The female licensed mental health counselor had over 10 years experience assessing the psychological, social, cultural and financial needs that impact recovering drug and alcohol addicts in an addiction program run by an international agency. Previously, the interviewee worked in a health facility that provided mental and psychosocial services to the elderly population.
From the interview with the licensed mental health counselor, it was clear that that the participant subscribes to a theoretical orientation known as cognitive-behavioral therapy (CBT), which essentially attends to dysfunctional emotions, maladaptive behaviors and other impaired cognitive processes exhibited by the population of recovering clients in the program using a multiplicity of goal-oriented, precise and methodical approaches.
The favorite part of the job, as proposed by the interviewee, entailed experiencing former drug addicts and alcoholics being reintegrated back into the society after undergoing a three-month program, which assisted them to select and internalize specific strategies that they could always use to deal with their problems.
The least favorite part of the job came in dealing with uncontrollable and potentially dangerous clients, who most often are in the last phase of addiction. According to her, this part is discouraging as it is increasingly difficult to make these clients follow the recommended treatment procedures, resulting in use of force in some cases.
The interviewee acknowledged that burnout is a normal part of practice and anybody planning to become a licensed mental health counselor should be prepared to face burnout and deal with it in a manner that is less likely to affect his or her health and wellbeing.
The interviewee said that she had experienced burnout when listening to intensely heart-wrenching life experiences of drug and alcohol addicts, and when sharing in the grief, loss, and sadness of family members of addicted clients.
Additionally, the interviewee suggested that it is important to develop internalized indicators that one could use to recognize burnout and fatigue early on before they became health and professional challenges.
The interviewee coped with the burnout by engaging in things that bring joy and relieve stress (e.g., leisure activities), exploring new hobbies, avoiding taking on extra clients, taking time each day to relax, reading non-professional literature for fun, and receiving counseling in difficult situations.
The interviewee took time to describe her transition from a student at the university to professional counseling in a program specifically providing mental, psychological and healthcare services for the elderly. She was surprised by the variances between her expectations as a student and the realities on the ground.
According to her, it is difficult to apply most of the theories learned from school in real-life contexts, hence the need for transitioning students to develop a flexible and innovative predisposition to deal with issues beyond the boundaries of the educational institution.
Consequently, the advice she provided to new counselors is to maintain an open mind and flexibility and also come up with new approaches to ensure they stay informed on current evidence-based practices in the field of counseling psychology.
Overall, this particular interview provided useful insights not only on how to deal with burnout and fatigue in practice settings but also on what attributes to consider and internalize in transitioning from student life to professional counseling.
The coping strategies advocated by the interviewee are critical in ensuring that my practice as a licensed mental health counselor will be largely successful in terms of dealing with mental and health challenges related to burnout and fatigue.
Don Snow has a 5-year history of outpatient diagnosis treatment of paranoid schizophrenia at ABC mental hospital. This is indicated by the statement, “Don Snow, age 45has received outpatient treatment at ABC for five years…”
Don Snow has had four inpatient admissions during the past twenty-five years due to violent attacks on family members.
In the last eight years, Don Snow has not had any inpatient admission for violent attacks on family members.
Don Snow has revealed intentions of harming his sister’s 8-year-old child. He even goes on to suggest to a nurse that the boy is a devil and that somebody should do something about it.
Legal issues
ABC mental clinic owes a duty of care to Don Snow as he has a history of over 25 years with the clinic.
Don Snow has the right of doctor–patient confidentiality.
The nurse has a duty to report the sentiments expressed by Don Snow to the relevant therapist of Don Snow.
Elaboration of legal issues
Duty of care: Don Snow is entitled to treatment and diagnosis from the ABC Mental clinic. This is because the clinic has a 25-year history of diagnosing Don Snow, hence the ability to identify the problem easily and the mere fact that Don Snow has been attending the same clinic for 25 years grants him the right of duty of care.
Doctor-patient confidentiality: As a professional, the therapist is entitled to maintain the confidentiality of the patient. The patient is supposed to be comfortable while revealing his intensions/thoughts without fear of them being revealed to a third party.
Duty of profession: The nurse, being part of the medical staff of ABC Mental clinic, is entitled to reveal any useful information to the relevant medical personnel, especially if the information will be of use in aiding the clinic’s patients. However, the information must never be divulged to third parties who do not need to have it or are unauthorized to access such information.
Rationale
Therapist/clinic action
The therapist should first handle the patient in his professional capacity as a therapist. This means that he should try to know the reasons as to why Don Snow has fantasies about harming his sister’s child, whether the intended shotgun is for the fulfillment of the fantasy, and from where he intends to purchase it. By using the available history of the patient, the therapist can know if the therapy will work in preventing the occurrence of the patient’s fantasies.
If it will not work, the therapist should inform the clinic’s management on the situation, who in turn will deliberate on whether to turn the matter to the right authorities or decide the best course of action. Before informing the relevant authorities, the clinic should explore other options like admitting the patient and working on the harmful fantasies, and gauging the response. By doing this, the clinic/therapist will be protecting the doctor–patient confidentiality rule (Showalter, 2008).
Liability to the therapist/clinic
In case Don Snow fulfills his fantasies of harming his sister’s child, the therapist/clinic might be held liable for withholding the information to the authorities before the harmful act. The question of liability may be tricky due to the patient–doctor confidentiality rule, although the therapist has the responsibility of reporting incidents that are likely to cause harm to others before they take place. Before reporting the intended harmful act to the relevant authorities, all possible channels of preventing the harm from occurring should be exhausted thus having the reporting action as the last option (Showalter, 2008). By reporting, the intended harmful act to the relevant authorities without exhausting the available channels will put the doctor–patient rule in jeopardy as patients in the future lack trust in their medical personnel.
Reference
Showalter, J. S. (2008). The Law of Healthcare Administration. Edition 5. Chicago, Health Administration Press.
One burning issue in the matter of the juvenile justice system is the question of youngsters with mental health problems within the confines of correctional facilities. This issue has been at the forefront of most lobby groups that advocate for the fair and just treatment of the disadvantaged individuals. The youngsters with mental health issues have always been a formidable challenge to the juvenile justice system in many places worldwide.
It is hard for everyone when a juvenile commits a crime. This is more pronounced when he or she is certified with a mental disorder. As much as the authorities attempt to address the problem of accommodating them within the correctional facilities, there is still need to put in more effort. It will not do anyone any good to turn the correctional facilities into surrogate psychiatric hospitals. Addressing the tension filled intrinsic behavior that is exuded by juveniles against the justice system that is in place, ought to be among the front running priorities of the authorities.
The enforcers of the law must yield to the fact that there are some aspects of juvenile delinquents, especially their behavior, that may be based upon contending mandates, as well as priorities, which encompass the need to rehabilitate the young offenders as well as to maintain a hold on them for their responsibility for their actions. They may also need to recognize the need for them to protect the public. As much as it may be a challenging task, the staff members have to learn how to balance these priorities.
Involvement in illegal behavior and partaking, in criminal activities, may be defined as juvenile delinquency. It is the involvement of an individual in activities that may be considered as being against the law by a young person who is considered legally underage. Status offenses are those prohibited to certain people (Schmalleger 2011, p. 34).
They may include a wide array of activities such as drinking alcohol as well as smoking tobacco products. Other offenses may be categorized in this group such as running away from home, as well as truancy. They are illegal to people of certain ages while the same is not applicable to others makes them status offenses. Juvenile courts handle only cases for minors while adult courts handle cases for mature people. Most of the variables that correlate with juvenile crime rates are typically in the category of drugs. Bullying and mistreatment also aggravate the situation. Ignorance is also one critical variable. Peer pressure plays a significant role too. Statistics show that the rate of juvenile delinquency dropped from 2006 to 2010. It is projected that there will be a steady increase in the number of juvenile cases from 2011 up to 2025. Currently, that percentage is rising.
Reference
Schmalleger, F 2011, Criminal justice today: an introductory text for the 21st century, 11th edn, Pearson/Prentice Hall, Upper Saddle River, NJ.
In order to practice mental health counseling, an individual requires an appropriate license and can voluntarily obtain certification to ascertain their compliance with professional standards. Certification is provided on the national level by the National Board for Certified Counselors (NBCC), and licensure is issued by a particular state and is valid in this state only.
The purposes of licensure and certification are different, but both require a certain set of skills, knowledge, and experience to ascertain that the counselor is a qualified professional. The purpose of this paper is to analyze and compare the requirements and provisions for mental health counseling licensure and certification in Florida and discuss their impact on the public.
Licensure
State licensure is permission issued by a state’s government that allows an individual to practice mental health counseling or identify themselves as a professional counselor. The provisions for the regulation and licensure of counseling services in Florida are set forth by Florida Statue 491 (FS491).
As stipulated in Section 491.004, mental health counseling licensure is performed by the Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling (“Clinical, Counseling, and Psychotherapy Services”, 2019). It was established to guarantee that every mental health care worker meets requirements for safe practice.
The first section (491.002) of FS491 defines mental health counseling as a service that deals with the population’s emotional survival by providing services of a phycological nature. To secure public health and safety, it should be performed only by individuals that have the necessary qualifications that the Statute sets to stipulate. Section 491.003 comprises a list of terms used to refer to different aspects of mental health practice and their definitions.
Section 491.005 lists the requirements that an applicant needs to meet in order to get a mental health counseling license. They include submission of an application, payment of the appropriate fee, a relevant master’s degree, two years of clinical experience, a theory and practice examination, and an appropriate level of knowledge in mental health counseling (“Clinical, Counseling, and Psychotherapy Services”, 2019). Section 491.0065 also adds that, to obtain a license, an applicant is required to complete an education course on HIV and AIDS.
An individual who does not satisfy education or experience requirements can register as an intern, as stipulated in Section 491.0045. According to Section 491.0046, one can also apply for a provisional license that is valid for 24 months and allows them to practice under the supervision of a licensed counselor.
To renew the license, according to Section 491.007, one needs to pay a fee and provide evidence that they have met the requirements for continuous education listed in Section 491.0085 (“Clinical, Counseling, and Psychotherapy Services”, 2019). The license can also be placed on inactive status at the licensee’s request while they are completing education requirements or are involved in an investigation, and reactivated for a fee, as stated in Section 491.008.
For professionals who have a license issued in another state and need to endorse it in Florida, Section 491.006 applies. The requirements include the payment of a fee, demonstration of the sufficient level of knowledge in mental health counseling, possession of an active valid license received through examination, and 3 to 5 years of practice (“Clinical, Counseling, and Psychotherapy Services”, 2019). The applicant should not be under any investigation, and the license should be held in good standing.
Section 491.009 includes a list of reasons for denial of a license or disciplinary action. Sections 491.0111 and 491.0112 specifically address the subject of sexual misconduct and the applicable penalties, stating that counselors committing sexual misconduct with the client are charged with a third-degree felony (“Clinical, Counseling, and Psychotherapy Services”, 2019). Section 491.012 lists violations regarding the unsanctioned use of titles and licenses, with the exceptions stipulated in Section 491.014.
