h cuttiford
New Member
- Joined
- Oct 19, 2009
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- Female
- HSC
- 2009
Mental Health
1. Critically evaluate why it is a health priority in Australia. Use information and trend data from CURRENT health reports and acknowledge the sources of the data.
Include discussion about how social justice principles are applied.
(12 marks)
Mental illness is defined as a clinically diagnosable disorder that significantly interferes with an individual’s cognitive, emotional or social abilities. There are numerous types of mental illness, ranging from depression to schizophrenia to dementia, all of which come in varying degrees of severity. Mental health is amongst Australia’s national health priorities because it has been recognised as one of high importance and is a growing concern.
The Mental Health Council of Australia (MHCA) reported that “1 in 5 (20%) Australians will experience some form of mental illness each year and 3 in 100 (3%) will be seriously affected”. These statistics show the high prevalence of mental illness in Australia. The last 3 National Health Surveys indicate the progressive increase in prevalence of long term mental disorders, rising from 5.9% in 1995, to 9.6% in 2001, to 11.0% in 2004–05 (age-standardised). Anxiety and mood disorders were the most common. Depression is predicted to be the world’s largest health problem by the year 2020. Until recently, mental illness was relatively misunderstood and there had been little research into its prevalence and the implications on individuals and communities. The progressive increase in incidence may be influenced by growing acceptance of mental illness and greater education which has encouraged people to come forward.
It can be difficult to calculate the mortality rate caused by mental illness because it does not directly cause death. Fatalities caused by mental illness are usually from suicide, injury or substance abuse. Co-morbidity refers to the presence of more than one disease or health condition at a given time. It contributes to the mortality rate of mental illness. The NHPC report from 2005 shows that mortality rates have significantly decreased from the late 1990’s and appears to be coming to a plateau.
The costs of mental illness to individuals can be financial, psychological or physiological. Financial costs include health care services, such as diagnosis, treatment, rehabilitation and medication. Other financial costs are loss of income which stems from time off work, inability to find employment or an individual could loss their job because of their mental illness interfering with their work. One of the major problems of mental illness is that it is usually long term, meaning that sufferers cannot quickly return to work, rather time off often accumulates and uses up holidays and sick leave. Also, ongoing costs such as counselling can build up to become extremely expensive.
Psychological costs include lowered self worth/self esteem and emotional distress, while physiological costs may be decreased quality of life or ultimately death. All of these can lead to break downs in relationships or social isolation from family or friends. The impacts of mental illness on an individual often occur in a spiralling effect, meaning once an illness such as depression sets in, this can lead to unemployment and social isolation which may then cause the sufferer’s depression to deepen.
The costs of mental illness to the community is also very significant and can be direct or indirect. Direct costs include money spent on health care services such as treatment, diagnosis, research, education and prescriptions. The ABS health expenditure report for 2000-01 showed that $3741million was spent on mental health care. Reports from 2005-06 show that the mental illness accounted for over 320,000 hospitalisations. Indirect costs may include days off work which affect employers and other employees, as well as the effect of individual’s behaviour on other people. If not treated- mental health can cost communities through substance abuse, particularly alcohol, and increased crime. Another consideration is that children of parents who suffer from mental illness often develop mental disorders themselves, causing more cost to the community. The Government is keen on preventing mental illness because this is a much more cost effective way of spending money, rather than pouring out more money later on for long term treatment, hence the large amount of money allocated to research and education.
For health conditions to be made a national priority, they must demonstrate the potential to be improved, that is to be worth investing time and money into upgrading facilities and services and implementing health promotion initiatives. Mental health has the potential to change through prevention by early detection, increased awareness and education, such as that which is provided to students in schools. Also, with better treatment services, the quality of life of people suffering from mental illness can be improved/maintained. It is important that there is a potential for change seen in mental illness as the purpose of directing funding, research and resources into health promotion initiatives is to make an impact on the prevalence of the disease.
Mental illness does not discriminate, it affects Australians across the whole social spectrum, including varying age, gender, ethnicity, location and socioeconomic status. However, some of the population groups in which mental illness is more common is in youth aged 15-25, individuals of a low socioeconomic status and rural/isolated communities. Equal access is becoming increasingly important as it is apparent that it is a very influential factor in individuals receiving sufficient health care to treat and detect mental illness.
