SWN005 Mental Health Landscape and Social Work Practice

1
SWN005 Mental Health Landscape and Social Work
Practice

• Dr Niki Edwards

2
AIMS

• QUIZ appreciate the role that stigma and
  discrimination play in the management of mental
  illness and mental health problems (self
  reflection).
• Awareness of key definitions of mental illness,
  mental disorders and mental health problems.

3
Quiz

• Please write down TRUE or FALSE to following
  questions.
• We will come back to these at the end of the
  presentation.
• This presentation will address many of the issues
  raised.

4
True or False 1

• Mental health is a life long process. It
  involves a sense of harmony and balance for the
  individual, family, friends, their community and
  more broadly society.

5
True or False 2

• Mental illness is a single rare disorder that is
  uncommon. It only affects a small number of
  people.

6
True or False 3

Being treated for a mental illness means an
individual has in some way "failed" or is weak.
7
True or False 4

• People with mental illness are violent and
  dangerous so should be approached with caution,
  and fear.

8
True or False 5

• People with mental illness have childlike
  perceptions of the world (they lack intelligence)
  and will always need to be taken care of.

9
True or False 6

• Mental illness is not a true medical diagnosis
  eg. people with depression should (and could)
  really just snap out of it, get a job, and get
  on with life.

10
True or False 7

• Depression and other illnesses, such as anxiety
  disorders, do not affect children or adolescents.
  Any emotional problems they have are just a part
  of growing up ie. they just grow out of it.

11
True or False 8

• People with severe mental illness should really
  be cared for in hospital. (They are best cared
  for in hospital)

12
True or False 9

• Mental illness is NOT a life sentence ie.
  recovery IS possible for people with mental
  illness.

13
True or False 10

• No individual or cultural group is immune from
  mental illness.
• It is a global phenomenon.

14
True or False 11

• People living with mental illness expect to be
  rejected by the community and are therefore
  reluctant to engage with others.

15
True or False 12

• The effects of stigma and discrimination may
  have a greater impact on an individual than the
  actual mental illness.

16
Introduction

• Mental Health Social Work
• SWN005

16
17
Introduction

• Mental illness is common, effects 15 people
  during their lifetime.
• Universal mental health problems and mental
  illness is experienced by people of all
  countries, by women and men of any age and
  socioeconomic status, and in urban and rural
  environments.
• Global phenomenon and global health priority eg.
  not just in developed countries.

18
Introduction

• "Mental illness is Australia's great invisible
  epidemic. Of all the diseases in our community,
  it exhibits the grossest mismatch between the
  cost of the disease, the disease burden, and the
  amount that is spent collectively by the
  community to address that cost."
• Commonwealth of Australia (2006) A national
  approach to mental health from crisis to
  community. www.aph.gov.au/Senate/committee/mentalh
  ealth_ctte/report/index.htm

19
Introduction

• As with many diseases, mental illness can be
  severe for some people and mild in others.
• People with a mental illness dont necessarily
  look like they are sick, particularly if their
  illness is mild.

20
Introduction

• No objective tests only subjective assessment.
• Other individuals may show more explicit symptoms
  such as confusion, agitation, or withdrawal.
• Often others first notice something is wrong,
  rather than the person.
• Cascade effect individual, those around them and
  society.

21
Introduction

• Social workers have a key role to play in working
  with people living with mental illness.
• Work at micro, mezzo and macro levels.
• Roles in assessment, diagnosis, treatment and
  interventions.
• Roles in advocacy (individual and systemic) and
  policy and program review and development (local
  through to national/international).

22
Legislation and Service Delivery Guidance

• Policy and Services

22
23
Mental health system

• OKits a BIG problem
• How does society respond?
• How do Australian governments rise to the
  challenge of providing appropriate services to
  people living with mental illness?...or carers
  supporting people with psychosocial disability?

24
Queensland mental health system

• Far more than acute inpatient mental health beds
  or community mental health services (clinics and
  outreach assessment teams) provided by Queensland
  Health.
• NB role for general practitioners
• (gatekeepers/ usually first
• point of call).
• Psychiatrists, social workers,
• psychologists other clinicians in private
  practice (Medicare Better Outcomes initiative).
• Non-clinical mental health services/psychosocial
  disability support provided by non-government
  organisations (NGOs).