Sections 491.0141, 491.0143, and 491.0144 address the subject of controversial therapy practices: hypnosis, sex therapy, and therapy of juvenile sex offenders. The statute allows all licensed counselors to practice hypnosis (“Clinical, Counseling, and Psychotherapy Services”, 2019). Practicing sex therapy requires meeting certain qualifications set by the board. In order to treat juvenile sex offenders, special training and coursework are required from a licensed counselor, with specific qualifications determined by the board.
The confidentiality of patient information is addressed in Section 491.0147. It states that any communication between a licensed counselor and a patient is confidential. However, this privilege may be neglected when criminal and disciplinary actions are concerned. The counselor has the right to disclose information to a law enforcement agency if a patient threatens to commit a crime against a person, or the counselor makes a clinical judgment that they have such an intention.
Sections 491.0148 and 491.0149 address the formal requirements for licensed mental health professionals: maintaining records and displaying of license and registration. Counselors are entitled to conspicuously display their license and include the words “licensed mental health counselor” on their promotional materials (“Clinical, Counseling, and Psychotherapy Services”, 2019). Each counselor needs to keep records in accordance with the rules determined by the board and can transfer these records to other therapists only with the client’s consent.
Supervision is addressed in Chapter 64B of the Florida Administrative Code. Section 2 defines supervision, establishes the aims, types, rules, and procedure for providing guidance to an intern, and comments on the subject of the conflict of interest (Florida Administrative Code R. 64B4-2).
Section 31 lists the requirements for a supervisor, who should be a licensed mental health counselor with five years of clinical experience and complete a course in supervision (Florida Administrative Code R. 64B4-31). It also provides a list of courses that are considered relevant for application for a mental health counseling license under Section 491.005 of FS491.
Certification
Mental health counseling certification is a credential issued by the NBCC to ascertain that an individual meets the national standards set by the counseling profession. These standards include the completion of a graduate degree, the successful passing of a national examination, relevant work experience, and adherence to the professional code of conduct.
Certification is voluntary; it does not substitute a state-issued license and is not required for practice. It identifies counselors who have met the established professional standards and continue to fulfill the requirements for continuing education and renewal of certification. An NBCC certificate enhances one’s professional reputation and credibility and increases their opportunities for career advancement.
The NBCC offers a number of benefits for certified counselors. It publishes and updates professional materials, such as a peer-reviewed journal, a newsletter, and the Code of Ethics. Certified counselors can earn free continuing education courses and get priority enrollment on international opportunities (“Benefits of being an NCC”, n. d.). The NBCC also has an online portal that allows counselors to track their continuing education. Certified counselors are provided with professional liability insurance that protects them from bearing the full cost of defending against clients’ claims and lawsuits.
The flagship certification offered by the NBCC is the National Certified Counselor (NCC) that is a generic certification for professional counselors that does not designate a specification. To apply for the NCC certificate, one must ensure they meet the requirements concerning education, coursework, supervision, professional endorsement, and work experience, and adhere to the NBCC’s ethical policies (“National Certified Counselor (NCC)”, n. d.). An applicant also needs to pass the National Counselor Exam or the National Clinical Mental Health Counseling Examination and pay an application fee.
Another certification issued by the NBCC is the Certified Clinical Mental Health Counselor (CCMHC), which is a premier certification for mental health care workers. It establishes that an individual is a highly skilled professional who adheres to the highest standards of practice and has met stringent requirements.
In order to obtain the CCMHC certificate, one needs to be a National Certified Counselor, have relevant education, complete clinical training in supervised field experience, obtain a professional endorsement, and have sufficient work experience (“Certified Clinical Mental Health Counselor”, n. d.). They also need to pass the National Clinical Mental Health Counseling Examination and pay a fee. The CCMHC is issued for five years, and, to maintain it, a practitioner has to meet the ongoing requirements for continuing education and ethics attestation.
Licensure and Certification: Similarities and Differences
NBCC’s certification is a voluntary credential issued to ascertain that a mental health practitioner meets national professional standards, while state licensure is permission to practice counseling. Certification is issued by the NBCC and is valid across the entire country, while licensure is provided by a particular state and works in this state only. Different states have different application processes and requirements for obtaining the license.
Board certification and state licensure both set professional standards and are used to define mental health care workers, but their purposes are different. Certification helps to recognize qualified professionals who voluntarily adhere to national counseling standards and provides a mechanism for dealing with claims and concerns (“National Certified Counselor (NCC)”, n. d.). Licensure is intended to legally define professionals who can provide counseling services in a particular state.
In Florida, the requirements for obtaining licensure and certification are similar. They include relevant education, a period of supervision, work experience, the appropriate level of knowledge, and the successful passing of an examination. In order to obtain certification, an individual needs to pass either the National Counselor Examination or the National Clinical Mental Health Counseling Examination. To issue a license, the state board purchases the examination from the Professional Examination Service of the National Academy of Certified Clinical Mental Health Counselors or similar organization.
Impact of Licensure and Certification on the Public
Certification and licensure standards for health care professionals are both established with the purpose of protecting public safety. Section 491.002 of Florida Statute 491 states that mental health counseling deals with an individual’s emotional survival that affects physical survival, and, therefore, should be strictly regulated and practiced only by qualified professionals (“Clinical, Counseling, and Psychotherapy Services”, 2019). The NBCC requires strict adherence to the professional Code of Ethics to provide high-quality services.
Both FS491 and the NBCC’s Code of Ethics are undertaken to protect patients’ privacy and confidentiality of personal information. Section 491.0147 of FS491 states that any communication between a licensed counselor and a client is confidential (“Clinical, Counseling, and Psychotherapy Services”, 2019). NBCC’s Code of Ethics stipulates that the NCC should take any means required to protect the patient’s confidentiality and prevent unnecessary invasion of privacy (National Board for Certified Counselors [NBCC], 2016).
Exceptions include the cases when the client communicates a threat to commit a crime, or when the release of information is required by a court order. In this case, patient information should be disclosed only to the extent required by the situation. When dealing with licensed and certified counselors, patients can be sure that their personal data is protected and will not be transferred to a third party.
The standards established by FS491 and the NBCC’s Code of Ethics also aim to protect the public from professional misconduct. FS491 includes a list of reasons for the withdrawal of licensure and disciplinary action, including the penalty for sexual misconduct (“Clinical, Counseling, and Psychotherapy Services”, 2019).
The NBCC also prevents counselors from engaging is sexual or romantic relationships with clients and discourages all other forms of ethics violations (NBCC, 2016). NBCC acts as an intermediary between counselors and clients in claims and lawsuits. Both licensure and certification ensure that an individual can expect strict adherence to professional standards from a counselor and can take necessary actions in case of misconduct.
Conclusion
FS491 and Chapter 64B4 of the Florida Administrative Code stipulate the provisions for obtaining and maintaining mental health counseling licensure in Florida. It is required to legally define a professional counselor and ensure that they adhere to professional guidelines and are accountable for their actions.
The NBCC issues voluntary certification for mental health practitioners that is not obligatory for practice but is used to acknowledge that an individual meets the national standards set for the counseling profession. Both licensure and certification are aimed to protect patients’ interests, their privacy, and confidentiality of personal information. Strict adherence to the standards set by the NBCC and the state regulations ensures safe and effective counseling practice.
References
Benefits of being an NCC. (n. d.). National Board for Certified Counselors. Web.
Certified Clinical Mental Health Counselor. (n. d.). National Board for Certified Counselors. Web.
Mental illness is a common condition in the U.S, which triggers disproportionate impacts on the populace. According to Seo et al. (2019), around one in five adults in the U.S live with a psychological condition. In 2018, approximately 51.5 million people aged 18 and above had a mental disorder in the U.S (Seo et al., 2019).
Its incidence was significantly high among females (24.5%) compared to males (16.3%) (Seo et al., 2019). Various health-related policies have been developed in the U.S to address this issue. These procedures aim to minimize the incidence rates of psychological conditions within the population, improve access to appropriate interventions, and enhance positive health outcomes. This paper seeks to evaluate the efficacy of one of these policies, particularly the Affordable Care Act (ACA), in promoting mental health practice.
A Description of the Policy
The Patient Protection and Affordable Care Act (PPACA) is distinguished as a detailed reform within the U.S healthcare sector, signed or passed as legislation in March 2010 by the former U.S President, Barrack Obama. The ACA is a U.S public health policy watershed, which was revised by the Health and Education Reconciliation Act (Creedon & Cook, 2016). Through a sequence of amendments and extensions, the ACA represents the healthcare system’s legal model in the U.S. It establishes the fundamental licit protections, which, until its inception, were absent.
Provisions of the ACA
Provisions under the ACA are aimed to curb the increasing healthcare expenses, expand the health workforce, enhance better systems and quality performance, emphasize wellness and disease prevention, expand insurance access, and promote consumer protections. These stipulations may be organized within three fundamental objectives:
Continuous and universal healthcare insurance access: The two major procedures for enhancing better insurance coverage include 1. Medicaid coverage expansion. 2. The establishment of online marketplaces or health insurance exchanges for certified and government-regulated insurance plans.
Health insurance affordability: The legislation underscores the provision of subsidies for health insurance purchases through tax credits for U.S citizens with modest incomes. A wide range of grants is available for specific groupings.
Care and coverage adequacy: The legislation delineates fundamental benefits in ten primary categories that should be integrated into all insurance plans.
The CMS (Centers for Medicare and Medicaid Services) was tasked with developing contemporary healthcare provision frameworks. This was due to likelihood of the increasing influx of patients into the healthcare system, which could trigger significant surges in aggregate healthcare expenditures. These models could enhance better healthcare quality while minimizing or stabilizing costs. The ACOs (Accountable Care Organizations) is an example of the model.
According to Huguet et al. (2018), it refers to a network of healthcare providers who share care costs and medical responsibility for a specific patient group. The above-mentioned model preceded the ACA as an option to the conventional payment system – fee-for-service. Another healthcare delivery framework devised by the CMS is health homes. This model operates at practitioner teams’ level instead of networks.
According to Thomas et al. (2019), health homes encourage the delivery of team-based and patient-centered care coordination for people with various chronic illnesses, including substance abuse and mental health disorders. This model was intended to improve care quality and enhance significant cost reductions by minimizing emergency department (ED) and hospital use.
Social Issues that Led to the Development of the ACA
Many forces intersected to demand healthcare reform within the U.S due to various issues. Over the previous several decades, there was a significant surge in care costs. This phenomenon was ascribed to the rapid advancements in treatment and diagnostic processes. Substantial healthcare costs were also attributed to the effects triggered by non-competitive payment models.
The healthcare setting’s revenue and physicians’ income relied on the number of patients seeking primary care and implemented medical procedures. During this era, many Americans acquired health indemnity through employer-sponsored insurance plans. To control the increasing healthcare costs, insurance organizations denied coverage to people with pre-existing illnesses and revoked coverage whenever they became ill, and decreased the benefits guaranteed under insurance plans.
Enterprises also initiated approaches that triggered the eradication of family plans and limited workers’ options regarding coverage plans. This consequently led to significant increases in the rate of individuals without health insurance. According to Thomas et al. (2019), approximately 48 million people in 2010 were uninsured due to the conventional practices within the healthcare sector. These individuals often lacked preventive services, and, according to Huguet et al. (2018), they only sought medical interventions in instances where their underlying health conditions were unbearable or critical.