Social justice aims to promote the interest of those who are most disadvantaged, in the endeavour to achieve equity through health promotion. It promotes inclusiveness and establishing supportive environments for all.
This includes individuals and communities participating in decision making processes and issues which affect them, ensuring that health promotion is effective rather than dictation which is unsuccessful. An example of how to increase participation is holding a meeting with selected members of a community to discuss the regions major health issues and suggest health promotion initiatives which are most likely to be successful. To increase participation of individuals, this may include more discussion during the diagnosis period, input into modifying medication programs and examining what may be the cause of the problem in a holistic approach before immediately starting on medication.
Equity is the state of being equal and fair relating to the allocation of resources without discrimination. This can be achieved by educating people in schools because this does not discriminate between gender, ethnicity, socioeconomic status or any other social factors.
Access refers to the availability of health information and education for all and is becoming increasingly important. An example of a method of providing easier access for rural/remote areas in Lifeline and information on the internet because this does not discriminate against people based on their location, rather makes it easier for them to access relevant information and advice. Another example is travelling counsellors who visit remote areas to offer their service to individuals who would otherwise have to travel long distances to talk to a professional counsellor.
All people have the right to achieve good health through treatment and care. This means that regardless of a persons attitudes or behaviour, they still have the right to the same opportunities as everybody else in receiving health care. An example of this is an individual who suffered brain injuries from a car accident in which they were speeding and driving irresponsibly, still has the right to health care for the mental injuries sustained from the accident although it was their poor behaviour which caused the accident.
Mental illness is a growing problem and with the trends showing increasing incidence, it is important that still more is to be done to educate individuals and communities and there needs to be improvements in providing access for all in order to decrease the prevalence this problem. This is a priority area because the Government are interested in decreasing the prevalence, huge cost to the community and because they are able to impact on these high rates and expenditure due to the potential for further change.
Rural/Isolated Communities
2. Identify a particular population group that is experiencing health inequalities in your chosen priority area. Justify why this particular population group is experiencing health inequalities in the priority area.
(10 marks)
A priority population group is a group of people within a population who are at a particular risk from a disease/illness. It is important to identify priority populations in order to direct government health care expenditure and to design health promotion initiatives which target these groups, in order to decrease the prevalence of the disease.
A priority population group experiencing inequities in mental health is rural/isolated communities. Male farm owners and managers are likely to commit suicide at twice the national average. There are many contributing factors, particularly access and culture, which causes these communities to suffer inequalities in mental health care.
Access is a major contributing factor to these inequalities, including access to diagnosis. In many remote areas, communities do not have any residential mental health care specialists, such as counsellors, phycologists, psychiatrists and social workers, meaning they must travel two or three hours to the nearest large town. This is an extreme cost; financially, emotionally and is also very time-consuming- time which is taken off work causing more financial strain. These costs impact very severely on an individual, often preventing them from seeking medical advice and support when it is critical.
Another component of inequity in access to mental health care is treatment. Treatment includes accessing advice from mental health specialists. Treatment often involves medication, such as anti-depressants. For treatment of mental illness to be effective, particularly depression, there needs to be a collaborative approach of medication and counselling. However, this can be extremely difficult for patients if they live far distances from health care professionals, because treatment programs can not be readily reviewed.
Although education is provided without discrimination in schools, youth are more likely to leave school at an early age in rural areas. This means they are less likely to recognise a mental illness and are also less likely to seek support.
Socioeconomic status is another limiting factor in many rural/isolated communities. Lack of finance is often a barrier because it prevents individuals from being able to access support. This may be because they cannot afford time off work to seek advice from health care professionals. Individuals of low socioeconomic status may be more likely to develop mental disorders, particularly anxiety disorders, from excessive stress about money which prevents them from being able to properly function. This shows how low socioeconomic status in remote regions can limit individuals access to mental health care and places extra burdens on them which is an inequality they experience which is detrimental to their health.
Unfortunately, another barrier to individuals in rural/isolated communities is issues concerning privacy and confidentiality. The nature of small communities to share private and personal information is often off putting to individuals who are suffering from an undiagnosed mental illness and are struggling to seek help. This means that a mental disorder which started off easily treatable, may develop into a much worse condition due to lack of support in small towns.
