations carried out by colonized indigenous people. However, because of colonization, the social identity of these people became real for them and others.In the United States barren patients atomic number 18 overrepresented in mental institutions, and have drive increasingly so over the postwar period. This has particularly been the case in spite of appearance state mental infirmarys, where nonage groups constitute 35 per cent of the hospital commonwealth, and are subject to higher(prenominal) place of admission and readmission. In a review of eight epidemiological studies conducted in the United States between the ripe 1950s and mid- 1970s, Kessler and Neighbors (1986) found that among persons with low incomes sour people exhibited significantly more than distress than etiolated people. They claimed, therefore, that race is an measurable independent variable quantity in determining the likelihood of an individual becoming mentally ill. on that point is some dispute over what to make of this secern. Cockerham (1990) maintains that the majority of studies on the incidence and dissemination of mental health problems suggest that race is not an independent variable race alone does not appear to produce higher grade of mental disorder for particular groups. Rather, it is because more ominous people are in the lower social cases that they tend to demonstrate more signs of mental distress. Others, however, disagree. Halpern (1993) lay outs that minority status can be demonstrated to result in a tendency towards psychiatric problems.As with gender, a number of studies have been conducted indicating that racial bias exists in the estimation, diagnosis and treatment of mental health problems. It has been found, for ex fat, that white therapists largely rated their black clients as being more psychologically impaired than did black therapists. Patients who are un cooperative, threatening or abusive are more likely to be diagnosed as being mentally ill if they have minority status. In particular, it has been found that being black tends to increment the chances of a person being diagnosed as being schizophrenic (Wade, 1993). authentic groups such as people of Afro- Caribbean origin tend to be more likely than whites to receive psychotherapy. Minority groups have proved less able to make use of community- based dish ups. This is partly because they have lacked the resources to participate in the development of community care, and partly because of the lack of interest in or understanding of the specific cultural needs of minority groups when establishing goods ( Wade, 1993).The term Afro- Caribbean refers to black people who either still live in Caribbean or who moved to Britain. Britain is an ex-colonial power, which enslaved and forcibly transported African people. Afro-Caribbean people have higher range of diagnosis for schizophrenia bu t lower rates for depression and felo-de-se than indigenous whites. An unresolved debate about over- representation is whether it is actual ( black and Irish people are mad more oftentimes) or whether it is a function of misdiagnosis .The data of Irish people highlight why the stresses of racism, based purely on skin contort, are not an adequate account statement of differences in mental health status. Although Afro- Caribbean people are vulnerable to psychosis, preponderance rates of all diagnostic categories are higher than for the indigenous ( non- Irish)whites in Britain.What are the implications of comparing and contrasting these two ex-colonized groups for our understanding of the relationship between race and mental health? The first point to emphasise is that addicted the white skin of the Irish, racism based on skin colour may be a stressor but is not one that accounts for racial differences in mental health. A second point is that while twain groups are post-colonia l remnants of forced migration, the circumstances for each were different. Third, the circumstances of migration to Great Britain were analogous in some focal points but not others. Employment opportunities governed population movement in each. Fourth, as ex-colonized, Afro- Caribbeans and the Irish have been recurrently stigmatized and rejected. A confirmation of this point is that these groups are also over-represented in the prison population, not just in involuntary specialist mental health services. Fifth, and following the previous point, whatever the causal explanations for over- representation, the racial bias means that these groups are disproportionately dealt with by specialist mental health services. As the latter(prenominal) are dominated by coercion, this outcome can be panorama of as a form of structural disadvantage for these groups.The needs, issues and concerns of black and minority ethnic people (BME) with mental health problems have been pushed to the fore of the theme health policy agenda (Department of Health, 1999 Department of Health, 2005). Britain is a multi- cultural community where the percentage of the population that is from minority groups is steadily increasing. In 2001 minority groups comprised 7 per cent of the population, with a concentration in capital of the United Kingdom and other inward city areas.BME communities occupy particular positions of disadvantage in the United Kingdom. Inequalities are reflected across all indices of economic and social well- being.They generally have higher rates of unemployment, live in poorer housing, report poorer health, have lower levels of faculty member achievement and higher rates of exclusion from schools.The tragic but significant marker for BME communities was the death of David Bennett while being restrained by treat staff on a medium secure ward. After a long campaign by his family, an independent inquiry report think that the NHS mental health services are institutionall y racist( Norfolk, Suffolk and Cambridgeshire SHA, 2003). The government afterward published an action plan for Delivering Race Equality (Department of Health,2005). This plan has common chord building blocks to develop more appropriate and responsive services, to provide kick downstairs quality information on the mental health needs of BME, to hike up greater community engagement in the planning and delivery of mental health services. DRE focuses on organisational change, but fails to appreciate the heterogeneity within the BME population, and the mazy range of identities and practices it contains.It also fails to appreciate that the inequalities in mental health for black people exist within a broader historical and contemporary mise en scene of social and economic inequalities and prejudice. Moreover, the problem seems to have been framed in the context of culture- thus, the focus in the DRE strategy on developing a culturally competent workforce. Fernando (2003) argues tha t a focus on culture can itself be racist and therefore has to be examined in this context.Another issue to date is the bushel of racial disadvantage and