Furthermore, Kminski et al. (2017) indicate that emergency medical interventions were typically costly than routine care. As a result, medical-related expenses become the primary cause of individual bankruptcy in the U.S. However, following the ACA’s implementation, healthcare access for all individuals, including those with chronic illnesses and mental health conditions, increased significantly. The Act also initiated significant modifications in the coverage benefits provided by insurance plans, and the U.S experienced a surge in the rate of insured people. Employers were also mandated to provide insurance to all their workers.
The Population Targeted by the ACA
Traditional Medicaid Beneficiaries
Under the preventive benefits section, the above-mentioned policy (ACA) classifies adult beneficiaries into two primary groups. The first category includes newly qualified recipients whose insurance coverage encompasses “vital or crucial health benefits” consisting of preventive services stipulated by the Public Health Service Act. The other grouping consists of conventional Medicaid beneficiaries who are still entitled to the long-established benefits package under Medicaid. According to Seo et al. (2019), preventive services have been distinguished as a federal requirement for this populace segment, particularly those aged 21 and below. For adults aged 21 and above, this service is optional.
Pregnant Women
The statute renders services that promote tobacco cessation an essential benefit for the above-mentioned populace segment. According to Seo et al. (2019), care delivery services included under tobacco cessation include pharmacotherapeutic approaches, including non-prescription and prescription medications sanctioned by the FDA (Food and Drug Administration), counseling, therapy, and diagnosis. This is in accordance with the guidelines by the Public Health Service (Thomas et al., 2019). These services may be provided by physicians or under their supervision, or by other licensed and authorized healthcare practitioners.
Individuals with Pre-existing Conditions
The ACA mandates the HHS secretary to provide grants to U.S-based states to establish chronic disorder programs for Medicaid recipients. According to Mechanic and Olfson (2016), the above-mentioned stipulation is contained under section 4108 of the ACA. Initiatives established under this program are usually easily accessible, widely available, evidence-based, comprehensive, and are designed and specifically suited to this populace segment’s needs. Grants awarded to states should be used to perform education and outreach campaigns to increase the community’s awareness.
Individuals Eligible for Family Planning Approaches
The ACA developed a new state qualification option regarding coverage for supplies and services for family planning. Under this provision, states may opt to extend insurance coverage to specific people who may be considered ineligible for Medicaid for financial or categorical reasons. Benefits under this provision include supplies and services that promote family planning as well as the therapeutic and diagnostic approaches related to family planning.
Evidence-Based Practices That may be Implemented as a Result of the Policy (ACA)
Strategies to Manage Smoking and Dependency/Addiction
Nicotine Replacement Therapy (NRT)
The most widely researched and utilized the pharmacotherapeutic approach for managing nicotine withdrawal and dependence is the therapeutic utilization of medications containing nicotine. NRT products assume several forms, including tablets, oral inhalers, nasal sprays, transdermal patches, and gum. Kruger et al. (2016) identify transdermal patches as a gradually sustained release approach for nicotine delivery, while tablets, oral inhalers, nasal sprays, and gum as acute dosing nicotine forms.
NRTs act by providing breakthrough and general craving nicotine relief with the instant elimination of nicotine. Several evidence-based pieces of research endorse NRTs’ use in smoking cessation. For instance, a survey by Hartmann-Boyce et al. (2018) revealed that all approved NRT forms increase an individual’s chance of terminating tobacco smoking successfully. According to Hartmann-Boyce et al. (2018), this approach increases one’s likelihood of ending this behavior by fifty-to-sixty percent.
NRT’s intervention’s efficacy does not depend on the potency of additional support given to the patient. Another study by Krishnan et al. (2017) identified NRT as the most effective approach for facilitating smoking cessation. These researchers further recommended increasing the duration and supply of NRT to enhance its efficiency in eradicating this deportment.
Furthermore, a qualitative study by Silla et al. (2014) revealed that people who use NRT are usually highly inclined to terminate tobacco smoking compared to non-users. According to Silla et al. (2014), these individuals are also likely to implement techniques or approaches which reinforce their cessation attempts. To achieve better outcomes, this evidence-based methodology may be combined with behavioral therapy.
The “5A’s”
Successful interventions typically commence with distinguishing users and effective interventions based on an individual’s willingness or commitment to quit. The five primary therapy phases incorporate the “5A’s”: arrange, assist, assess, advise, and ask (Chai et al., 2018). Below is a description of each phase:
Ask: It involves distinguishing and documenting the status of tobacco use for each patient during every visit.
Advise: This should be conducted in a clear, personalized, and strong manner. Practitioners should encourage every tobacco using patient to quit.
Assess: This involves evaluating the willingness of the patient to initiate an attempt to quit smoking.
Assist: Pharmacotherapy and counseling should be initiated when the patient is committed to terminating the behavior.
Arrange: This phase underscores the need to schedule follow-ups ideally within the initial week following the quit date.
Studies highlight this intervention’s efficacy in enhancing smoking cessation and improving patients’ knowledge of the behavior’s impacts. For instance, a survey by Chai et al. (2018) revealed the efficacy of the 5A comprehensive approach in enhancing an improved cognizance of anti-smoking attitudes and smoking among migrant workers.
The research outcomes of a study by Kruger et al. (2016) indicated that the “5A’s” intervention was linked to substantial improvements in the use of medication and counseling aimed to promote smoking cessation among patients. From the results of the above reviews, it is evident that the “5A’s” approach is crucial in enhancing smoking cessation approaches and improving patients’ insights into the impacts of this behavior.
Evaluation of the Policy
Affordability
The ACA has been associated with positive and negative views with regard to affordability. The coverage expansion under this policy has triggered significant improvements in insurance coverage, with the rate of uninsured individuals decreasing from 16% to 9.1% from 2010 to 2015; this is a 43% decline (Manchikanti et al., 2017). Between 2010 and 2016, the U.S recorded a substantial reduction in the uninsured people’s number from 49-to-27 million (Manchikanti et al., 2017).
Dependents’ coverage (up to 27 y/o) to over 2 million in early 2015. Non-elderly’s access to a private physician registered a 3.5% increase, while medication access increased by 2.5% (Manchikanti et al., 2017). A 5.5% decrease was recorded among individuals unable to afford care, whilst records for poor health outcomes reduced by 3.4% (Manchikanti et al., 2017). Contrarily, Enrolment to healthcare exchanges recorded significant failures typified by fewer registrations than anticipated; this may be ascribed to out-of-pocket expenses and high premiums.
Cost/Expense Containment
The U.S healthcare sector has recorded significant reductions in the growth rate of pertinent expenses. There have been substantial improvements in workers’ financial risks with regard to healthcare costs with a decline in the prevalence of employees without a yearly out-of-pocket expense limit.
Following the ACA’s implementation, the healthcare sector’s payment systems have undergone considerable changes, including modifications in Medicare Advantage programs’ compensation rates and adjustments in the reimbursement of the private sector. Contrarily, the ACA decreased medical care affordability due to the surge in out-of-pocket and health insurance costs; this includes increased premiums, co-insurance, and deductibles.
Quality Improvement
This policy has also been linked with considerable improvements in healthcare quality. For instance, According to Manchikanti et al. (2017), there has been a 17% significant reduction in the incidence of hospital-acquired diseases (HAI), including pressure ulcers, infections, and adverse drug cases between 2010 and 2014. Furthermore, the AHRQ (Agency for Healthcare Research and Quality) outcomes linked HAI declines with 87.000 prevented demises over four years (Manchikanti et al., 2017).
Contrarily, this policy has been correlated with significant increases in patient waiting times and the decreased contributions to preventive disease services. The adoption of electronic health systems (EHR systems) has also been correlated with a high skepticism concerning its efficacy in quality improvement, with multiple physicians expressing their frustrations with the technology.
The Impact of the Policy (ACA) on Access to Mental Health Services
As indicated earlier, there were over 48 million uninsured individuals in the U.S before the passage of the ACA; this statistic consisted mainly of the low-income populace. This population segment has been correlated with the increased incidence of psychiatric disorders. Before the ACA’s enactment, the Mental Health Parity and Addiction Equity Act and Mental Health Parity Act demanded that all large-grouping employer insurance coverage offering psychological health services guarantee their coverage (Thomas et al., 2019).
This was to be done at a level similar to surgical and medical services. However, these legislations were not applicable to small- and individual-group programs. Depending on a person’s coverage type, insurers typically screened clients for any previous history of mental health and utilize this knowledge to cap and exclude services linked to mental health, deny coverage, limit drug access, and increase cost-sharing and premiums.
However, the ACA’s passage helped address these issues by joining mental healthcare access with coverage expansions. Strategies to increase insurance coverage caused a substantial decrease in the uninsured populace’s rate to around 30.4 million in 2018 (Mechanic & Olfson, 2016). These approaches include allowing the young populace segment to maintain their eligibility for receiving healthcare using their parents’ plans until they attain 26 years and expand the Medicaid program (Mechanic & Olfson, 2016). The policy also warranted mental health service access within Medicaid expansion programs and the small-group and individual plans (fully insured).
The ACA mandated the integration of ten vital health benefits (this includes prescription drugs and mental health) into these insurance programs. The statute also endorsed the incorporation of the MHPAEA parity stipulations to the above-mentioned plans and demanded all programs cover preventive approaches such as the screening for conditions related to psychiatric health at zero costs (Mechanic & Olfson, 2016).
The policy also emphasizes that small-group and individual plans meet the adequacy standards established by provider networks. The statute also terminated the lifetime and annual benefit caps, and it also eradicated medical underwriting which is prevalent in small-grouping and individual marketplaces. Currently, insurance programs cannot impose cost impediment and deny coverage due to patients’ underlying mental health disorders.
The Policy’s Impact on Social Workers
ACA’s enactment facilitated the integration of social work practice in the healthcare sector by expanding its scope. A study by Bachman et al. (2017) supports this viewpoint by arguing that these professionals under the above-mentioned specialty play an instrumental role in facilitating the attainment of the ACA’s primary objectives. These goals include improving healthcare quality, minimizing healthcare costs, and increasing insurance coverage.
According to Bachman et al. (2017), social workers currently assume various health-related duties in the healthcare setting, including behavioral health counselors, care coordinators, and patient navigators. Regarding mental health, social workers can integrate clinical interventions, including short-term psychotherapy, disease management groupings, and cognitive-behavioral therapies during patients’ hospitalization to trigger significant improvements in health outcomes while minimizing utilization and costs.
Following the ACA’s sanctioning social workers’ demand and roles in primary care settings and health, homes increased significantly. Social workers typically play critical roles in public health and prevention interventions by encouraging patients’ adherence to medications, offering home visitation services, and addressing mental health, childhood obesity, and other chronic conditions. These settings allow these experts to integrate their behavioral health skills, as well as disease prevention and health promotion adroitness during care delivery to ensure the achievement of positive patient outcomes.