The stoic attitude of rural communities has been detrimental to the health of many. Stereotyping of males in society causes many men to suffer in silence, not seeking treatment, or ultimately they will commit suicide. Due to an unsupportive environment, people living in rural areas experience inequities in accessing mental health care because support is a major component in mental health recovery. Seeking help is often perceived as a sign of weakness so it is much harder for individuals to ask for help from family, friends or medical professionals.
Mental illness has increased in recent years in rural communities due to the prolonged drought which has placed added financial and emotional stress on individuals, families and entire communities. This stress and the inability to cope often leads to substance abuse, particularly alcoholism, increased crime and higher unemployment rates. Sadly, here begins a vicious cycle, as youths witness these patterns and develop the same poor behaviours.
Although men have a much higher suicide rate, women are twice as likely to attempt suicide which reflects the stress placed on women in rural areas. The lack of close connections with other women often leads to rural women developing depression and the longing for emotional support can become overwhelming.
There have been a number of attempts to reduce the inequities experienced in these regions, such as the Beyond Blue website, which provides easier access for those who live far away from mental illness specialists. However, the problem remains as mental illness still has a high prevalence in rural/isolated communities. More work is needed to achieve equity for this priority population group in mental illness.
Mental Health Matters- Don’t beat around the bush
3. Design an original health promotion initiative that could be used to decrease the inequalities experienced by the group you wrote about in question two.
The risk factors associated with your chosen priority area must also be addressed.
The characteristics of the new public health approach must be used to design health promotion initiatives- be aware that you need to consider a number of different agencies to help deliver the initiative.
(8 marks)
To decrease the inequalities experienced in mental health in rural/isolated communities, a health promotion initiative could be to establish an ongoing program in these areas, in which mental health specialists meet with community groups. The program would involve running community forums, in small and large size groups, which educate people about what mental illness is and how it can develop. It would also teach individuals how to recognize the signs and symptoms of mental illness and how to approach helping an individual who is suspected of suffering from a mental disorder. This would develop personal skills and increase community capacity to change.
The program would not only be education and awareness based, but would also offer strong support for individuals who are suffering mental illness and are in need of help. This would be by providing counselling, and greater one-on-one discussion. The program would be the first step in connecting that individual to the appropriate health services and individuals would receive a “mentor” to follow their progress and be someone that they can talk to at anytime. The mentor’s responsibility would be to ensures that there is sufficient collaboration between different health services, such as hospital treatment and counsellors. This is designed to create a supportive environment for mental illness sufferers.
For those who live on properties out of town, they can receive free pamphlets containing information about what is being taught in the programs, in order to break down geographic barriers. For people in rural areas to be responsive, there would need to be a lot of personal based connection. This could be achieved by program operators making appointments to meet with people on their properties, to inform them about the program content and where to seek support. Also, a website could be established about the program, so that people can access information at any time, or to seek further information by setting up an anonymous blog to ask questions. A referral email address would also be offered if an individual wishes to speak to a specialist further.
As a part of the program, individuals who have previously suffered mental illness may share personal stories, in an attempt to break down cultural barriers and stoic attitudes of small communities, encouraging people, particularly men that it is ok to seek advice and ask for help. If people are uncomfortable asking their questions in a group setting, they can fill out an anonymous form so that their questions can be addressed in the next session.
The program would be run at flexible times to cater for those who work at difficult hours or have varying commitments. The program would not be pure dictatorship, but would allow open question and discussion times. The program would be run at various venues, including schools, workplaces and after-hours at a community centre. This flexibility would make it more convenient for individuals to attend, which would allow maximum involvement and increase community participation.
For this program to be possible, there would need to be sufficient funding from the state and local government. This funding would be needed to entice mental health care professionals to be involved in the program, to cover the costs of travel, venue hire, pamphlet costs, and costs of upkeep, such as the internet support service. The program would be run at a low cost so that people of a low socioeconomic status are not disadvantaged. Free child care may be offered to parents while the meetings are held so that they can participate more in the sessions.
