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PUBH6001 Health Policy And Advocacy
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PUBH6001 Health Policy And Advocacy
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Course Code: PUBH6001
University: Laureate International Universities
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Country: United States
Question:
In this Assignment, you will engage in policy analysis. Choose a health policy (either current or past), either at the state or federal level, to analyse in this Assignment (eg, mental health policy, women’s health policy, preventatve health policy, men’s health policy, the Northern Territory interventon).
Address the following questons in your Assignment but please do not answer the questons as a series of short answers:
The Problem and Context
Describe the current and historical policy context of the problem.
What is the problem which the policy seeks to address? What problems are highlighted? What problems have been overlooked?
Frame of Reference/Dominant Discourse
What is the common frame of reference or dominant discourse evidence within this policy?
Are certain words and phrases commonly used?
Are there any underlying assumptons behind these?
Targets, Stakeholders and their Representaton
Who is the target of the policy (the subject of the discourse)?
Who are the other stakeholders identfed in the policy? Describe key insttutonal structures, agencies and workforce capacity building.
How are the subjects of the policy being represented?
How are diferent social groups portrayed in this policy and what implicatons does this have?
Are there any moral judgements expressed in this representaton?
Policy process
Who were the stakeholders involved in the development of the policy? Who was overlooked?
Whose interests were represented in the development of the policy? Which voices were not heard?
What were the potental competng interests and power diferentals of those involved in the development of the policy?
What was the motvaton for stakeholders in creatng this policy?
Were there any partcular windows of opportunity that enabled the development of this policy?
Policy Solutons
What solutons are put forward to address the problems? What alternatve solutons might have been overlooked?
Are there any social/power/ethical implicatons of this policy?
Efectveness
Consider the implementaton of the policy. How efectvely do you think the current policy has been implemented?
What are the accountability processes for the policy?
Consider evaluaton measures (indictors) and any evaluaton which has been undertaken. How efectve has the policy proven to be?
Answer:
Introduction
Good mental health for the general population in a given country depends on the country’s mental health policy. Many people with mental illnesses tend to keep away from the public, an indication that they have no confidence in the state to protect them or cover them whatsoever. Their participation in the national agendas is also likely to be low. In many cases, these people tend to be harmful and dangerous. The government needs therefore to ensure that these individuals are covered, and the public population needs to be kept safe from the harm to the mental inebriates who get fierce, Slade, Teesson & Burgess (2009).
A well formulated mental health policy plan is instrumental in motivating various stakeholders to step up in their efforts to ensure that the general population are well served as regards to their mental health services, which include carrying out campaigns and sensitizations on mental health issues or managing mental instability cases, Degenhardt et al (2008). In this regard, a national mental health policy is a must – have for any country that vision in the well-being of their citizens.
Problem Context
The national mental health policy holds that ‘on-the-ground’ treatment strategies alone cannot solve the mental health challenges in the country. There is need for preventive approaches to be given a upper hand in dealing with these cases, Berry, Bowen & Kjellstrom (2010).
This paper will inquire into the need to re-assess the current mental health policy in Australia and even internationally. In order for the marginalized groups of individuals with mental disabilities to be given an equal opportunity in the society, there would be a great need for reformation. A careful analysis of the existing policy is a prerequisite for any pact that is willing to defend the rights of the mentally disabled class, Berry et al (2010). Policy analysis will be instrumental to help understand challenges that social workers as well as to mental health workforce are facing. The service and work that is carried out by humanitarian agencies fighting for the rights of the mentally disabled is highly dependent on the national mental health policy of the nation. Analysis of the current mental health policy in Australia is the core objective of this paper.
Target and stake holders of the Policy
Promoting mental health and managing current mental instability cases has been on the top agenda in Australia’s national health strategies and imitates for over a decade now. In this regard, mental health and public health sectors have sought to unite in order to embrace need for a broader understanding of the mental health implications. The Australian National Mental Health policy 2008 has been an important driver for providing preventive strategies to reduce cases of mental instabilities in Australia, McGorry, Bates, & Birchwood (2013). The first mental health strategy was formulated in 1992 and was the first initiative to bring mental health reform to the national table. It is this strategy that gave birth to the national mental health policy.