Furthermore, case management adroitness possessed by social workers has also been identified as crucial proficiencies required to attain the ACA goals. According to Bachman et al. (2017), these professionals are usually trained to evaluate clients’ environments and strengths; this role is congruent with the ACA’s new functions, including patient navigating. Social workers could also be instrumental in advocating for the needs of hard-to-reach populaces. Contrarily, the ACA has triggered an increased demand for social workers to engage in professional research, enroll for specialized training, and enhance this specialty’s professional distinction.
Entitlement Programs Impacted by the ACA
Social security benefits
Non -taxable benefits linked to social security, including SSDI (social security disability income), are typically regarded as income under the ACA, which impacts tax credits. Therefore, this means that when computing one’s subsidy eligibility, their social security income (SSI) is utilized to ascertain their qualifications and may impact the amount they are entitled to (Seo et al., 2019).
This viewpoint is supported by Kominski et al. (2017), who argue that a person’s eligibility for subsidized health coverage plans and income-based Medicaid is usually calculated utilizing a household’s MAGI (Modified Adjusted Gross Income). Its computation is ascertained by the Medicaid regulations and IRS (Kominski et al., 2017). Therefore, if one receives SSDI, their benefits must be incorporated as part of their MAGI.
Medicare and Medicaid
The ACA minimized the increasing rates of Medicare payments to providers and decreased compensations to Medicare Advantage programs for six years to reduce the rising healthcare costs. The above-mentioned policy also included stipulations that aimed to improve benefits under Medicare by offering coverage for specific preventive benefits, including colorectal and breast cancer screening, diabetes, and cardiovascular disorders.
The policy also included strategies to close the doughnut hole or coverage gap in the benefits linked to Part D medications (Creedon & Cook, 2016). Furthermore, the ACA initiated significant expansions to broaden the eligibility threshold and increase care accessibility regarding Medicaid.
How the ACA is Trauma-Informed
A significant correlation exists between life trauma and increased mortality risks due to chronic disorders. The ACA was passed as legislation to increase access to quality and affordable health insurance for multiple U.S citizens and the increases in healthcare spending. The statute also provided new noteworthy protections, rights, and benefits, which prevented insurance organizations from denying coverage, subsidized healthcare expenses, and demanded that insurers offer coverage to individuals with underlying conditions.
According to Creedon and Cook (2016), pre-existing illnesses are typically chronic diseases requiring medical interventions in acute, community, and primary care facilities. The ACA’s implementation guaranteed the increased access to healthcare services, particularly by individuals diagnosed with these illnesses. The above-mentioned approach also ensures that healthcare providers attain an in-depth comprehension of deportments that cause chronic disorders.
Life trauma can trigger lifestyle activities, which influence chronic diseases’ onset. Therefore, through increased access, healthcare practitioners can get a comprehensive understanding of previous traumatic occurrences in a patient’s life, which consequently promotes the provision of appropriate care and better health outcomes.
How the ACA Promotes Human Rights
The ACA promotes human rights by advocating for the entitlement to better health through healthcare access. Following this policy’s implementation, the U.S experienced a surge in the rate of insured people. Employers were also mandated to provide insurance to all their workers. Healthcare access for all individuals, including those with chronic illnesses and mental health conditions, has also increased significantly. The Act further initiated significant modifications in the coverage benefits provided by insurance plans.
The young populace segment is currently eligible for receiving healthcare using their parents’ insurance plans until they attain 26 years. Despite these significant milestones, the policy does not warrant healthcare access to every individual in the U.S. To counter this drawback, legislators can conduct substantial amendments to the policy to ensure that it accommodates every person’s healthcare need, particularly access.
Conclusion
Mental illness relates to an extensive range of psychological health disorders that affects an individual’s behavior, thinking, and mood. The ACA is a U.S public health policy watershed, which was revised by the Health and Education Reconciliation Act. This policy enhances the universal healthcare insurance access, health insurance affordability, as well as care and coverage adequacy.
The ACA plays a crucial role promoting mental health by increasing care access, operational efficiency, and improving patient outcomes. This act supports human rights and is trauma-informed; however, I recommend its amendment to ensure it guarantees healthcare access for all individuals and healthcare expense reductions.
References
Bachman, S. S., Wachman, M., Manning, L., Cohen, M. A., Seifert, R. W., Jones, D. K., Fitzgerald, T., Nuzum, R., & Riley, P. (2017). Social Work’s role in Medicaid reform: A qualitative study. American Journal of Public Health,107(Suppl 3), S250–S255. Web.
Hartmann‐Boyce, J., Chepkin, S. C., Ye, W., Bullen, C., & Lancaster, T. (2018). Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Systematic Reviews, 2018(5), 1–194. Web.
Huguet, N., Springer, R., Marino, M., Angier, H., Hoopes, M., Holderness, H., & DeVoe, J. E., (2018). The impact of the Affordable Care Act (ACA) Medicaid Expansion on visit rates for diabetes in safety net health centers. The Journal of the American Board of Family Medicine, 31(6), 905-916. Web.
Manchikanti, L., Helm, S., Benyamin, M. R., & Hirsch, J. A. (2017). A critical analysis of Obamacare: Affordable care or insurance for many and coverage for few? Pain Physician, 20, 111-138. Web.
The problem researched in the proposed study is the question of misrepresentation of mentally ill people in public view, particularly in the aftermath of mass shootings. The problem is evidenced by the prevailing public and media discourse that is typically centered around the mental health of the perpetrator, even if there is no evidence suggesting that the perpetrator experienced any mental health issues. Such framing is problematic for two reasons. First of all, it shifts the public attention away from the real causes of gun violence. Secondly, it contributes to the perpetuation of the existing stigmas and stereotypes regarding the mentally ill individuals, effectively obscuring the unaddressed problem of victimization of the mentally ill (Teplin, McClelland, Abram & Weiner, 2005). On the medical side, there is no scientific evidence that supports the claim that mental health issues are inherently linked to increased violence (Peterson, Skeem, Kennealy, Bray & Zvonkovic, 2014).
The proposed study aims to analyze whether the phenomenon of misrepresentation can be classified as an instance of a moral panic. Moral panics are a concept used in the social constructionist approach to social sciences, including criminology, that refers to those events that prompt one part of a community to believe that another distinct social group threatens the well-being of their community or society (Goode & Ben-Yehuda, 2009). This phenomenon is problematic because it leads to the demonization and dehumanization of the members of the group that is perceived to be dangerous, and it also hinders and obstructs effective policy-making. The goal of the study is to reveal the inappropriateness of a mental health-centered approach to gun control public policy and emphasize the need for information dissemination and education in the sphere of mental health.
Current Events
Media accounts that warrant the relevance of the selected research problem appear both in printed and online outlets with disconcerting frequency. Thus, for instance, the recent random mass shooting that took place in Kalamazoo, Michigan, has been attributed to the mental instability and possible depression of the perpetrator. Thus, for instance, an article in The Guardian that was published in the aftermath of the event included statements made by a professor at Penn State University about the commonness of mental health histories in such cases. The citation seems irrelevant as the author himself later admits that the perpetrator in the Kalamazoo case did not fit the typical mass shooter profile (Felton, 2016).
Even those cases where the primary motivation behind the crime is linked to other reasons prompt policy-makers to bring the mental health dimension to the discussion about the gun control reforms. This was the case in the recent San Bernardino shooting: even though the authorities suspected the shooting to be primarily linked to terrorism, one of the speakers called for updating the country’s mental health laws, without making a clear link between the shooting and these laws (Frej, 2015). Such kind of lobbying has been so powerful that it even resulted in a major gun control reform approved by President Obama in early 2016. The reform that was subject to significant controversy, in fact, merely clarified the existing patient privacy laws, requiring certain organizations to disclose some mental health-related information to the national background check database (Whitman, 2016). What these stories have in common is that they tend to ignore the fact that most people who suffer from mental health issues are, in fact, nonviolent.
Goode, E., & Ben-Yehuda, N. (2009). Moral panics: The social construction of deviance (2nd ed.). Oxford, UK: Blackwell Publishing.
Peterson, J.K., Skeem, J., Kennealy, P., Bray, B., & Zvonkovic, A. (2014). How often and how consistently do symptoms directly precede criminal behavior among offenders with mental illness? Law and Human Behavior, 38(5), 439-449.
Teplin, L. A., McClelland, G. M., Abram, K. M., & Weiner, D. A. (2005). Crime victimization in adults with severe mental illness: Comparison with the National Crime Victimization Survey. Archives of General Psychiatry, 62(8), 911-921.
The connection between the mental issues of an individual and the probability of them developing the patterns of criminal behavior is a rather questionable area (Meloy & Hoffmann, 2013). However, viewing the people with mental disadvantages as possible perpetrators is likely to conflict with people’s concept of social justice, therefore, triggering an increase in the moral panic rates. Therefore, to facilitate the wellbeing of the citizens and at the same time make sure that the rights of the mentally disadvantaged should not be infringed, one must consider the connection between the development of criminal behaviors, the progress of mental disorders, and the role that the moral panic rates in the society have on people’s perception of people with mental issues as possible criminals.
Research Question
The study in question is aimed at checking whether the disclosure of information regarding people with mental issues as possible perpetrators should be viewed as admissible in contemporary society is the primary research question to be answered in the course of the analysis. The research question, therefore, can be put in the following manner:
Do people with mental health issues display the behavioral patterns that can be defined as the ones similar to those of perpetrators, and how does the issue of the moral panic factor in the process of vilifying the mentally impaired as possible criminals?
Significance
Although the study under analysis cannot be viewed as the ultimate tool for proving either innocence or potential danger of people with mental issues, it will still shed some light on the subject matter. Thus, the research can be viewed as an attempt to prompt a change in the current concept of social justice. By pointing to the connection between mental issues and criminal behavior – or the lack thereof – the research will set the foundation for a change.
Literature Review
People with Mental Health Issues as Perpetrators
Society has always displayed the tendency of viewing people with mental issues as a source of consistent threat (Gold & Simon, 2015). While admittedly inspired by prejudice and not necessarily applicable to any instance of a mental disorder, the connection between the inclination to criminal behavior and the development of a mental disorder has been explored and stated as evident by a variety of researchers (Large, Ryan, Callaghan, Paton, & Singh, 2013). The reasons for the above attitudes are quite understandable. Since mentally challenged people are prone to facing fewer legal repercussions and having less responsibility for their actions due to their health issues, they can be viewed as possible perpetrators. Moreover, the very fact that the above members of the American society do not fully realize the consequences of their actions makes one doubt whether they are capable of restricting themselves to the socially admissible behavioral patterns and abstaining from developing criminal ones.
Moral Panic vs. the Actual Danger
One must admit, though, that the phenomenon of moral panic plays a huge role in vilifying people with mental disorders (Paterson, McIntosh, Wilkinson, McComish, & Smith, 2012). Moral panic is typically defined as the situation, in which “a condition, episode, person or group of persons emerges to become defined as a threat to societal values and interest” (Falkof, 2015, p. 47). Therefore, it can be assumed that moral panic, when reinforced with the help of a specific source, such as media, may affect the concept of social justice. In other words, moral panic regarding the possible threat that mentally challenged people supposedly pose to society may shape the current concept of social justice. As a result, people with mental issues may become easily vilified, and their intentions can be interpreted as socially unacceptable.