25
Queensland mental health system

• Public and private, government and
  non-government, and hospital and community
  services comprise the Queensland mental health
  system.
• Cross-sectoral responsibility everyones
  business.
• Queensland Government (Queensland Health) is the
  major provider of acute services for people with
  serious mental illness.
• Hospital and Health Services provide based
  community mental health services and hospital
  based beds.
• QH oversees the provision of authorised mental
  health services, as per the Mental Health Act
  (Qld) 2016.

25
26
Queensland mental health system

• Most common way of seeing a private psychiatrist
  is through a referral from a GP, which allows the
  Medicare rebate to be claimed.
• Notably in rural areas, private psychiatrists may
  not be available.
• Private psychiatrists mainly provide outpatient
  services from their consulting rooms or inpatient
  services to private hospitals.
• Some may have specialist interests (eg. working
  with particular age groups or disorders, and
  specific therapies).

27
Queensland mental health system

• Psychiatric Disability and Psychosocial
  Rehabilitation Support Services (non-clinical
  mental health services)
• A range of services provides employment
  placement, support, information, day and
  residential programs and family respite.
• Many are NGOs with government funding.

28
Non-government sector

• Non-government service providers in Queensland
  deliver/implement a range of programs including
• community awareness and education
• early intervention
• family and peer support
• independent living and support
• non-clinical counselling services
• building sector capacity through training and
  organisational development activities.

• Queensland Alliance for Mental Health is a NGO
  that supports over 240 community organisations
  working in mental health in Queensland
  www.qldalliance.org.au/

29
National Mental Health Strategy

• Mental Health Statement of Rights and
  Responsibilities 1991
• National Mental Health Policy 1992
• National Mental Health Plan, 199298
• Second National Mental Health Plan,199803
• National Mental Health Plan 200308
• COAG National Action Plan for Mental Health
  2006-11
• National Mental Health Policy 2008
• Fourth National Mental Health Plan 2009-14
• Fifth National Mental Health Plan
• States and Territory mental health policies,
  plans and strategies

30
National Mental Health Policy (2008)

• Principles underpinning future mental health
  reform
• To promote the mental health and wellbeing of the
  Australian community and, where possible, prevent
  the development of mental health problems and
  mental illness
• To reduce the impact of mental health problems
  and mental illness, including the effects of
  stigma on individuals, families and the
  community
• To promote recovery from mental health problems
  and mental illness and
• To assure the rights of people with mental health
  problems and mental illness, and to enable them
  to participate meaningfully in society.

31
National Standards for Mental Health Services
(2010)

• The first National Standards for Mental Health
  Services were developed in 1996, focused on
  raising the quality of acute mental health
  services.
• The key changes to the 2010 Standards are
• Addition of a Recovery Standard and
• Expansion of the applicability of the 2010
  Standards.
• The 2010 Standards are now applicable to
• The public health system (inpatient,
  rehabilitation and community) and private
  hospitals
• Private office based providers and
• NGOs.

32
Fourth National Mental Health Plan 2009-2014
Set an agenda for collaborative government action
in mental health for five years from 2009, offers
a framework to develop a system of care that is
able to intervene early and provide integrated
services across health and social domains, and
provides guidance to governments in considering
future funding priorities for mental health.
33
Fourth National Mental Health Plan 2009-2014

• 5 priority areas for government action in mental
  health
• Social inclusion and recovery
• Prevention and early intervention
• Service access, coordination and continuity of
  care
• Quality improvement and innovation and
• Accountability - measuring and reporting
  progress.
• Robust accountability framework and governments
  must report annual progress to the Council of
  Australian Governments.
• Includes indicators for monitoring change in the
  way the mental health system is working for
  people living with mental illness as well as
  their families and carers.

34
Fifth National Mental Health and Suicide
Prevention Plan?

• http//www.health.gov.au/internet/main/publishing.
  nsf/content/mental-fifth-national-mental-health-pl
  an
• Seeks to establish a national approach for
  collaborative government effort from 2017 to 2022
  across eight targeted priority areas
• Achieving integrated regional planning and
  service delivery.
• Effective suicide prevention.
• Coordinated treatment and supports for people
  with severe and complex mental illness.
• Improving Aboriginal and Torres Strait Islander
  mental health and suicide prevention.
• Improving the physical health of people living
  with mental illness and reducing early mortality.
• Reducing stigma and discrimination.
• Making safety and quality central to mental
  health service delivery.
• Ensuring that the enablers of effective system
  performance and system improvement are in place.