To encourage people to attend the forums, school students may be given flyers in school to take home to their parents, which tells them about what is happening and offers a free meal with the program. For some families, it would be effective to home flyers with children, however, for some this communication would not work. To overcome this, the events can be advertised on radio, as this reaches a wider and generally older audience. And, as mentioned previously, face to face communication is most likely to be effective, so a door knock approach would be likely to succeed. Posters can be put up in local businesses to promote the initiative as a positive, supportive environment. In order to reach the community, a diverse range of communication methods are necessary, to reach individuals of different age, socioeconomic status, gender and ethnicity.
This initiative would empower individuals because it is providing easier access, as it is breaking down geographic barriers by taking the services to them. Educating people gives them more control over their health because they are then able to make informed decisions about seeking help and changing any modifiable risk factors. The program assists in developing personal skills because it helps break down cultural barriers and stereotypes which helps people to seek help and support. They also learn how to assess whether somebody they know is in need of support and teaches them how to cope with a friend or relative suffering from a mental illness. Also, the individual is given more control over their health by having a large amount of input to their diagnosis and treatment. This process is supported by having a mentor as it helps the individual to feel supported and involved in the decision making, in regards to both diagnosis and treatment.
Community participation would be increased by this initiative because it involves meeting with individuals in a non-threatening environment which encourages them to provide input into what areas of mental health they feel are most severely impacting on their community and it provides an opportunity for them to make suggestions about strategies to deal with mental illness and how best to approach the subject. This subject ensures that it is not just dictating to individuals and community groups, but is an interactive, learning environment which can offer support to those in need. The program would aim to develop partnerships in the community through schools and workplaces, building relationships with them to strengthen the awareness campaign about mental health and providing links which lead people towards the accurate and relevant information provided by the program.
This initiative recognizes the social determinants of health, which lead to the inequalities experienced in mental health in rural areas. The program targets these social determinants by addressing the issues of geographic location, culture and socioeconomic status. To overcome these barriers, Government funding is allocated specifically to supporting these rural initiatives, assisting mental health specialists to reach these areas and using local government funding to advertise the program and pay for using facilities. Addressing culture change is a major issue and one of the most influential social determinants in small communities. To change this, the program offers a friendly, safe and comfortable environment, extending an invitation to all members of the community to attend. Also, by sharing personal stories of previous mental illness sufferers, it breaks down the barrier of mental health being a taboo subject, confronting the issue directly.
Although this initiative is not flawless, it is headed in the right direction, as it looks at overcoming the social, cultural and economic barriers which have led to inequalities experienced in mental health in rural/isolated areas. The program looks at both sides of mental illness- supporting sufferers and also supporting the community, to enable them to better cope with the impacts of mental illness.
References
Australian Institute of Health and Welfare, 2008, “Australia’s Health 2008”
Mental health (AIHW)
accessed on 6th November
NSW HSC Online, Charles Sturt University, NSW DET
HSC Online
accessed on 7th November
Australian Bureau of Statistics
1301.0 - Year Book Australia, 2006
accessed on 7th November
Peter Guirguis (Date unknown)
http://www.boredofstudies.org/courses/others/pdhpe/2002_PDHPE_A_Health_Priorities_Guirguis.pdf
accessed on 7th November
World Health Organization, Western Pacific Region office databank, 2004
http://www.wpro.who.int/NR/rdonlyres/82A0988E-9C45-4889-92F1-106221F257BF/27/aus04hdb_final.pdf
accessed 7th November
Medical Journal of Australia, 2005, Hickie, Groom, McGorry, Davenport, Luscombe, “Australian Mental Health forum: time for real outcomes”,
eMJA: Australian mental health reform: time for real outcomes
accessed 8th November
Mental Health Council of Australia, 2005
Mental Health Council of Australia - MHCA
accessed 8th November
Department of Health and Ageing
Department of Health and Ageing - Mental health
accessed 8th November
Australian Democrats Action Plan (2008), “Mental Health”
http://www.democrats.org.au/docs/ActionPlans/Heath_Mental_2007.pdf
accessed 10th November
Band Six Pty Ltd (Date unknown)
http://www.bandsix.com.au/Sample/PDHPE.pdf
accessed 12th November
2005, Glam Publisher Network
Depression Treatment, Medication, Help, Symptoms: Anxiety Attacks Depression Test, Types, ADHD Causes
accessed 17th November
Beyond Blue, 2007
beyondblue: the national depression initiative - Depression in Rural People
accessed 21st November
Eastern Health, 2003
Mental Health Program
accessed 22nd November
1. Critically evaluate why it is a health priority in Australia. Use information and trend data from CURRENT health reports and acknowledge the sources of the data.