Researches point to the fact that moral panic has a very powerful effect on people’s perception of social justice: “Social action, social justice, and critical issue arguments appear to have benefitted most from the trickle-down” (Gehrke & Keith, 2014, p. 87), as the analysis of a similarly controversial issue of media violence has shown. On the one hand, the concept of moral panic has little to do with the problem regarding the treatment of mentally incapacitated people as potential criminals. On the other hand, the ethical implications of the above decision are very likely to have a tangible effect on the moral fabric of society. By assuming that mentally unstable people and people with mental health issues pose a serious threat to society as possible criminals, one may create an impression of holding prejudices against the specified denizens of the population (Hartley-McAndrew & Crawford, 2016). The above assumption conflicts with the principles of democracy that the current American society is built on. There is a threat that the given assumption will lead to the development of social moods that may restrict the freedoms of the specified members of the U.S. population. One might claim that the phenomenon under analysis cannot be deemed as entirely negative as it may serve as the means of preventing the actual crime from occurring.
Tools for Managing the Related Threats
While the means for addressing the issue above are not yet defined clearly, a range of strategies for managing the development of prejudice and averting the threat of victimization along with the one of an attack from a mentally unstable person, have been suggested.
First and most obvious, awareness must be raised so that the information regarding the subject matter could be made available to all those concerned. As a result, the effects of moral panic are going to be reduced significantly. Even though the link between the development of criminal behavior and the existence of specific mental health issues is yet to be tested, it is crucial that people should educate themselves about the issue. Consequently, a mass campaign aimed at raising awareness is often viewed as a possible tool.
Risk Rates and the Means of Addressing Them
Because of the ambiguity of the subject matter and the lack of clarity regarding the identification of potential malefactors among mentally unstable people, the risk rates cannot be defined with a significant amount of precision.
Methodology Themes
The research under analysis is liked closely to a variety of themes as far as its methods are concerned.
Theme 1
The innovativeness of the study can be viewed as the primary theme to be addressed when it comes to discussing the research. As ti has been stressed above, the study under analysis explores the areas that have not yet been addressed fully due to the obscurity of the subject matter and the potential ethical implications that it might trigger. Therefore, though addressed in several recent studies, the problem of mental health issues and the unwillingness of people to connect the subject matter to the increasing crime rates due to moral panic still needs further exploration.
Theme 2
Another theme that is closely linked to the methodology of the paper, the issue regarding the topicality of the study needs to be addressed. Although the problem of victimization of people with mental issues cannot be deemed as critical at present, several studies point to the fact that the subject matter needs further analysis (Kaszeta, 2014). On the one hand, the fear for personal safety, which people experience when considering the possibility for patients with mental issues to be prone to criminal behavior, is understandable. On the other hand, claiming that people with mental deficiencies are more likely to commit crimes means victimizing them and, thus, depriving them of their basic human rights.
Theme 3
In this respect the theory of criminal behavior needs to be addressed as one of the elements of methodology – or, to be more specific, the theoretical framework that the research analysis is going to be based on. At this point, the fact that the number of criminal behavior theories is rather vast needs to be brought up. As a rule, biological, sociological, and traditional criminal behavior theories are identified. As the names of the theories above suggest, the biological one tends to view criminal behavior as intrinsic due to a specific set of biological characteristics, whereas the sociological one attempts viewing the problem from the perspective of the social interactions. In other words, in contrast to the former, the latter suggests that people, in general, and mental patients, in particular, start committing crimes as a result of the influence that their social environment has on them. The traditional criminal behavior theory, in its turn, assumes that the criminal behavior should be viewed as the impact of a blend of the biological and social factors. (Adler, Mueller, & Laufer, 2012).
Theme 4
Another theme that can be linked to the methodology, the concept of a survey as the tool for data retrieval can be reviewed.
Methods
Seeing that the research to be carried out seeks the answer to the question regarding the relations that can be defined as qualitative, there is no tangible need to quantify the output. Thus, it will be reasonable to assume that a qualitative research design is the best choice for the paper. To answer the question above, therefore, one will have to consider qualitative relationships between the dependent (i.e., the perception of people with mental issues as possible criminals by the society) and the independent (i.e., the power of moral panic) variables.
The survey mentioned above will be used as the primary source for retrieving the data from the target population. 120 people will be selected to participate in the research and be provided with survey questions to respond to. The surveys will be distributed electronically; however, prior to retrieving responses from the participants, one will have to provide the latter with a consent form that they will have to fill in so that their answers could be used for the study. As far as the people under age are concerned, their parents or guardians will have to consider signing the consent form.
The survey results will be sampled with the help of the random sampling technique. The above approach will contribute to the promotion of objectivity in research as it will help locate the answers that are not connected to each other and, therefore, provide an unbiased representation of the situation. It is assumed that a random sampling of 20 responses will suffice for an all-embracive analysis.
The coding technique will be used to locate the necessary information. A taxonomy of codes that will help identify certain patterns in the responses of the participants will be developed. It is suggested that the codes such as “moral panic,” “criminal development,” “etiological factors,” etc. will have to be included into the taxonomy so that the information could be arranged in the most efficient manner and that correct conclusions could be made. The concept of etiological factors brought up above can be defined as the factor that served as the pivoting point of the problem development (Stevens, 2013). In other words, it has a direct relation to the subject matter as it helps gain a better insight on the issues regarding the development of criminal behavioral patterns in people with mental health impairments.
Identifying the codes that occur the most frequently in the responses of the surveys created, one is likely to receive enough data needed to either confirm or subvert the hypothesis concerning the issue in question. It is expected that the study will return the results that show the deplorable effects of moral panic in relation to health issues and criminology.
The further analysis, therefore, will be aimed at locating the frequency of the occurrence of particular codes. The latter, in their turn, will be interpreted so that the relationships between the key variables could be identified and that the research question could be answered. At present, it is expected that a significant rate of correlation between the attitude towards the issue of mental health and the increasingly high rates of moral panic will be identified. The link between the crimes committed and the number of people suffering from specific health issues, in its turn, is highly unlikely to be represented. The effects that the current moral stance on the treatment of people with mental impairments and the criminalization thereof, in its turn, is likely to be located comparatively fast.
Limitations
It should be noted, though, that the study under analysis has its limitations, the sample size being the key one. Since the research can be defined as time-bound, carrying out a vast analysis of the subject matter including a larger number of samples is impossible. Therefore, the outcomes of the study will have to be approximated.
In addition, there are high possibility rates for the outcomes of the study to be affected by the personal stance of the research on the subject matter. Even though the study under analysis does not use interviews and adopts the surveying technique instead, the chances for the results of the analysis to be affected by the personal convictions of the author of the paper are rather high. The rates of the research objectivity can be enhanced by adopting a rigid methodology technique.
Internal and External Validity
Validity is a highly important concept in research, especially in its experiment-based kind. The term ‘validity’ denotes the extent to which a given study is logical and lucid, as far as its factual and causal claims are concerned (Maxfield & Babbie, 2014, p. 127). When one evaluates the merits of a research study, they frequently discuss its internal and external validity: while both types are equally important, they do, nevertheless, frequently present a trade-off in experimental research.
Internal validity refers to the study’s own consistency, logic, and soundness. Thus, a researcher that produces an internally valid study ensures that the logic that they apply to the research subjects is consistent and clear. Typically, internal validity is maximized when the researcher has greater control over the experiment and can claim with greater certainty that the conclusions of their study are, in fact, reliable. For instance, a researcher claims that victimization is the leading predictor of future engagement in violent crime. If they can isolate other variables that may affect this link in their study sample – for instance, the socioeconomic status of the respondents – then they produce a more internally valid study.
However, the more control the researcher exercises over the study, the more it undermines its external validity as the experiment’s conditions become somewhat artificial. External validity refers to the extent to which the study’s findings are generalizable in respect to the general population, and not just to the study’s sample. A researcher attempting to maximize the study’s external validity will try to conduct an experiment in more natural conditions – however, the less control a researcher has over the study, the less internally valid its findings tend to be.
Conclusion
The connection between mental health and the development of behavioral patterns that can be defined as criminal needs further analysis as groundless assumptions made in the specified area may lead to the infringement of people’s rights. Indeed, the victimization of mentally impaired people is against the current principles of democracy as it jeopardizes the safety of the target denizens of the population. However, apart from affecting people with mental deficiencies, the specified issue also poses a significant concern to the wellbeing of the rest of the U.S. population. In case the supposition regarding the connection between the mental health of a person and their inclination toward a certain criminal behavior pattern is correct, the lack of action toward facilitating the safety of the rest of the U.S. citizens may lead to drastic results.
Therefore, a detailed analysis of the subject matter must be carried out. A study will attempt at answering the question regarding the connection between the concept of moral panic and the process of identifying people with mental issues as possible criminals. In other words, the study will focus on identifying how the phenomenon of moral panic shapes people’s perception of mental patients as possible criminals.
The significance of the problem is quite obvious. In the era that heralds democracy as the foundation for the development of social justice, the issue of victimization of mental patients must be addressed as the subject of concern. Moreover, the wellbeing of the people that are affected by the issue is questioned until the problem is resolved.
It is expected that the current stance on the issue of mental patients and their relation to the current crime rates will be reviewed from the perspective of the contemporary social justice. Te study will, therefore, shed some light on whether the phenomenon of moral panic prevents people from victimizing mentally impaired patients, whether the society judges the latter, or whether an objective viewpoint on the subject of the research is supported in the American society.
Reference List
Adler, F., Mueller, G. O. W., & Laufer, W. S. (2012). Criminal justice: An introduction. (6th ed.). Philadelphia, PA: University of Pennsylvania Press.
Gehrke, P. J., & Keith, W. M. (2014). A century of communication studies: The unfinished conversation. New York., NY: Routledge.
Gold, L. H., & Simon, R. I. (2015). Gun violence and mental illness. Opa-Locka, FL: American Psychiatric Publishing.
Falkof, N. (2015). Satanism and family murder in late Apartheid South Africa: Imagining the end of whiteness. New York, NY: Springer.
Hartley-McAndrew, M., & Crawford, D. (2016). A commentary on autism and moral development: What can we learn from the Sandy Hook School shooting? North American Journal of Medical Science, 6(3), 1–7.
Kaszeta, D. (2014). CBRN and hazmat incidents at major public events: Planning and response. New York, NY: John Wiley & Sons.
Large, M. M., Ryan, C. J., Callaghan, S., Paton, M. B., & Singh, S. P. (2013). Can violence risk assessment really assist in clinical decision-making? Australian & New Zealand Journal of Psychiatry, 48(3), 286-288.
Maxfield, M., & Babbie, E. (2014). Research methods for criminal justice and criminology (2nd ed.). Stamford, CT: Cengage Learning.
Meloy, R. J., & Hoffmann, J. (2013). International handbook of threat assessment. Boston, MA: OUP USA.