35
Critique
https//croakey.org/magical-realism-and-the-draft-
fifth-national-mental-health-plan/
36
Roadmap for National Mental Health Reform
2012-2022

• COAG initiative that outlines directions for all
  governments over next 10 years - 2.2 b
  investment.
• Our long term aspiration is for a society that
  values and promotes the importance of good mental
  health and wellbeing maximises opportunities to
  prevent and reduce the impact of mental health
  issues and mental illness and supports people
  with mental health issues and mental illness,
  their families and carers to live contributing
  lives.
• Indicators and accountability.
• Mixed responses consider looking at
• http//theconversation.com/five-views-of-the-roadm
  ap-for-national-mental-health-reform-11216

37
Roadmap for National Mental Health Reform
2012-2022

• Priority 1 Promote person-centred approaches.
• Priority 2 Improve the mental health and social
  and emotional wellbeing of all Australians.
• Priority 3 Prevent mental illness.
• Priority 4 Focus on early detection and
  intervention.
• Priority 5 Improve access to high quality
  services and supports.
• Priority 6 Improve the social and economic
  participation of people with mental illness.

38

• http//www.mentalhealthcommission.gov.au/our-repor
  ts/our-national-report-cards.aspx
• The National Mental Health Commissions 2017
  National Report on Mental Health and Suicide
  Prevention.
• Reporting on the outcomes of engagement with
  stakeholders and the work of the Commission to
  help shape a mental health system that can
  respond to peoples needs more effectively.
• In the process of developing a new monitoring and
  reporting framework which will guide future
  reports.
• This framework will also assist national reform
  in mental health and suicide prevention through
  the lens of consumers and carers, and their
  experiences.

39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42

• Queensland Mental Health Commission
• http//www.qmhc.qld.gov.au/work/queensland-mental-
  health-and-drug-strategic-plan/

https//www.qmhc.qld.gov.au/wp-content/uploads/201
7/02/Discussion-Paper_A-renewed-plan-for-Queenslan
d_Feb-2017.pdf
43
(No Transcript)
44
Challenges

• Positive mental health outcomes for people living
  with mental illness depends on much more than
  mental health policy.
• Good mental health and wellbeing depends as much
  on things like housing, employment, education,
  personal and family support (cross-sectors) ie.
  people are primarily social relational beings.
• Need to adopt a life course approach (needs
  change over time).

Its not an individual problem everyone is
responsible and has an NB role to play.
45
Challenges

• Tension between funding for mental health
  hospital beds and community options (eg. step
  down/step up services).
• BUT funding allocated to mental health still does
  not reflect the prevalence of mental health
  problems and associated psychiatric disability in
  the community.
• No national infrastructure for mental health
  promotion, prevention and early intervention.
• Contemporary services continue to focus on
  chronic illness.

46
Challenges

• Health system still focuses on low prevalence
  disorders and high prevalence disorders left to
  GPs and private sector.
• Specialised mental health services cluster around
  hospitals, acute mental health services, jails.
• Growth in the non-government sector (outsourcing
  by government to save) and allegations of
  de-professionalisation of mental health.
• Mental health needs of minority groups
  neglected eg. dual disability, refugees, people
  with mental illness in rural communities etc.

47
Conclusion

• Shift over time from institutionalisation to
  community care, noting resourcing issues for a
  good life in the community.
• Mental health is a now a major focus of
  Government policy and increased funding.
• Evidence that mental health and wellbeing is
  closely linked to social determinants of health
  including low income, unemployment, poor housing.
• Promotion, prevention and early intervention in
  mental health and wellbeing is acknowledged.
• Emphasis in policy and programs on equity,
  access, equality and participation .
• Increasing focus on recovery and consumer and
  care involvement.

