Mental Health Service Delivery in Australia – Pre and Post-Deinstitutionalization
Instructions:
“Mental health service delivery and philosophy has significantly changed since pre-deinstitutionalisation and the introduction of the Recovery Framework in Australia. Critically analyse the effects that this has had on the health of people with mental illness and on the consumer experience.”
As a guide, in order to answer this essay question, the completed essay should give the reader an understanding of what mental health service delivery was prior to deinstitutionalisation and an overview of what the Recovery Framework is and how it is implemented in Australian mental health services.
Evidence to support this should be critically analysed rather than described and should be based on primary sources of literature (at least ten different references should be used within 5 years or less).
Demonstrate: Comprehensive/detailed knowledge and understanding of the topic and the relevant theories/concepts used. Key concepts are well defined, explored and interwoven throughout the essay. Critical analysis evident throughout essay
Solution
Mental Health Service Delivery in Australia – Pre and Post-Deinstitutionalization
The provision of quality mental health care is critical for the promotion of mental health in Australia. The achievement of success in delivering quality care and treatment to mental health patients relies greatly on the implementation of the most effective approach. According to a 2014 report by the WHO and the Calouste Gulbenkian Foundation, community-based services are the most effective in providing mental health treatment and care. The consideration of the effectiveness of the approach led to deinstitutionalization and the implementation of the Recovery Framework in Australia. A shift from institutionalization to the Recovery Framework has impacted the Australian mental health services delivery significantly, influencing the health and wellbeing of people will mental illness majorly. This essay offers a critical analysis of the mental health service delivery pre and post deinstitutionalization and brings out the impact of the implementation of the Recovery Framework on the patients.
Deinstitutionalization gives people with mental illness the chance to receive quality treatment and care while living in a community setting. Pre-deinstitutionalization, people suffering from mental health diseases were confined in mental hospitals and institutions for treatment and care. The approach denied the patients independence and better quality of life within their communities. However, while the approach was theoretically a great idea, it was ineffective in dealing with people used to socialization and a better life in their homes but good for the homeless, victimized, and isolated people. According to the Kliewer et al. (2014), some patients deteriorated upon release from the institutions, re-institutionalization was common, while others died. Deinstitutionalization gives patients the opportunity to receive treatment and care without isolation, improves the patients’ independence, and promotes their adaptability to change (The Department of Health, 2014). As a result, its implementation continues to influence the health and wellbeing of people with mental illness positively by enhancing the effectiveness of treatment and care as compared to the quality of mental health services delivery pre-deinstitutionalization.
The improvement of the quality of mental health services through the Recovery Framework promotes the health of the patients. The Framework allows the delivery of recovery-oriented services, which ensure the provision of evidence-based treatment and care. The patients receive therapy, rehabilitation, treatment, and the psychosocial support that promotes their mental health and wellbeing. According to the Australian Institute of Health and Welfare (2017), the approach improves the quality of mental health services offered and promotes the health of the patients without having to confine them in a mental institution. Most importantly, it has improved the number of people accessing and using the services due to the convenience and independence that comes with community-based approach. The Institute states that while 35% of people with mental illness in a period of 12 months in 2007 sought mental health services, the percentage increased significantly to 46% in 2016 (Australian Institute of Health and Welfare, 2017). The awareness, accessibility, and patient independence improvement by the recovery Framework continue to improve mental health in Australia.
However, an imminent challenge is the perception among people and certain communities that mentally ill people are dangerous. Communities are not sufficiently-aware of mental illnesses and most people are frequently afraid of people with the illnesses (Mental Health Australia, 2016). According to the Mental Health Foundation of Australia (2017), the fear cause stigmatization, rejection, discrimination, and harassment prevent people with mental illness from seeking professional help. The implementation of the recovery framework in societies where people hold these notions exposes the patients to a great risk self-harm or harm from the society members. While the implementation of the framework targeted, among other things, eliminating isolation of institutionalization, people suffering from mental illness continue to face the same issue in homes and within their communities (MHA, 2015). This impacts their mental health making the achievement of success in treating and managing the illnesses difficult. On this point, deinstitutionalization and the introduction of the Recovery Framework impact on the health of mentally ill people negatively and, therefore, the need for awareness-creation and improvement of the quality of treatment ad care delivered.