Paterson, B., McIntosh, I., Wilkinson, D., McComish, S., & Smith, I. (2012). Corrupted cultures in mental health inpatient settings. Is restraint reduction the answer? Journal of Psychiatric and Mental Health Nursing, 1(1), 1-16. Web.
Stevens, H. (2013). Crime and mental disorders. Aarhus C: Aarhus University.
Over the years, individuals and communities have considered three definitions of health. First, they perceive health as both subjective and objective concept and its extension beyond the physical realm. Secondly, the definition involves maintenance and improvement of health. The final definition considers the essence of health to human life. The purpose of this essay is to contrast the professional definition of health and illness. It justifies that these definitions are symptoms of spirituality. My definition of health therefore, is the spiritual well-being of an individual or a community whereas illness is the physical outcome or the manifestation of the spiritual poor being of the community or an individual
Definition of Health and Illness
While scholars have focused on the physical domain of health and illness, it is still a puzzle among the societies, which esteem the religious definition of health and illness. Although several studies have established the relationship between spirituality and health, scholars have not yet provided a conclusive definition of health and illness. Spirituality defines the inner soul and the inherent nature of the human beings. According to Hart (1988), the well-being of a community depends on the behavior of the individuals in that community (p.123). Adherence to the taboos of religion results into a healthy community.
Biblically, people should heed and adhere to the will of God if at all their health is to remain ill free. World Health Organization defines “health as the state of well-being in which the physical, social, and mental functioning of an individual or community is in its normal order” (Clare, 2002, p.39). According to specialists, absence of infirmity in the body of an individual is the absolute definition of health. When the individuals do not attain these conditions, professionals consider them ill.
Scholars argue that people’s spiritual judgment hinges on their deeds and therefore, they have to differentiate between the good and bad as defined by their religion. The choice between right and wrong is the ultimate determinant of the health of the community. If people’s choice is to do right for instance, then God blesses them and keeps them off the wrath. If the deeds are against the taboo of the religion, God imposes a divine punishment unto them. This punishment may be a form of sickness. The result of the punishment therefore is physical diseases, which professionals fight to combat. As per the Biblical context, illness is the state of lack of harmony between God and humankind. Biblically, whenever human beings infringed the will of God, the result would be physical, mental, or social illness.
As presented in the above discussion, harmony between God and human beings characterizes health. The physical nature of human beings depends on their spirituality. As per biblical context, human can preserve their spirituality if only they maintain good relationship with God. Jeremiah (30:17) states that “but I will restore you to health and heal your wounds” (Humphrey, 2002, p.260). Human beings are healthy only if they are in harmony with God. If however, the human spirituality is not well, as per the God’s will, then illness will haunt the community. Illness is the nature of spiritual transgression. Diseases, which professionals describe as illness, are the physical manifestation of the divine punishment to the human beings because of their violation of the religious taboos.
That is, moral and physical health is dependent on the spirituality and if the spirituality is not preserved, illness, which doctors and nurses diagnose based on the physical and moral symptoms occurs. The role of nurses is to provide care and love to the ill. Care and love are components of spirituality, which guide human kind in comprehension for the need of life. It is through their spiritual well-being that the nurses are able to provide the necessary care to the sick in the society. Indeed, “Spirituality is an important aspect in nursing practice” (Clare, 2006, p.145). The health of the society therefore depends on the spirituality of the nurses. Adoption of faith and religion in the nursing practice will consequently improve the health of the society since nurses will incorporate spirituality components, love, and care into the nursing practice.
The world views health as just the absence of diseases. This view is likely to affect the definition presented in this essay in varied aspects. It is imperative to acknowledge the significant attachment, which human beings have to the physical and moral nature of their environment. This connotes that the definition of health being the physical and moral well-being of the society will supersede the definition presented in this essay (Hart, 1988, p. 23). Again, the focus on the improvement of health is more physical-centered than spiritual since humans perceive spirituality as a complicated subject; in fact, some do not believe in it. In the light of these revelations, spirituality therefore is the basis of health of a community and in order to avoid illness, the society should focus on its spiritual preservation.
Conclusion
Separation of health from spirituality is impossible since faith is the guiding principle for care and love among nurses, their spiritual well-being is very significant for the health of the community. Indeed, it is the inherent component of the being of the human nature. Therefore, it is justifiable that health is the spiritual well-being of the society. If the spirituality is not well, physical and moral health of the community consequently deteriorates justifying the assertion that, illness is the spiritual poor being of the society; this definition underscores my definition of health and illness. A person’s worldview will affect this definition depending on one’s religious perspective.
References
Clare, W. (2006). Treading Lightly: Spirituality Issues in Mental Health Nursing. International Journal of Mental Health, 15, 144-152.
Hart, L. (1998). Biological basis of the behavior of sick animals. Neurosci: Biobehav, 12, 123-126.
Humphrey, N. (2002). Great Expectations: The Evolutionary Psychology of Faith- Healing and the Placebo Effect, in the Mind Made Flesh, 255-285. Oxford: Oxford University Press.
The mental health practice model serves as a guideline for individual and institution-based practice when offering recovery-oriented mental health care. It targets public institutional settings. Therefore, it incorporates public health support in most of its formulations, perspectives, and rationale. The model has two themes. First, it is recovery focused because all the efforts directed to consumers contribute to their recovery. It seeks to give the beneficiaries a sense of identity, role, and purpose for their lives so that mental illness no longer burdens them. The model will be focusing on the positive outcome that is available in every case of mental health. It seeks to restore hope and optimism for consumers who have a mental illness or an experience with the problem. Second, the model focuses on assertive care management. It relies on sufficient staffing, coordination, and responsibility for treatment that goes to the clients.
Mental Health Practice Model
This model is based on the work of mental health case managers in designing interventions for respective cases such that they accomplish the consumer’s goals and access resources from the public mental health service bodies and the community. It seeks to equip and guide organizations to handle every case presented within the model and be able to respond to any crisis. Recovery is a leading term in mental health policy and service, and it has different meanings. For this model, there is a difference between clinical recovery and personal recovery. The restoration of social functioning and the cessation of symptoms will be the definition used for clinical recovery (Rook, 2013). Meanwhile, personal recovery covers the anticipation and results perceived by the person. It includes personal growth, healing, and self-determination, all happening holistically. Overall, the model sees recovery as a philosophy being pursued. Therefore, it combines aspects of clinical and personal recovery (Adler & Castro, 2013).
The model should make the transition from a biomedical view of mental health to a holistic approach to seeing and practicing health interventions for mental illnesses. Practitioners and the entire practice should be able to build on individual strengths by following the model. Given that the model seeks to empower a person as they undergo the recovery process, it will also attempt to balance the risk that people take when they are on a recovery journey. The aim will be to balance positive risk-taking needs and safety.
Data Collection
Data collection for the model concentrated on a literature review of international literature focused on mental illness recovery interventions. The review looked at organizational practice and individual practice, to highlight systematic issues affecting mental health practices. It also sought to bring out people’s experiences of care, with adult care being a major category for review. In some cases, literature referred to general populations, including children and youth. The highlight is that people need a sense of personhood when they are journeying towards recovery. On the other hand, data collection will be done by teams in charge during the implementation of the model, and it will cover all aspects of client care for use in subsequent decision-making tasks.
Overall Framework for the Model
The framework for mental health practice provides nine domains of working. The domains are cognizant of findings from the literature about the organizational practice and individual practice. The domains are the promotion of a culture of hope, development of autonomy and self-determination, collaboration using partnerships or meaningful engagements, as well as focusing on strengths and holistic and personal care. Others are family, careers, supporting people and their significant others, community participation, and citizenship, responding to diversity and reflecting and learning (Reiss-Brennan, 2014).
There will be the following considerations and approaches used to ensure that the entire model and those using it are all oriented to the recovery philosophy throughout the domains supported by this model. There will be core principles that will guide the practice. They will also determine the decisions and interactions that people have in the course of providing care in a particular area of health. There will also be the use of essential capabilities to ensure the principles are working. The capabilities include behaviors, attitudes, skills, and knowledge, which will rely on literature findings and best practices in health. Good practice examples will form the core of the approaches, where examples are chosen will exemplify the setting selected to provide mental health recovery. Lastly, good leadership arguments and examples will be taken to service leaders and managers such that they can describe and direct governance structures to realize the correct orientation of a recovery organization.
Mental health professionals will use optimistic language and support colleagues and families to celebrate recovery. They will research and understand environmental variables and then work towards supporting people’s recovery efforts. All messages and documentation will use the recovery-oriented language. Besides, practitioners will require knowledge of updated recovery outcomes. The organization will recognize the shared responsibility of workers and clients so that the resulting environment is secure for everyone. It will also get feedback from the clients and their significant others as a way of improving service delivery. Local policies will be used to ensure that the procedures taken as part of mental health services are embracing autonomy, self-determination, and choice.
Teams will be working with people in the context of their cultural identity and values to understand people’s triggers and incidences of not being well. The results will support interventions that work towards recovery for unique cases. All personnel will rely on inquisitive and active listening skills in communicating with patients and their families. They will also personalize cases and be supportive and positive with users of aspects of their lives to create friendly and professional relationships. Also, they will incorporate their professional skills to ensure that clients get appropriate choices and personalized support.
The management of a health institution implementing the model will be tasked with the authorization and support for the employees to prioritize space and time that is needed for proper joint practice. The attitude required of health professionals will be that of recognizing and valuing people’s resilience and strength. As a team, professionals will work on fostering willingness within their organization to try new things. They will also support people who are trying new things. Depending on their capabilities, they can make room for other staff members to practice their skills and benefit the organization and then encourage peer support (Reiss-Brennan, 2014).
All personnel tasked with caregiving will routinely ask about clients’ wishes and support needs. They will review goals, values, and interests, and then use the information as the basis of care personalization. They will network and build collaborative programs with health service providers working in non-mental capacities to ensure a holistic approach to mental health recovery for clients. Besides, they will seek information concerning services that a customer has had before being referred to them for a particular service. Professionals will be encouraged to make home visiting and conduct environmental assessments as a way of improving outcomes. They will actively find flexibility in responding to client needs or availability. The management will encourage regular case conferences to sustain a culture of improvement and support clients’ access to a broad spectrum of services.
Social Marketing and Working in Teams
The application of commercial marketing principles in healthcare allows health care professionals to make effective health interventions at the community level. Here, techniques that work in the commercial sector are applied in the health care setting as methods of promoting behavior change socially in cases like smoking and sexual behavior. For this model, the behaviors of focus are self-determination, eating disorders, hyperactivity, and attention deficit among others. The model will bring out health communication strategies that have been successful in other health interventions. They include the use of mediated, interpersonal, and other forms of communication. There will also be the use of marketing approaches to communication, like the placement of messages in health premises such as clinics. Public awareness campaigns that promote and disseminate information at a community level outreach program will also be handy (Evans, 2006).
However, there is recognition of the increase in the number of health challenges relating to mental health that can affect the effectiveness of the respective delivery channels. Therefore, the model will combine social marketing elements and teaming strategies. The idea is to promote a holistic approach that has relevant resources to respond to any emerging challenges of message and intervention delivery. Teaming is a traditional social work practice that has worked well with mental health programs. Different perspectives of individuals who have diverse educational, professional, and personal life experiences integrate when practicing as a team. Therefore, a barrier emerges and protects against personal bias. Instead, informed decision-making and learning based on working solutions or non-working ones that need improvement prevail.