48
Key references

• Australian Bureau of Statistics (2007). National
  Survey of Mental Health and Wellbeing Summary of
  Results. ABS Cat No. 4326.0. Canberra ABS.
• Begg S, Vos T, Barker B, Stevenson C, Stanley L,
  Lopez AD, 2007. The burden of disease and injury
  in Australia 2003. PHE 82. Canberra AIHW
  www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id644
  2459747
• Forbes, M., Barker, A. and Turner, S., 2010, The
  Effects of Education and Health on Wages and
  Productivity, Productivity Commission Staff
  Working Paper, Melbourne.
• Fourth National Mental Health Plan 2009-2014
  www.health.gov.au/internet/main/publishing.nsf/con
  tent/mental-pubs-f-plan09
• Mental Health Council of Australia Mental Health
  Fact Sheet Definitions of Mental Illness
  www.mhca.org.au/documents/Definitionsofmentalhealt
  h.pdf
• http//www.mentalhealthcommission.gov.au/our-repo
  rt-card.aspx
• Queensland Health. The Health of Queenslanders
  2010. Third Report of the Chief Health Officer
  Queensland. Brisbane 2010 http//www.health.qld.g
  ov.au/cho_report/
• Roadmap for National Mental Health Reform
  2012-2022
• https//www.coag.gov.au/sites/default/files/The2
  0Roadmap20for20National20Mental20Health20Refo
  rm202012-2022.pdf.pdf

49
Resources

• National help lines
• Lifeline 24 hour counselling and referral 13 11
  14
• Kids helpline counselling for people under 18
  years 1800 55 18 10
• Just Ask rural mental health info 1300 13 11 14
• Mens Line Australia 24 hour counselling for men
  1300 78 99 78
• National web sites
• BeyondBlue www.beyondblue.org.au
• Black Dog Institute www.blackdog.org.au
• depressioNet www.depressionet.com.au
• Mental Health Council www.mhca.org.au
• SANE Australia www.sane.org
• Government
• Federal Government Mental Health
  www.mentalhealth.gov.au
• Queensland Health www.health.qld.gov.au

50
Mental health landscape

• ANSWERS TO THE QUIZ

50
51
True or False 1

• Mental health is a life long process. It
  involves a sense of harmony and balance for the
  individual, family, friends, their community and
  more broadly society.

TRUE but everyone is potentially vulnerable to
mental health problems and mental illness. Risk
factors for mental illness include recreational
drug use, smoking, alcohol misuse and dependence,
socioeconomic disadvantage and life events such
as trauma, stress, bereavement, and unemployment
etc.
52
True or False 2

• Mental illness is a single rare disorder that is
  uncommon. It only affects a small number of
  people.

FALSE There are multiple types of mental illness,
each with its own features and underlying causes.
Some symptoms are shared across different
diagnoses. Saying mental illnesses are all the
same is just like saying that all cancers are the
same. Just like cancer, causes and treatments all
differ. Mental Illness is common, with over a
one year period, 15 of Australians experiencing
mental illness.
53
True or False 3

Being treated for a mental illness means an
individual has in some way "failed" or is weak.
FALSE A mental illness is not a character flaw.
It is a diagnosable medical illness, and it has
nothing to do with being weak or failing in some
way. It has been suggested that society is
failing people with mental illness and that the
best way of judging a society is how it treats
its most vulnerable people.
54
True or False 4

• People with mental illness are violent and
  dangerous so should be approached with caution
  and feared.

FALSE Most violent people have no history of
mental disorder and most people with mental
illness have no history of violent behaviour.
Research indicates that people receiving
treatment for a mental illness are no more
violent or dangerous than the general population.
The use of drugs or alcohol has a stronger
association with violence than does mental
illness. People living with a mental illness are
more likely to be victims of violence, especially
self-harm. When it does occur, violent behaviour
usually happens in the context of distressing
hallucinations or treatment that has not been
effective.
55
True or False 5

• People with mental illness have childlike
  perceptions of the world, lack intelligence and
  will always need to be taken care of.

FALSE Many studies show that most people with
mental illness have average or above-average
intelligence. Mental illness, like physical
illness, can affect anyone regardless of
intelligence, social class or income level. What
support is required will differ significantly
between individuals and depend upon their unique
circumstances and experiences.
56
True or False 6

• Mental illness is not a true medical diagnosis
  eg. people with depression should (and could)
  really just snap out of it, get a job, and get
  on with life.

FALSE Although people with mental illness can
play a big part in their own recovery, they did
not choose to become ill, and they are not lazy
because they cannot just "snap out of it." Mental
illness cannot be willed away. Ignoring the
problem does not make it go away, either. It
takes courage to seek professional help.
57
True or False 7

• Depression and other illnesses, such as anxiety
  disorders, do not affect children or adolescents.
  Any emotional problems they have are just a part
  of growing up eg. they just grow out of it.