The implementation of deinstitutionalization demands the consideration of possible negative impacts such as homelessness. The deinstitutionalization of homeless people with mental illness poses a challenge in accessing the mental health services and impacts their mental health significantly (WHO; Calouste Gulbenkian Foundation, 2014). These people are at risk of continued suffering. Institutionalization was effective in taking care of the homeless with an option of re-institutionalization. However, the current Framework does not provide an effective platform for dealing with the homeless. For the strategy to work effectively in treating and caring for people with mental disorders, the Government must first invest in sufficient housing for the homeless. Otherwise, releasing the people to homelessness would contribute to acuteness of the disorders. The stress that come with lack of housing promotes stress and the development of other mental illness such as depression (Mental Health Australia, 2015). The implementation of the Recovery Framework before addressing serious concerns such as homelessness impacts on the mental health of people with mental illness negatively (AIHW, 2017).
In conclusion,
deinstitutionalization and the specific implementation of the Recovery
Framework promises the improvement of quality in delivering mental health
services in the country. It promotes recovery-oriented service delivery in a
community-based approach where the patients continue enjoying their
independence, psychosocial support, and quality life. While institutionalization
isolated the ill because of the perceptions of the people and the lack of sufficient
resources in the communities, the Framework promotes awareness to alleviate
stigmatization and support to enable the patients to receive services in a
community setting. As a result, deinstitutionalization has achieved significant
success in promoting mental services delivery, the health and wellbeing of
people with the illnesses. However, poor implementation continues to influence
the mental health of the people with mental illness significantly. The creation
of awareness in the recent past has reduced fear, stigmatization, victimization,
and harassment of the mentally ill. However, many people continue to hold the same
perception which led to institutionalization in the first place.
Bibliography
AIHW, 2017. Homelessness. [Online]
Available at: http://www.aihw.gov.au/homelessness-publications/
[Accessed 28 3 2017].
Australian Institute of Health and Welfare, 2017. Overview
of mental health services in Australia. [Online]
Available at: http://mhsa.aihw.gov.au/background/
[Accessed 28 3 2017].
Kleiwer, S. P., McNally, M. & Trippany, R. L., 2014. Deinstitutionalization:
Its Impact on Community Mental Health Centers and Seriously Mentally Ill. [Online]
Available at: http://files.eric.ed.gov/fulltext/EJ875402.pdf
[Accessed 28 3 2017].
McKenna, B., Furness, T., Dhital, D. & Ireland, S., 2014. Recovery-Oriented Care in Older-Adult Acute Inpatient Mental Health Settings in Australia: An Exploratory Study. Journal Of The American Geriatrics Society, 62(10), pp. 1938-1942.
Mental Health Australia, 2015. Housing stress exacerbates
mental illness. [Online]
Available at: https://mhaustralia.org/media-releases/housing-stress-exacerbates-mental-illness
[Accessed 28 March 2017].
Mental Health Australia, 2016. stigma. [Online]
Available at: https://mhaustralia.org/tags/stigma
[Accessed 28 March 2017].
MHA, 2015. Mental Health Australia submission to the
Senate Standing Committee on Community Affairs Inquiry into the Social Services
Legislation Amendment Bill 2015. [Online]
Available at: https://mhaustralia.org/submission/mental-health-australia-submission-senate-standing-committee-community-affairs-inquiry
[Accessed 28 March 2017].
The Department of Health, 2014. National framework for
recovery-oriented mental health services. [Online]
Available at: http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-recovfra
[Accessed 28 March 2017].
Thomas, K., Rickwood, D. & Brown, P., 2017. Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia. Health & Social Care In The Community, 25(1), pp. 243-254.
WHO; Calouste Gulbenkian Foundation, 2014. Innovation in
deinstitutionalization: A WHO Expert Survey. [Online]
Available at: http://www.who.int/mental_health/publications/gulbenkian_innovation_in_deinstitutionalization/en/
[Accessed 28 3 2017].