discrimination on individuals , their families and communities. Petel and Fatimilehin (1999) suggested that the impact of racism is psychological, social and material. The effects of these are likely to be detrimental to mental health, but it has to be borne in mind that for some it may be minimal, while for others it may be of great significance to their emotional well-being. The effects of racism on the individual may have wider impacts on families and communities . The impact of racism therefore has to be analysed in the context of histories of migration, histories of alienation, the subordination that resonates for these groups, and the way in which these groups have been stigmatised and continue to be stigmatised in order of magnitude today. in that respect are many competing discourses and perspectives on what constitute s mental illness. Bracken and Thomas (2005)argue that our acquaintance of mental illness and distress is indeterminate and new ways of thinking about mental illness are constantly emerging. Coppock and Hopton (2000)suggest that there is ample evidence to show that mental illness is affected by social and political circumstances. Mental illness can be deeply dehumanising and alienating. It is generally regarded with anxiety and fear and loads to rejection and exclusion. A report by the well-disposed Exclusion Unit (2004) found that people with mental health problems are among the most disadvantaged and socially excluded groups in society.The stereotype of big and heartrending has been fixed in the popular case of Christopher Clunis- a back man who had a diagnosis of schizophrenia, who randomly killed a stranger to him, Jonathan Zito, in a London underground in 1992. Keating et .al (2002) have demonstrated that such unimaginative views of black people, racism, cultural ignorance, stigma and anxiety associated with mental illness often combine to influence the way in which mental health services assess and respond to the needs of BME communities. There are at to the lowest degree three factors that underpin black peoples experiences of the mental health system one, how black people are treated in society two, how people with mental health problems are treated in society and three, the power of institutions to control and coerce people with mental health problems. Black peoples experiences in society have an impact on their mental and emotional well- being these experiences in turn influence how they experience and perceive mental health services, and their position in society affects how they are treated in mental health services.Eradicating the disparities in mental health treatment and outcomes for a black people requires change in individual practices, but this can only be successful if supported by changes at the organisational level. Efforts to change mental and emotional well- being for BME communities should be anchored in an understanding of history, broader societal conditions and contexts, and black peoples lived experiences not just their experiences of racism, but also how they have survived in the face of seven-fold adversities.McKenzie (2002) has argued that the lack of definition of mental health from a British African Caribbean perspective and the use of diagnostic criteria based on white European norms rather than on the values and experience of the African- Caribbean population is problematic.Further evidence Hunt (2003), Keating, Robertson and Kotecha (2003) and McKenzie (2002) suggests that people from BME communities experience a number of social and environmental risk factors which adversely affect their mental health. These include high unemployment rates poor housing, racism, low educational expectations, particularly for African and Caribbean boys (Grater London warrant/ London Health Observatory 2002) iso lation and a lack of assenting to opportunities for personal development.A report by the black mental health charity Footprints (UK) (2003), which works primarily with African Caribbean service users, has identified go on issues of concern about care and treatmet as the need for better assessment to promote more culturally acceptable interventions, concerns about medication, including high dosages and polypharmacy, resulting in numerous adverse side- effects and negative staff attitudes.Keating et al. (2003) have highlighted the point that black people see using mental health services as a degrading and alienating experience and that their perception is that service respond to them in ways that mirror some of the controlling and dictatorial dimensions of other institutions in their lives, for example exclusion from schools and contact with police and the condemnable justice system.The National Service Framework for Mental Health ( NSFMH) is an important driver and ways a key ste p in actively signalling that health services must ensure that the needs of people from BME communities are incorporated in the planning processes from mental health care. The framework accent the need for respective(a) communities to be consulted about the ongoing effectiveness and suitableness of services.The NHS Plan is underpinned by ten core principles that are aimed at ensuring that people who use mental health services are at the nubble of determining how services are delivered. The NHS Plan contains an explicit fruition of the diversity that exists within Britain.The recently published strategy on black mental health again underscores the governments commitment to race equality and outlines the underpinning roles of the NSFMH and the NHS Plan in ensuring that its modernisation programme within mental health is delivered.In oddment the impetus and improvement for mental health service delivery to BME communities can be seen. Many people who use mental health services, however, would argue that what is less tangible is change in hospital wards, day centres, residential homes and engagements with community mental health teams in essence, at the coal face. There is scope for substantial and sustainable change. It will require a recognition by mental health professionals of the strengths that service users and their families can bring in reshaping service delivery, partner- professionals and, most importantly, agreement by service providers and service users on clear and mutually agreed goals and outcomes about what constitutes improved care and treatment. Efforts to improve mental and emotional well- being for BME communities should be anchored in an understanding of history, broader societal conditions and contexts, and black peoples lived experiences not just their experiences of racism, but also how they have survived in the face of multiple adversities.Beata KulinskaStudent no 09284805Word count 2999ReferencesPilgrim, D.(2005) key out Concepts in Mental Health. London Sage Publications Ltd.Scull, A.(1979) Museums of Madness .Harmondsworth Penguin.Stone, M,( 1985) Shellshock and the psychologists. 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