The target of this policy includes the public and private health services, especially those that deal with mental cases, mental health enthusiasts and policy makers for mental health. The key target audience are the, major stakeholders who are basically concerned with mental health partners. Mental health services may consider to specifically class the mental health consumers as with age or level of interaction with mental health issues, Slade, Teesson & Burgess (2009). These may include child and adolescent group, elderly persons group and forensic mental services group. This categorizing approach makes it easy for delivery of mental health services. Hence, most mental health advocacy agencies find it more convenient to operate with such classes as opposed to working with the whole community. These are some of the considerations that need to be put in place when planning and implementing strategies for mental health management, Fritze et al (2009).
Other stakeholders in the national mental health policy include all specialists in providing mental health knowledge in all categories, private hospitals mental health departments and private psychiatry service centers, Berry et al (2010).
The policy brings together a number of social groups recognized by the Australian government. These include the community care, housing, employment, justice affairs, and welfare among others. These sectors are regarded as playing a very important role in enhancing the amelioration of the mental health of the community help in implementation of preventive measures in the population, and in the recovery of the affected class of individuals. The Australian government is committed to promote more inclusion of social groups from the community. Social inclusion is geared toward inclusion of even the marginalized groups, for example the Aboriginal and Torres Strait Islander children, McGorry et al (2013).
Policy Process
Francis, Wood, Knuiman & Giles-Corti (2012). have discussed in their paper the relationship between in urbanization and ride in mental health cases. In their article is evidence drawn of urbanization linked to mental health challenges within the towns. According to their research, there are many factors that can lead to mental health challenges in highly populated areas in urban centers, Grob (2014). Noise and escalated pollutions from industries, work pressure, inadequate green rest environments are amongst the cases that would contribute to these challenges. Poverty, another characteristics in urban centers also play a major role and it is linked to mental challenges.
Their paper categorizes the causative factors of mental instabilities into non-linear type and cyclical types. Poverty cases bring about the cycle of mental complications which if not checked will almost always encourage mental instability cases. The paper strongly challenges the current policy for mental health and begs for a balanced system that will ensure preventive measures are taken to reduce mental health disability cases, Umberson & Karas Montez (2010).
The National Mental Health Policy 2008.
Frame of Reference
A mental health policy normally involves a statement of vision, policies and values that will form the background of the policy and a statement of objectives. These vital elements to be found in any sound policy are formulated parallel with one another, Davidson, Ridgway, Kidd, Topor & Borg (2008).
Implementing the Mental Health Policy 2008.
In implementation of any policy, strategies of implementation must be laid down first. These strategies will be the core of the future policy plan.
The very first obligation in implementing a policy is to re-assess strategy options. What follows is to determine the resources needed to implement the policy, and whether they are available. Once the strategies to implement have been clearly understood, the established costs of implementation can then be established.
The last thing is to establish implementation plan. The plan should be clear with objectives clearly outlined strategies laid out and desired targets recorded. Timeline, outputs and challenges ought to be clearly stated too, Cooper et al (2008).
Formulation of the policy -Stakeholders
A stake holder involves an individual or organization that is involved in implementing something or executing some task, who are liable to either gain or lose from the outcome of the process. They can as well be considered as partners who cooperate and work together for the success of the project at hand.
The stakeholders who worked together to formulate the 2008 mental health policy worked for the interest of the general public. As a basis for their interests, these are the aims that they had in mind:
To promote mental wellbeing of the Australian general population, and to prevent cases of mental instability.
Decrease impact of mental health problems.
Enhance recovery of mental inebriate cases in the general population
Defend rights of mental disabled cases and to ensure that they have equal rights with other citizens in the national agendas.
These objectives were the basis under which the mental health policy was formulated.