FALSE Children and adolescents can develop mental
illness, including severe mental illness. Since
World War 2 there has been a substantial increase
in psychosocial disorders among young people. The
incidence of mental illness in young people is
now well documented and shown to be the highest
of any age group. In Australia, the prevalence is
approximately 14 in children aged 4-12 years
19 13-17 and up to 27 for 18-24 years . Many
young people do not access services. Left
untreated, these problems can get worse. Talk
about suicide should be taken very seriously.
58
True or False 8

• People with severe mental illness should really
  be cared for in hospital.

• FALSE Most people can recover from mental
  illness, especially if they receive help
  early. Some people will only experience one
  episode of mental illness and recover fully,
  others may be well for long periods with
  occasional episodes, and a minority of people
  will experience ongoing psychiatric disability.
  Most people with mental illness will be treated
  while living in the community. Some people may
  require admission to hospital but will return to
  supported community accommodation. There is
  overwhelming advice from people with mental
  illness and their families and friends that
  living in the community with appropriate support
  and assistance, is the preferred option.

59
True or False 9

• Mental illness is a life sentence ie. recovery
  is not possible for people with mental illness.

FALSE Most people can and do recover from mental
illness although early treatment is key. Recovery
is described as a deeply personal, unique
process of changing ones attitudes, values,
feelings, goals, skills, and/or roles. It is a
way of living a satisfying, hopeful, and
contributing life even with limitations caused by
illness. Recovery involves the development of new
meaning and purpose in ones life as one grows
beyond the catastrophic effects of mental
illness (Anthony, 1993) Recovery-oriented
services are essential to mental health treatment
and community care.
60
True or False 10

• No individual or cultural group is immune from
  mental illness. It is a global phenomenon.

TRUE People from any background can develop
mental illness. Cultural background affects how
people experience mental illness and how they
understand and interpret the symptoms of mental
illness. Many Aboriginal and Torres Strait
Islander peoples carry a significant burden of
grief and loss from an early age, due in part to
the high rates of mortality, illness,
incarceration, and deaths in custody.
Pre-migration experiences and the process of
resettlement in a foreign land can impact on the
mental health of people from culturally and
linguistically diverse backgrounds and their
children.
61
True or False 11

• People living with mental illness expect to be
  rejected by the community and are therefore
  reluctant to engage with others.

TRUE Stigma has 2 major components public
(reaction of general public to people with mental
illness) and self-stigma (prejudice that people
with mental illness tend to turn towards
themselves (Goffman, 1963). The more visible the
stigmatizing mark or condition, the more society
believes the individual should be able to control
it and the greater the negative impact of not
being able to do so. Stigma creates a culture of
us and them. Stigma hinders help-seeking
behaviours.
62
True or False 12

• The effects of stigma and discrimination may
  have a greater impact on an individual than the
  actual mental illness.

TRUE It is human nature to fear what is not
understood. Therefore mental illness is feared by
many people and, unfortunately, still carries a
stigma (defined as a mark or sign of disgrace)
which results in negative discrimination at
school, at work, in relationships etc. Because of
stigma and discrimination, many people hesitate
to get help for a mental health problem for fear
of being looked down upon. It is unfortunate that
this happens because effective treatment exists
for almost all mental illnesses. Worse, the
stigma experienced by people with a mental
illness can be more destructive than the illness
itself.
63
Resources

• National help lines
• Lifeline 24 hour counselling and referral 13 11
  14
• Kids helpline counselling for people under 18
  years 1800 55 18 10
• Just Ask rural mental health info 1300 13 11 14
• Mens Line Australia 24 hour counselling for men
  1300 78 99 78
• National web sites
• BeyondBlue www.beyondblue.org.au
• Black Dog Institute www.blackdog.org.au
• depressioNet www.depressionet.com.au
• Mental Health Council www.mhca.org.au
• SANE Australia www.sane.org
• Government
• Federal Government Mental Health
  www.mentalhealth.gov.au
• Queensland Health www.health.qld.gov.au

64
Contact Us

• Visit us https//assignmenttask.com/nursing/
• Email help_at_assignmenttask.com
• Phone [phone]