Include discussion about how social justice principles are applied.
(12 marks)
Mental illness is defined as a clinically diagnosable disorder that significantly interferes with an individual’s cognitive, emotional or social abilities. There are numerous types of mental illness, ranging from depression to schizophrenia to dementia, all of which come in varying degrees of severity. Mental health is amongst Australia’s national health priorities because it has been recognised as one of high importance and is a growing concern.
The Mental Health Council of Australia (MHCA) reported that “1 in 5 (20%) Australians will experience some form of mental illness each year and 3 in 100 (3%) will be seriously affected”. These statistics show the high prevalence of mental illness in Australia. The last 3 National Health Surveys indicate the progressive increase in prevalence of long term mental disorders, rising from 5.9% in 1995, to 9.6% in 2001, to 11.0% in 2004–05 (age-standardised). Anxiety and mood disorders were the most common. Depression is predicted to be the world’s largest health problem by the year 2020. Until recently, mental illness was relatively misunderstood and there had been little research into its prevalence and the implications on individuals and communities. The progressive increase in incidence may be influenced by growing acceptance of mental illness and greater education which has encouraged people to come forward.
It can be difficult to calculate the mortality rate caused by mental illness because it does not directly cause death. Fatalities caused by mental illness are usually from suicide, injury or substance abuse. Co-morbidity refers to the presence of more than one disease or health condition at a given time. It contributes to the mortality rate of mental illness. The NHPC report from 2005 shows that mortality rates have significantly decreased from the late 1990’s and appears to be coming to a plateau.
The costs of mental illness to individuals can be financial, psychological or physiological. Financial costs include health care services, such as diagnosis, treatment, rehabilitation and medication. Other financial costs are loss of income which stems from time off work, inability to find employment or an individual could loss their job because of their mental illness interfering with their work. One of the major problems of mental illness is that it is usually long term, meaning that sufferers cannot quickly return to work, rather time off often accumulates and uses up holidays and sick leave. Also, ongoing costs such as counselling can build up to become extremely expensive.
Psychological costs include lowered self worth/self esteem and emotional distress, while physiological costs may be decreased quality of life or ultimately death. All of these can lead to break downs in relationships or social isolation from family or friends. The impacts of mental illness on an individual often occur in a spiralling effect, meaning once an illness such as depression sets in, this can lead to unemployment and social isolation which may then cause the sufferer’s depression to deepen.
The costs of mental illness to the community is also very significant and can be direct or indirect. Direct costs include money spent on health care services such as treatment, diagnosis, research, education and prescriptions. The ABS health expenditure report for 2000-01 showed that $3741million was spent on mental health care. Reports from 2005-06 show that the mental illness accounted for over 320,000 hospitalisations. Indirect costs may include days off work which affect employers and other employees, as well as the effect of individual’s behaviour on other people. If not treated- mental health can cost communities through substance abuse, particularly alcohol, and increased crime. Another consideration is that children of parents who suffer from mental illness often develop mental disorders themselves, causing more cost to the community. The Government is keen on preventing mental illness because this is a much more cost effective way of spending money, rather than pouring out more money later on for long term treatment, hence the large amount of money allocated to research and education.
For health conditions to be made a national priority, they must demonstrate the potential to be improved, that is to be worth investing time and money into upgrading facilities and services and implementing health promotion initiatives. Mental health has the potential to change through prevention by early detection, increased awareness and education, such as that which is provided to students in schools. Also, with better treatment services, the quality of life of people suffering from mental illness can be improved/maintained. It is important that there is a potential for change seen in mental illness as the purpose of directing funding, research and resources into health promotion initiatives is to make an impact on the prevalence of the disease.
Mental illness does not discriminate, it affects Australians across the whole social spectrum, including varying age, gender, ethnicity, location and socioeconomic status. However, some of the population groups in which mental illness is more common is in youth aged 15-25, individuals of a low socioeconomic status and rural/isolated communities. Equal access is becoming increasingly important as it is apparent that it is a very influential factor in individuals receiving sufficient health care to treat and detect mental illness.