National Mental Health Strategy
The National Mental Health Strategy of 1992 that incorporated the convocation of all the Australian ministers would finally give birth to the mental health policy. The major gap that gave rise to this policy was the indifference that had been manifested to this sector, Kieling et al (2011). Furthermore, the drive for reforming the mental health sector was as a result of mental health professionals and consumers, who were eager to see the mental health system wholly reformed. In 1992, the United Nations released a declaration for the protection of persons with mental instability. Furthermore, inquiries in various states revealed a general abuse of the rights of the mentally challenged persons. There are the driving factors that led to the formulation of the mental health policy.
The ‘Burdekin’ Report
In 1993, the Burdekin Report revealed worrying state of mental illness status in Australia. The results were overwhelming. The report indicated a high level of mental health staff inadequacy, and therefore limited and inefficient mental health services, Gulliver, Griffiths & Christensen (2010). This is the report the face of Australia in regard to the mentally disabled persons. The report brought to light indifference in the community concerning the existence of mental instabilities, and the harm that the mental inebriates can caus. According to the report, there was a growing myth that people with mental illness cannot easily recover, Gulliver et al (2010).
Policy Solution and Effectiveness
Solution to identified Problems in Mental Health
Crime and substance abuse have a bi-directional relation to mental health. These as forces, bind with one another and reinforce mental risk in the society. Hence there is need for formulation of a new policy that will sensitize individuals and institutions on the need to be wary of these causative factors and be on the front end in implementing preventive measures that shall have been outlined in the policy in order to improve he urban life condition, Holdeman (2009).
Most reviewed scholarly works present discussions on possible changes that can be done and if they are feasible. However, it is vital to assess into the bias that social workers may have towards mentally disabled persons.
There is a great need for formulation of a better and efficient policy for urban centers. This will be clear by dissecting and cooking into the current mental health policy In Australia.
As a solution to the identified problem in Australia, the mental health policy was formulated. This was not the outcome of the national mental health strategy convocation. There are three other outcomes of the meeting, but the mental health policy is the major one. The other three were only supporting documents. The mental health policy includes the following principles:
Accountability
Legislation
Research evaluation
Implementing workforce
Prevention and awareness
Uniting mental health services with others
In 1998, Australian health ministers endorsed the country’s second national health plan. The significance of this plan was to put together current reforms and extend them especially on the ends of early prevention of mental instability cases and putting up clear preventive measures. Furthermore, it was the aim of the plan to increase partnerships with other public sectors and increase the quality and effectiveness of its service delivery, Slade, Teesson & Burgess (2009).
To improve the general mental health of the Australian population, external initiatives have also played a very important role. Some of those initiatives include the ‘beyond blue initiative’ that was sponsored by the Commonwealth, ‘More Options Better Outcomes” initiative which started in the year 2002 and ‘Mind Matters’ initiative, Kessler et al (2009).
Implications of this policy
Since National mental Health Strategy began in 1992, there have been a lot of changes in the national planning. Six years down the line, there was 61 % registered in increase in the general participation of consumers in the service delivery?, Kessler et al (2010).
There has been a registered improvement in the mental health service delivery. There are quite a number of advantages that have been registered since the first National Mental Healthy strategy meeting. There would have been more efficiency in service delivery had the mental health services been diversified, Slade et al (2009). For example, the National Mental Health Strategy Meeting would have involved creation of national initiatives to help in sensitization programs and offering of reformation services to the mental inebriates.
Implementation of the policy.
The mental health policy 2008 implementation has been a joint effort of the state governments and the government of Commonwealth and mental health service providers and consumers. The implementation is spearheaded by the ‘National Mental Health Working Group.’ Some of the realized benefits within the federal states in Australia include the following, World Health Organization (2014):
There has been a drastic decrease of psychiatrist centers in all the states
The mental health services have been blended with the mainstream health services of the states.
Consumers involvement in decision making processes has immensely grown
Psychiatrist support centers have doubled up
Due to reduced institutions across the states, money saved can now be used for other activities.