The aim will be to have everyone working toward the same goal through teamwork and social marketing strategies. Team members need to respect their mutual interests. They must understand and recognize the value of all team members. Team membership will rely on individual cases. Members will work together to determine the purpose of their mental health intervention and agreed on the decision-making pathway, the client’s strengths and needs, and action required to facilitate recovery on a given timeline. The mental health practice team will be central to this model.
Teams will be built according to localized needs and resources for a particular organization. They will include professionals, caregivers, community stakeholders, and clients. The communication approaches and working strategies that teams use must follow all health regulations currently in place (Reiss-Brennan, 2014). They must also be respectful of organizational rules. There will be a distinction between the people making up the team and the meetings that they hold to facilitate communication and coordination of their work. The nature of meetings will depend on case urgency and the need for intervention. On the other hand, membership in teams will be dynamic and flexible, reflecting changes in client needs during the recovery process, as well as the availability of resources like funding, policy guidelines, and level of demand for mental health services in the organization (Akland, 2012).
The belief of teamwork and social marketing approach emanates from the fact that consumers need adequate involvement in their care. Working collaboratively with consumers and their caregivers, as well as family members provides a community approach that is necessary for sustaining a recovery-oriented program that this model advocates. Besides, the model also follows the value of population-based planning and service delivery, which implies that practitioners and organization management will work towards providing services as close as possible to the clients.
On social marketing, the model will follow six basic stages of social marketing best practices. It will work on developing plans and strategies using behavior theory. It will then select communication channels and materials following a particular behavior change that is required, as well as knowledge of the target community. The third stage is to develop and pretest materials for use. The fourth stage is to use qualitative methods for the intervention. The communication program/campaign goes live at the fifth stage, and the last phase is about the assessment of its effectiveness in terms of the exposure and awareness created. In the evaluation phase, the focus is also on reactions to messages used in the campaign and any behavioral outcomes, such as signups to specified clinics by individuals seeking diagnosis and treatment of mental health problems. The social marketing intervention will be a loop, where the assessment feeds into the planning and strategizing stage to being the process (Thornicroft & Tansella, 2013).
Importantly, audiences will be segmented based on their perceived familiarity with elements of mental health practice and vulnerability to mental illness programs. There will be the use of commercial marketing targeting family members and caregivers, subject to funding by state health departments, national health department or other partners. The preferred behavior outcome for the approach will be to have the target audience show up for membership recruitment as part of mental health practice teams for their communities. The intention will be to grow the holistic approach to recovery.
There will be a heavy influence of persuasion theory in implementing the social marketing strategy. The theory mentions that people need engagement for them to be persuaded fully. They have to think favorably about the message, which takes time and continued exposure. In this regard, the stages of marketing described above will be instrumental in delivering the right information for determining the preferred intensity and length of the various campaigns run as part of this model.
The aim will be to change public attitudes on mental health and the behavior of people towards those having mental health issues. Another aim will be to maintain behavior gains made at the community level towards mental health. The social marketing approach will involve mental health practice teams as described previously. It will have three levels of implementation. There will be national engagement relying on mainstream media, and then community involvement relying on local events and the main influencers. Lastly, it will include individual action and empowerment interventions that focus on personal initiatives of mental health team members. The messages delivered in all campaign levels will be similar to increase their persuasion capacity. Health organizations will be tasked with the development of free tools and materials for sensitizing their clients and workers, while other institutions will be assisted by the mental health team at the community level to develop sufficient approaches for message delivery.
Funding Considerations and Sources
Funding for the model will come from the federal budget. Public institutions using the model will be able to qualify for funding based on their ability to meet the mental health needs of their clients. They will be able to demonstrate that the model assists them to expand mental health services for adults, children, and the youth. The model seeks to constitute a community level awareness of mental health problems and support collaborative approaches to care. Therefore, it allows for modification to fit into the current programs that a health institution could be implementing for psychiatric care clients. The model will be a working guideline for community-driven processes that identify the unmet mental health needs.
Besides reliance on federal funding, institutions and state departments of health will provide annual or multiple-year plans based on this model to seek funding from appropriate state funding agencies. Disclosure of financing will also allow gaps to be filled with other vehicles of financing, such as research grants that members of a mental health practice team may qualify for. Organizations are also capable of transferring their revenues and other financing allocations to the interventions under the model when they fit with their overall mandate. Such cases will include caregiving organizations for the elderly that have to deal with mental health problems as part of their mandate of providing care. The organizations already receive public funding at state and national levels; thus, they will only be carrying out their mandate as part of their adoption of this mental health practice model
Another source of funding will be the respective programs on the improvement of health that target different communities. For example, health intervention programs in schools can introduce aspects of this model in their intervention and allow funds allocated for general health improvement to be channeled to specific mental health interventions (Rossen & Cowan, 2014).
Another funding option will be community-based funding in recognition of the fact that states are actively moving away from centralized financing in running state-operated facilities. Instead, they are actively devolving health units and funding to the community level. One aim of the approach is to make it responsive to emerging medical needs and promote efficient resource allocation. A paper by Seiber, Sweeney, Patridge, Dembe, and Jones (2012) showed that an appropriate state funding formulae consider funding factors used by other states, legislative requirements for the given state, the available data, and local variation factors for the funding formula. In this regard, financing of this model will be affected by staffing and health care access policies that a particular state’s legislation has. Individual and corporate participants in the program will have to abide by the existing frameworks of public health delivery to qualify for government funding through state and federal support under various programs, such as direct hospital allocations, research grants, Medicaid, and staff salaries.
The model also includes volunteers who will only need facilitation for their services. They include community health workers, family members, and other stakeholders in communities (Balan & Pauna, 2014). They will be able to use their influence, community roles, and other privileges to access resources, such as transportation and accommodation in the course of fulfilling social marketing and other direct forms of mental health practice interventions.
Decision Support
The decision support for the model focuses on mental health promotion, primary care and access to services, adequate services for people having a severe mental illness, caring about caregivers, and preventing suicides. This model recognizes that mental health services need a comprehensive knowledge base. Therefore, a critical component will be the development of an information system that allows teams to deploy resources well and make fast and efficient decisions (Ganga, Kutty, & Thomas, 2014).
The key to decision support aims in the model is having appropriate strategies for recruiting qualified and experienced staff for respective organizations’ departments of mental health. It includes the development of a workforce that has the community’s interest at heart. The workforce must include psychiatrists, mental health nurses, clinical psychologists, and therapists. Getting the right numbers of professionals will be an important factor in supporting the effective functioning of teams and efficient decision making. The model advocates for inter-agency workshop plans to assist in ensuring that the employees are not undergoing significant stress in their jobs.
The inter-agency workshop plans will allow different institutions and community groups to work together to facilitate the skill mix. As a result, it will be possible to tackle current and future shortages of resources, especially staffing resources. The collaboration will be among mental health service departments and can have links with criminal justice agencies (Evans, 2014).
Another important element to support decisions will be the creation of a workforce representing the communities served. The service delivered must be culturally competent. Besides, members of the mental health practice team, especially the trained specialists, will have equal opportunities.
The activities covered in the model will include workforce planning to ascertain staffing positions for mental health nursing, psychiatry experts, clinical psychology, social work, care, and support staff, as well as professionals allied to medicine to pave way for collaborative work. Also, the model will rely on a national leadership program that combines the needs of mental health service leaders and general management programs. The leadership program will encourage the advancement of individual staff careers into specialties and associated management positions.
The model will use current sources of information supported by various states’ departments of health, as well as the federal department of health. The common sources of information will include reports on health needs assessments on respective communities, clinical guidelines, and clinical audits performed as part of ensuring public health service units offer excellent services. Individual nursing community organizations that act as knowledge repositories for nurses and other medical practitioners, such as the American Nursing Association will also be included (Cleary, Deacon, & Hunt, 2011).
Decision making will consider evidence-based practice when practicing the model. They will focus on interventions that are best practices and whose outcomes are proven as successful through the available evidence. Also, the model advocates for early intervention to reduce the decision-making burden and increase resource utilization for dealing with mental health problems in a community (Chapleau, Seroczynski, Meyers, Lamb, & Buchino, 2012). In this regard, the establishment of a skilled and supported multidisciplinary workforce is necessary. Moreover, the staffing considerations highlighted above will be critical in ensuring that adequate capacity for making decisions is realized to translate to efficient service delivery.
References
Adler, A. B., & Castro, C. A. (2013). An occupational mental health model for the military. Military Behavioral Health, 1(1), 41 – 45. Web.
Akland, G. (2012). Community engagement: A model mental health partnership. Journal of Community Engagement and Scholarship, 4(1), 71-71.
Balan, M., & Pauna, C. B. (2014). Models of mental health care financing in Europe. Annals- Economy Series, 3, 23-27.
Chapleau, A., Seroczynski, A. D., Meyers, S., Lamb, K., & Buchino, S. (2012). The effectiveness of a consultation model in community mental health. Occupational Therapy in Mental Health, 28(4), 379-395. Web.
Cleary, M., Deacon, M., & Hunt, G. E. (2011). Mental health nursing role models: What is valued? Journal of Psychosocial Nursing and Mental Health Services, 49(8), 6-7.
Intellectually upright human beings are able to think rationally and seek solutions to their life problems; however there are times that people suffer from incapability from making sound and rational decisions because of their state of mind. Mental illness or mental disorder is a combination of behavioral, affective, cognitive and perceptual components that hinder an individual from making sound decision.
According to Diagnostic and Statistical Manual of Mental Disorders (DSM), there are approximately 400 mental disorders in the world; however there have been disagreements among mental health care workers /professional on the line between mental illness and neurological disorders.
According to human rights and fundamental freedom chapter of the United States, people suffering from mental illness or disorder are considered not competent to make valid contracts.
In some instances, the people cannot be held accountable of their criminal and civil misconducts; the challenge facing the criminal justice administration is to determine which conditions should be held accountable of criminal and civil misconducts and what extent (Macks & Reeve, 2007). This paper discusses effective methods of mental health administration in the United States.
Mental health administration
The United States had been suffering from an increasing number of mental illnesses; the conditions were medical and some had resulted from some “social activities” like substance abuse. With the increased number of cases, the government opted to have a policy that would see the proper administration of the condition; this lead to the formation of the Substance Abuse and Mental Health Services Administration (SAMHSA) in 1992.
SAMHSA was established with the aim of looking for ways, using already concluded research on the topic, to improve the Americans mental health as a matter of clinical concerns and criminal justice systems. With the organisation, the government seeks to address issues and factors that results to mental health challenges from medical and drug and substance angle.
The mission of the organisation is to reduce the impact, and the spread of mental health illness among the Americans. When addressing the issue of mental health, it is crucial to understand that the condition may result as a medical issue and in some instances as social factor and in some instances drug abuse.
To reduce the spread, the most important element is to address the issues from their root causes and not address the symptoms without looking into the underlying parameters.