Social justice aims to promote the interest of those who are most disadvantaged, in the endeavour to achieve equity through health promotion. It promotes inclusiveness and establishing supportive environments for all.
This includes individuals and communities participating in decision making processes and issues which affect them, ensuring that health promotion is effective rather than dictation which is unsuccessful. An example of how to increase participation is holding a meeting with selected members of a community to discuss the regions major health issues and suggest health promotion initiatives which are most likely to be successful. To increase participation of individuals, this may include more discussion during the diagnosis period, input into modifying medication programs and examining what may be the cause of the problem in a holistic approach before immediately starting on medication.
Equity is the state of being equal and fair relating to the allocation of resources without discrimination. This can be achieved by educating people in schools because this does not discriminate between gender, ethnicity, socioeconomic status or any other social factors.
Access refers to the availability of health information and education for all and is becoming increasingly important. An example of a method of providing easier access for rural/remote areas in Lifeline and information on the internet because this does not discriminate against people based on their location, rather makes it easier for them to access relevant information and advice. Another example is travelling counsellors who visit remote areas to offer their service to individuals who would otherwise have to travel long distances to talk to a professional counsellor.
All people have the right to achieve good health through treatment and care. This means that regardless of a persons attitudes or behaviour, they still have the right to the same opportunities as everybody else in receiving health care. An example of this is an individual who suffered brain injuries from a car accident in which they were speeding and driving irresponsibly, still has the right to health care for the mental injuries sustained from the accident although it was their poor behaviour which caused the accident.
Mental illness is a growing problem and with the trends showing increasing incidence, it is important that still more is to be done to educate individuals and communities and there needs to be improvements in providing access for all in order to decrease the prevalence this problem. This is a priority area because the Government are interested in decreasing the prevalence, huge cost to the community and because they are able to impact on these high rates and expenditure due to the potential for further change.
Rural/Isolated Communities
2. Identify a particular population group that is experiencing health inequalities in your chosen priority area. Justify why this particular population group is experiencing health inequalities in the priority area.
(10 marks)
A priority population group is a group of people within a population who are at a particular risk from a disease/illness. It is important to identify priority populations in order to direct government health care expenditure and to design health promotion initiatives which target these groups, in order to decrease the prevalence of the disease.
A priority population group experiencing inequities in mental health is rural/isolated communities. Male farm owners and managers are likely to commit suicide at twice the national average. There are many contributing factors, particularly access and culture, which causes these communities to suffer inequalities in mental health care.
Access is a major contributing factor to these inequalities, including access to diagnosis. In many remote areas, communities do not have any residential mental health care specialists, such as counsellors, phycologists, psychiatrists and social workers, meaning they must travel two or three hours to the nearest large town. This is an extreme cost; financially, emotionally and is also very time-consuming- time which is taken off work causing more financial strain. These costs impact very severely on an individual, often preventing them from seeking medical advice and support when it is critical.
Another component of inequity in access to mental health care is treatment. Treatment includes accessing advice from mental health specialists. Treatment often involves medication, such as anti-depressants. For treatment of mental illness to be effective, particularly depression, there needs to be a collaborative approach of medication and counselling. However, this can be extremely difficult for patients if they live far distances from health care professionals, because treatment programs can not be readily reviewed.
Although education is provided without discrimination in schools, youth are more likely to leave school at an early age in rural areas. This means they are less likely to recognise a mental illness and are also less likely to seek support.
Socioeconomic status is another limiting factor in many rural/isolated communities. Lack of finance is often a barrier because it prevents individuals from being able to access support. This may be because they cannot afford time off work to seek advice from health care professionals. Individuals of low socioeconomic status may be more likely to develop mental disorders, particularly anxiety disorders, from excessive stress about money which prevents them from being able to properly function. This shows how low socioeconomic status in remote regions can limit individuals access to mental health care and places extra burdens on them which is an inequality they experience which is detrimental to their health.
Unfortunately, another barrier to individuals in rural/isolated communities is issues concerning privacy and confidentiality. The nature of small communities to share private and personal information is often off putting to individuals who are suffering from an undiagnosed mental illness and are struggling to seek help. This means that a mental disorder which started off easily treatable, may develop into a much worse condition due to lack of support in small towns.