All the states and territories have incorporated an amendment clause in their legislations to fulfill all the National Mental Health Strategy standards, Smith, Humphreys & Wilson (2008). The national Mental Health Strategy standards are all conformed to the United Nations standards as regards mental health. In order to make sure that all state agencies have conformed to all required legislations as regard mental health, the Attorney General came up with an instrument called ‘Rights Analysis Instrument that measures the compliance level of states and territories towards the mental health legislations, Slade, Teesson & Burgess (2009).
According to a report done by the Mental health council of Australia, there appears to be inconsistency in the way the National Mental Strategy’ legislations have been absorbed in by the various stakeholders, World Health Organization. (2014). There is therefore a possibility that the efforts of the National Mental Strategy may not be smoothly spread out to all stakeholders. This is an indication that the evaluation was not effective enough.
Conclusion
Mental health problems can be attributed to various factors. These may include and not limited to crime, drug and substance abuse amongst others. Depression affects many people throughout the world but can be managed by behavioral therapies, Francis et al (2012). The most effective way that this problem can be managed in Australia is by introducing preventive measures; this the world is in need of. It is imperative therefore that this issue be discussed and effective solutions be found. In conclusion, it is clear that the mental health reform efforts as held by the National Mental Health Strategy policies does not translate seamlessly to every stakeholder as is supposed to. While notable progress has been registered, there still remains a big gap that has to be bridged to ensure a complete and seamless mental health sector reform. There is still a gap in implementing the mental health policy. If this issue is not going to be addressed soon, we are liable to face more financial and social challenge in the future.
References
Berry, H. L., Bowen, K., & Kjellstrom, T. (2010). Climate change and mental health: a causal pathways framework. International journal of public health, 55(2), 123-132.
Cooper, J. L., Aratani, Y., Knitzer, J., Douglas-Hall, A., Masi, R., Banghart, P. L., & Dababnah, S. (2008). Unclaimed children revisited: The status of children’s mental health policy in the United States.
Degenhardt, L., Chiu, W. T., Sampson, N., Kessler, R. C., Anthony, J. C., Angermeyer, M., & Karam, A. (2008). Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO World Mental Health Surveys. PLoS medicine, 5(7), e141.
Davidson, L., Ridgway, P., Kidd, S., Topor, A., & Borg, M. (2008). Using qualitative research to inform mental health policy. The Canadian Journal of Psychiatry, 53(3), 137-144.
Fritze, J. G., Blashki, G. A., Burke, S., & Wiseman, J. (2008). Hope, despair and transformation: climate change and the promotion of mental health and wellbeing. International journal of mental health systems, 2(1), 13.
Francis, J., Wood, L. J., Knuiman, M., & Giles-Corti, B. (2012). Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia. Social science & medicine, 74(10), 1570-1577.
Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC psychiatry, 10(1), 113.
Grob, G. N. (2014). From asylum to community: Mental health policy in modern America (Vol. 1217). Princeton University Press.
Holdeman, T. C. (2009). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Psychiatric Services, 60(2), 273-273.
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., … & Wang, P. S. (2009). The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiology and Psychiatric Sciences, 18(1), 23-33.
Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O., … & Rahman, A. (2011). Child and adolescent mental health worldwide: evidence for action. The Lancet, 378(9801), 1515-1525.
Kessler, R. C., McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., … & Benjet, C. (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British Journal of Psychiatry, 197(5), 378-385.
McGorry, P., Bates, T., & Birchwood, M. (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202(s54), s30-s35.
Slade, J., Teesson, W., & Burgess, P. (2009). The mental health of Australians 2: report on the 2007 National Survey of Mental Health and Wellbeing.
Slade, T., Johnston, A., Oakley Browne, M. A., Andrews, G., & Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australian and New Zealand Journal of Psychiatry, 43(7), 594-605.
Smith, K. B., Humphreys, J. S., & Wilson, M. G. (2008). Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research? Australian Journal of Rural Health, 16(2), 56-66.
Umberson, D., & Karas Montez, J. (2010). Social relationships and health: A flashpoint for health policy. Journal of health and social behavior, 51(1_suppl), S54-S66.
World Health Organization. (2014). Social determinants of mental health. World Health Organization.
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