Despite the spread of mental illness in the American economy, hope is that prevention is possible (prevention works), effective treatment on those conditions that can be rectified exists and people can fully recover from the illness and live normal life.
The approach undertaken by the mental illness campaigners aims at looking at the matter from psychological and mental angle; the psychological angle handles matters of social standing while medical angle is concerned with the medical part of the deal. From a medical angle mental health is seen as a disease like any other that can be cured using appropriate medication and therapy.
The angle of mental health in medical terms sees mental ill people have their mind status not stable; they act in a strange way and have strange thoughts. From a social and behavioural angle, people with the conditions are not sick but have conditions that hamper normal operation of the mind thus they act in a strange manner.
According to this point of view, mental illness may result right from the birth and include some psychological development disorders that make people have difficulty in dealing with other people or living a normal life.
The definition of mental health from behavioural point of view includes those conditions that might have resulted from drug and substance abuse.
According to National Alliance for the mentally Ill (NAMI), atlatl 23% of American suffer from mental illness in any given year; the report coincides with the President’s New Freedom Commission on Mental Health remarks of the most common medical conditions in the United States which are depression, body dimorphic disorder, bipolar disorder, schizophrenia, and obsessive-compulsive disorder.
Cause of mental illness
the cause of mental illness is complex and cannot be fully be attributed to the same factors; this is so for the fact that the illness varies among people; despite the challenge of defining the real cause, the causes can be attributed to either biological, psychological, and environmental factors.
Biological factors
from a biological point of view, mental illness is caused by some abnormal balance of special chemicals in the brain called neurotransmitters; normal human being have a balance that controls their thinking and makes life worth living. According to medical practitioners neurotransmitters are the organs that assist brain nerve cells to communicate effectively and come up with the right decision.
In the event that the nerve cells are not communicating effectively, the result will be chemical imbalance in the brains resulting to an abnormal behaviour; these are some of the early symptoms of mental illness. In unfortunate cases, when an individual head or brain is injured, it can lead to the imbalance of the brain nerves resulting to mental illness.
Mental illness is one condition that has been known to be hereditably; this means that in some families the condition runs in their genetics. The genetic mental health condition is challenging to manage as it may mean that those people who come from families with a history of mental health have higher chance of developing the condition.
Susceptibility is passed on in families through genes thus those people who are born in a family with such genes are likely to have the genes in them but can be triggered by stress, drug abuse or traumatic event happening.
Certain infections can result to mental illness; they may result to the actual occurrence of the condition or can worsen the situation or symptoms. One of the most talked condition that result to the mental challenge is paediatric autoimmune neuropsychiatric disorder (PANDA) (a condition caused by Streptococcus bacteria) which results to numerous mental disorders among children.
There are some physical brain defects or injury that can result to mental illness; the situation happens when an individual suffers a damage that will affect the operations of brain nerves that their communication is hampered. Accidents are the main causes of such physical damages.
There is evidence that some prenatal damages can result to mental illness in a human life; some of the in eventualities that emerge include loss of oxygen in the brain at birth or mishandling of an infant.
Drugs and substance abuse is another factor that leads to mental illness, when someone has taken drugs, they affect the operations of the brains. Drugs hamper the right thinking of an individual creating some symptoms of mental illness. When someone has taken drugs they can hardly think upright, their thoughts and the way they take issues is affected by the drugs they have taken.
Long-term substance abuse, of substance like bang, cigarettes, alcohol, is associated to anxiety, depression, and paranoia; such conditions hampers the operations of the brain and hampers the brain nerves operations.
On the extreme there are other factors that can result to mental illness; they include poor nutrition, exposure to toxics such as lead or mercury, Adrenal Gland Fatigue, Inflammation in the Body, Hyperventilation, and Gut Brain Connection.
Psychological factors
There are a number of psychological factors that results to mental illness; the conditions may happen at early ages in one’s life or may result at old age. Mental capacity is developed from biological and social factors; in the event that a child underwent severe psychological trauma like emotional mishandling, physical mishandling, or sexual abuse; then the development of the child’s brain is likely to be hampered.
When a child has undergone the above development challenges, they are not able to make sound decision on their own and have the believe that life is unfair, such believes results to imbalances of the operations of brains nerve system resulting to them making some decisions that are weird.
During early life ages, if a child undergoes through a traumatic event for example the loss of a parent, brother, sister, or a friend that he or she highly regarded and valued, the child is more likely to be challenged in the future. the facts of the case results from having children who feel not worth the kind of life they are living and the misfortune is the challenged brain nerve operations.
In the event that a child suffers neglect and has poor socialization with others, the child is likely to have challenges of brain development.
Environmental factors
The environment that someone lives in has an effect on their mental development; there are certain sensors that can trigger an illness in a person resulting to their brain failing to operate maximally.
When such sensors occur, such a person has the challenge of making sound and upright decisions. some of the factors that act as sensors include death or divorce, living in extreme poverty, changing of lifestyles (this happens more when someone moves from a high living standard to low standard), some stereotypes and social cultural expectations (this happens mostly with women when the society holds some expectations that they cannot reach for example being slim associated with beauty).
In the event that someone has Substance abuse by the person or the person’s parents which might have an effect on brain development and the way they perceive issues.
Brain nerves are sensitive and need to be managed effectively to have stable and well thinking mind; in the event there is a misfortune or an occurrence that have resulted to hampered brain development, then the end result is a person who cannot think right and straight.
Other factors that can result to mental illness include excessive stress response and poor interaction of a person with others.
Prevention of mental illness
Mental illness can cut across age, gender, race, or income, it is thus of importance for medical practitioners and other social workers to devise mechanisms that facilitates prevention of mental illness.
Depending with the cause of the mental illness so does the method of prevention; in the case of medical mental illness, the patients and the medical practitioners have the role of coming up with the best medication that can address a particular patients condition.
To protect the spread among children, parents should be handled and issues around giving birth looked upon; prenatal and infancy home visits or support groups are of importance, there should be enough support from the medical practitioners. Parents should be trained on how to handle their children to prevent any in eventuality that might result to poor brain development.
In post natal and pre-natal clinics, parents should be taught on how to handle their children and protect their brains from external damage. When such measures have been implemented, mental complications resulting from mishandling of children will greatly be reduced.
drug and substance abuse is another area that governments, nongovernmental, and civil societies should address; drugs and substance abuse have an effect on the development of the brain thus when prevented, they will lead to reduced mental illness cases. To reduce drug abuse, the focus will be on cessation education and counselling for drug and substance users including those people who smoke especially when pregnant.
In modern medical environments, there have been fewer advocacies on the need to periodically test for mental fitness; medical practitioners should have targeted short-term mental health therapy that will assist people know their mental status and in the event that some immediate medication or therapy can be done, it is dome with immediate effect.
In contemporary lifestyles, there is need for change in how people live and the kind of lifestyle they adopt; with this notion, governments should enact self-care education for adults; such programs should advocate for exercise, proper nutrition, stress management, relationships and finances management in the society.
Such factors address the social standing of an individual in the wave to manage their social environments. It has been noted that stress and depression is one of the major cause of mental illness among adults; with the revelation, government and should join efforts with individuals to have programs of stress and depression management.
Mentoring and coaching programs for young children is another form that has emerged in recent times; with the style as a child develops, they are allowed to have someone whom they can share the issues facing them. With such a society there will be no accumulation of matters that can hamper the development of the brain or one that can result to poor decision making among children.
When early mental illnesses causes have been addressed by the coaches and mentors, the net effect is a society that has no stressed up people. Still among children, there should be a variety of adult-supervised after-school and weekend activities; with the supervision, parents will be able to learn of issues likely to affect an individual and put such measures that can prevent mental illness (Matson, Wilkins & Fodstad, 2010).
Human rights of people with mental disorders
Mentally challenged people face a number of discrimination; there are times that they find their rights and fundamental freedoms being ignored. They are often ostracized from society and fail to receive the care they require; in some nations or towns they are left to suffer even lack of basic human wants like food and shelter.
according to fundamental human rights and freedom, mental illness save to violent medical case are human conditions which need the society to intervene and show these people love, respect them and guide their ways. With such interventions, the people are likely to become better and improve their decision making.
When symptoms likely to suggest that someone is suffering mentally have been spotted, it should be the role of the government to come up with measures that can assist in establishing and curing the person.
In some states, people with mental illness are discriminated from education, employment and housing, voting, marrying or having children; such moves are discriminatory and needs to be addressed effectively.
To respect mentally handicapped people life, it is important to change people’s attitudes and raise their awareness on the need to respect their rights. It is the role of government’s ministries, family groups and health professionals to address the matter with the urgency it deceives.
Human rights charter to some extent seems to ignore the obvious difference that prevails among intellectually upright people and those who are mentally ill. The charter needs to be reviewed to include such clauses that directly affect the life of mentally ill people.
In some events, it would be important to empower mental health service providers to offer services without fear or favor. policies that can lead to such moves include allocating those enough funds to handle the increasing cases (Steadman Barbera & Dennis, 1994).
Mental illness and criminal justice
one of the main challenge facing the criminal justice system administration is to determine at what extent should mentally challenged people be held accountable for their did. the challenge is even higher because some conditions should be treated the same way as normal case while others have no criminal liability whosoever.
Another challenge some with the event that someone develops the mental illness when already in custody; to address matters of criminal justice and mental illness, SAMHSA Center for Mental Health Services recommends of different measures to ensure that justice prevails and fundamental human rights and freedoms of mentally ill are respected.
Jail diversion is the most common method used by criminal justice administrators assisted by medical practitioners to determine the state on a detainee. the report from the medical department is used to when determining the case; the challenge comes with the timeliness of the action and the fact that the test will take effect after the occurrence of a crime.
There have been moves in the United States to develop community-based mental health dispositions for mentally ill detainees; however the success of the proposal is raging because of technical issues (Crozier & Tincani, 2007).
Conclusion
Mental illness refers to subjective distress in the level of cognitive or emotional well-being of an individual; the condition results from a complex of factors among them biological, psychological, and environmental.
Mentally ill people have been ostracized from many societies worsening their condition; in the United States, Substance Abuse and Mental Health Services Administration (SAMHSA) is mandated with the role of researching the best ways to prevent the spread of the condition.
It works alongside non-governmental organizations and civil movements to seek remedy to the challenging issue of integrating mentally ill people in to the society.
References
Crozier, S., & Tincani, M. (2007). Effects of social stories on prosocial behavior of preschool children with autism spectrum disorders. Journal of Autism & Developmental Disorders, 37(9), 1803-1814.
Macks, R. J., & Reeve, R. E. (2007). The Adjustment of Non-Disabled Siblings of Children with Autism. Journal of Autism & Developmental Disorders, 37(6), 1060-1067.
Matson, J., Wilkins, J., & Fodstad, J. (2010). Children with autism spectrum disorders: a comparison of those who regress vs. those who do not. Developmental Neurorehabilitation, 13(1), 37-45.
Steadman, H., Barbera, S, & Dennis, D. (1994). A national survey of jail diversion programs for mentally ill detainees. Hospital and Community Psychiatry, 45(1), 1109-1113.