The stoic attitude of rural communities has been detrimental to the health of many. Stereotyping of males in society causes many men to suffer in silence, not seeking treatment, or ultimately they will commit suicide. Due to an unsupportive environment, people living in rural areas experience inequities in accessing mental health care because support is a major component in mental health recovery. Seeking help is often perceived as a sign of weakness so it is much harder for individuals to ask for help from family, friends or medical professionals.
Mental illness has increased in recent years in rural communities due to the prolonged drought which has placed added financial and emotional stress on individuals, families and entire communities. This stress and the inability to cope often leads to substance abuse, particularly alcoholism, increased crime and higher unemployment rates. Sadly, here begins a vicious cycle, as youths witness these patterns and develop the same poor behaviours.
Although men have a much higher suicide rate, women are twice as likely to attempt suicide which reflects the stress placed on women in rural areas. The lack of close connections with other women often leads to rural women developing depression and the longing for emotional support can become overwhelming.
There have been a number of attempts to reduce the inequities experienced in these regions, such as the Beyond Blue website, which provides easier access for those who live far away from mental illness specialists. However, the problem remains as mental illness still has a high prevalence in rural/isolated communities. More work is needed to achieve equity for this priority population group in mental illness.
Mental Health Matters- Don’t beat around the bush
3. Design an original health promotion initiative that could be used to decrease the inequalities experienced by the group you wrote about in question two.
The risk factors associated with your chosen priority area must also be addressed.
The characteristics of the new public health approach must be used to design health promotion initiatives- be aware that you need to consider a number of different agencies to help deliver the initiative.
(8 marks)
To decrease the inequalities experienced in mental health in rural/isolated communities, a health promotion initiative could be to establish an ongoing program in these areas, in which mental health specialists meet with community groups. The program would involve running community forums, in small and large size groups, which educate people about what mental illness is and how it can develop. It would also teach individuals how to recognize the signs and symptoms of mental illness and how to approach helping an individual who is suspected of suffering from a mental disorder. This would develop personal skills and increase community capacity to change.
The program would not only be education and awareness based, but would also offer strong support for individuals who are suffering mental illness and are in need of help. This would be by providing counselling, and greater one-on-one discussion. The program would be the first step in connecting that individual to the appropriate health services and individuals would receive a “mentor” to follow their progress and be someone that they can talk to at anytime. The mentor’s responsibility would be to ensures that there is sufficient collaboration between different health services, such as hospital treatment and counsellors. This is designed to create a supportive environment for mental illness sufferers.
For those who live on properties out of town, they can receive free pamphlets containing information about what is being taught in the programs, in order to break down geographic barriers. For people in rural areas to be responsive, there would need to be a lot of personal based connection. This could be achieved by program operators making appointments to meet with people on their properties, to inform them about the program content and where to seek support. Also, a website could be established about the program, so that people can access information at any time, or to seek further information by setting up an anonymous blog to ask questions. A referral email address would also be offered if an individual wishes to speak to a specialist further.
As a part of the program, individuals who have previously suffered mental illness may share personal stories, in an attempt to break down cultural barriers and stoic attitudes of small communities, encouraging people, particularly men that it is ok to seek advice and ask for help. If people are uncomfortable asking their questions in a group setting, they can fill out an anonymous form so that their questions can be addressed in the next session.
The program would be run at flexible times to cater for those who work at difficult hours or have varying commitments. The program would not be pure dictatorship, but would allow open question and discussion times. The program would be run at various venues, including schools, workplaces and after-hours at a community centre. This flexibility would make it more convenient for individuals to attend, which would allow maximum involvement and increase community participation.
For this program to be possible, there would need to be sufficient funding from the state and local government. This funding would be needed to entice mental health care professionals to be involved in the program, to cover the costs of travel, venue hire, pamphlet costs, and costs of upkeep, such as the internet support service. The program would be run at a low cost so that people of a low socioeconomic status are not disadvantaged. Free child care may be offered to parents while the meetings are held so that they can participate more in the sessions.
To encourage people to attend the forums, school students may be given flyers in school to take home to their parents, which tells them about what is happening and offers a free meal with the program. For some families, it would be effective to home flyers with children, however, for some this communication would not work. To overcome this, the events can be advertised on radio, as this reaches a wider and generally older audience. And, as mentioned previously, face to face communication is most likely to be effective, so a door knock approach would be likely to succeed. Posters can be put up in local businesses to promote the initiative as a positive, supportive environment. In order to reach the community, a diverse range of communication methods are necessary, to reach individuals of different age, socioeconomic status, gender and ethnicity.
This initiative would empower individuals because it is providing easier access, as it is breaking down geographic barriers by taking the services to them. Educating people gives them more control over their health because they are then able to make informed decisions about seeking help and changing any modifiable risk factors. The program assists in developing personal skills because it helps break down cultural barriers and stereotypes which helps people to seek help and support. They also learn how to assess whether somebody they know is in need of support and teaches them how to cope with a friend or relative suffering from a mental illness. Also, the individual is given more control over their health by having a large amount of input to their diagnosis and treatment. This process is supported by having a mentor as it helps the individual to feel supported and involved in the decision making, in regards to both diagnosis and treatment.
Community participation would be increased by this initiative because it involves meeting with individuals in a non-threatening environment which encourages them to provide input into what areas of mental health they feel are most severely impacting on their community and it provides an opportunity for them to make suggestions about strategies to deal with mental illness and how best to approach the subject. This subject ensures that it is not just dictating to individuals and community groups, but is an interactive, learning environment which can offer support to those in need. The program would aim to develop partnerships in the community through schools and workplaces, building relationships with them to strengthen the awareness campaign about mental health and providing links which lead people towards the accurate and relevant information provided by the program.
This initiative recognizes the social determinants of health, which lead to the inequalities experienced in mental health in rural areas. The program targets these social determinants by addressing the issues of geographic location, culture and socioeconomic status. To overcome these barriers, Government funding is allocated specifically to supporting these rural initiatives, assisting mental health specialists to reach these areas and using local government funding to advertise the program and pay for using facilities. Addressing culture change is a major issue and one of the most influential social determinants in small communities. To change this, the program offers a friendly, safe and comfortable environment, extending an invitation to all members of the community to attend. Also, by sharing personal stories of previous mental illness sufferers, it breaks down the barrier of mental health being a taboo subject, confronting the issue directly.
Although this initiative is not flawless, it is headed in the right direction, as it looks at overcoming the social, cultural and economic barriers which have led to inequalities experienced in mental health in rural/isolated areas. The program looks at both sides of mental illness- supporting sufferers and also supporting the community, to enable them to better cope with the impacts of mental illness.
References
Australian Institute of Health and Welfare, 2008, “Australia’s Health 2008”
Mental health (AIHW)
accessed on 6th November
NSW HSC Online, Charles Sturt University, NSW DET
HSC Online
accessed on 7th November
Australian Bureau of Statistics
1301.0 - Year Book Australia, 2006
accessed on 7th November
Peter Guirguis (Date unknown)
http://www.boredofstudies.org/courses/others/pdhpe/2002_PDHPE_A_Health_Priorities_Guirguis.pdf
accessed on 7th November
World Health Organization, Western Pacific Region office databank, 2004
http://www.wpro.who.int/NR/rdonlyres/82A0988E-9C45-4889-92F1-106221F257BF/27/aus04hdb_final.pdf
accessed 7th November
Medical Journal of Australia, 2005, Hickie, Groom, McGorry, Davenport, Luscombe, “Australian Mental Health forum: time for real outcomes”,
eMJA: Australian mental health reform: time for real outcomes
accessed 8th November
Mental Health Council of Australia, 2005
Mental Health Council of Australia - MHCA
accessed 8th November
Department of Health and Ageing
Department of Health and Ageing - Mental health
accessed 8th November
Australian Democrats Action Plan (2008), “Mental Health”
http://www.democrats.org.au/docs/ActionPlans/Heath_Mental_2007.pdf
accessed 10th November
Band Six Pty Ltd (Date unknown)
http://www.bandsix.com.au/Sample/PDHPE.pdf
accessed 12th November
2005, Glam Publisher Network
Depression Treatment, Medication, Help, Symptoms: Anxiety Attacks Depression Test, Types, ADHD Causes
accessed 17th November
Beyond Blue, 2007
beyondblue: the national depression initiative - Depression in Rural People
accessed 21st November
Eastern Health, 2003
Mental Health Program
accessed 22nd November