Mental Health Service Delivery and Philosophy in Australia: A Critical Analysis

Deinstitutionalization in Australia

Discuss about the Mental Health Service Delivery and Philosophy.

Australia has been known to spend a huge amount of money on an annual basis for supporting individuals with mental illness. Mental health services in the country are comprised of a diversified and complex network of service providers and care settings, with overlapping and mixed responsibilities for funding, expenditure and service delivery (Sodhi?Berry et al., 2014). It is highlighted in the recent past that the mental health service delivery and philosophy in Australia has witnessed a major change since pre-deinstitutionalisation and the advent of the Recovery Framework in the country. The present essay critically analyses the impact of this measure on the mental health of individuals of the country with mental illness as well as on the consumer experience. The essay has the focus on what mental health services were delivered before the deinstitutionalisation and the general idea of what the Recovery Framework is and how its implementation has been considered in Australia. The essay is supported by a rich pool of evidence from the relevant field.

Deinstitutionalisation is the process of replacement of long-stay psychiatric hospitals with provision for community mental health services that are less isolated in nature. The process of deinstitunalisation acts in two distinct ways; the first focuses on reforms brought about in the mental hospital’s processes for the reduction of reinforcement of hopelessness, helplessness and maladaptive behaviour, and the second focuses on the reduction of the population size of mental institutes through the release of patients and shortened stays. Australian mental health care sector has adopted this policy of deinstituionalisation in the last three decades, and the process still continues, however, at a slower rate (Rosen et al., 2014). Goldman (2014) has highlighted that a major argument for deinstitutionalisation is the financial expediency disagreement suggesting that community care can be more cost effective when compared to institutional care.

Recovery is a representation of a new paradigm in the arena of mental health services that has come up in the last two decades, bringing transformational changes in the process of care delivery. It derives from different disparate bodies of knowledge and research. Studies have shown that individuals with serious mental illness show clinical improvements with the passage of time. Approaches resting upon recovery method puts up a chance to apply a transformative conceptual framework for culture and services in the sector. What lies at the core of this culture is the insights and lived experiences of the individuals suffering from mental health issues. The Recovery concept is associated with individuals who describe their experiences and affirm own identity beyond the constrictions of the diagnosis made (Slade et al., 2014). The National Framework for recovery-oriented mental health services in Australia supports high quality recovery-oriented service practice and delivery that is consistent is nature on a national basis. The framework is responsible for describing the main capabilities and the practice domains required for the mental health workforce in order to operate as per the recovery approach of care. Guidance is also provided by the framework on tailoring recovery-oriented services for responding to the diversity of individuals suffering from mental health issues. The development has been emphasized by exclusive consultation, research and lived experience. The recovery concept has been incorporated on an initial basis in the National Mental Health Plan 2003-2008 within the theme of prevention and promotion of mental health illness. The recent National Mental Health Policy 2008 adopts an approach that undertakes a ‘whole of government’ feature (Piat & Sabetti, 2009).

The Recovery Framework

Consistent research has indicated the high rate of mental illness in the community and the impact on the lives of individuals suffering from mental illness as well as their family members and carers. The government has suitably identified the concern and focused on different policies for addressing the issues. Prior to the deinstitutionalisation and the Recovery Framework, mental health counsellors had been working mainly with individuals who struggled with challenges like developmental issues and marital conflict but were healthy. Individuals with mental illness were put in healthcare settings and were dealt at an institutional level. The deinstitutionalisation legislation brought a section of people into the society that exhibited major important symptoms of mental disturbances. This proved to be a challenge for the health system as well as the mental health counsellors (Cleary et al., 2014).

Mechanic et al., (2013) identify that deinstitutionalisation of the healthcare settings and decamping of certain mental health care services has a vital impact on the mental health system as well as the patients, counsellor and all the agencies. For patients who suffer from serous mental illness, it is a significant challenge to learn to live in a community setting and difficult to triumph over the challenge. Shen and Snowden (2014) argue that the advantages for deinstitutionalisation have been traced in the professional literature, that holds true for Australia too. The benefits can be attributed to the better quality of life outside the institutions and independence achieved by the clients, reduction in needs for psychotropic medication and increased adaptability to change and increased socialisation. Though the concept of deinstitutionalisation may seem to be beneficial in theory, in practice it may fail to be beneficial. It may not work out to be as good as planned. Individuals who are supposed to be benefited by the process of deinstitutionalisation may become homeless, victimised and isolated. Individuals released from the institutions may exhibit deteriorated conditions, and loss of lives may also become an issue.

Kliewer et al., (2009) has suggested that the community, in general, is afraid of the individuals who suffer from mental illness as they are thought to be dangerous. This certain notion often leads to victimisation, stigmatisation, rejection and harassment. Support for these individuals is, therefore, less, and they are found to be at an increased risk of self-harm. In place of getting absorbed in to the community, individuals with mental illness trade the isolation of healthcare settings for the isolation of home. It has been indicated by many studies that individuals with mental illness are victims of crime and violence at a much higher rate. Wexler (2013) in this regard states that an additional challenge due to deinstitutionalisation is the incarceration of the patients with mental illness. Studies exploring the connection between crime and homelessness and deinstitutionalisation have suggested a statistically noteworthy correlation between homelessness and deinstitutionalisation and a more significant relationship present between criminal activity and deinstitutionalisation. It can be concluded that deinstitutionalisation, though provides freedom, does not work to solve the issues for the prerequisite of mental health care services.

Impact on Mental Health Care System and Counselling Profession

The recovery approach adopted by Australia is beneficial for the community as it recognises the importance of lived experience and successfully provides a chance for exchange of skills, knowledge and expertise. The approach challenge traditional and customary notions and concepts by breaking down most of the conventional demarcation between health care professionals and patients. Within this paradigm, all individuals are respected for the strength and experience they had and showed dignity (McGorry et al., 2013).

At the end of the discussion, it can be concluded that deinstitutionalisation and provision for Recovery Framework in the country of Australia are having a profound impact upon the care services provided and the counselling profession. Though the development of deinstituionaliatin and incorporation of mental health care services into the Australian community is to be encouraged, the major challenges that it brings along cannot be neglected. Mental health care professionals are being forced to give an appropriate response to the change brought about in the health care sector, and they are striving to gain additional skills and competencies for addressing the new needs. All failures pertaining to deinstituionalisation are a result of errors in implement models of care and support. Mental health services are to be improved in future in Australia and aftercare components are to be given more attention.

References

Cleary, M., Jackson, D., & Hungerford, C. L. (2014). Mental health nursing in Australia: resilience as a means of sustaining the specialty. Issues in mental health nursing, 35(1), 33-40.

Goldman, H. H. (2014). Community psychiatry in the United States 50 years after the Community Mental Health Centers Act. Epidemiology and psychiatric sciences, 23(1), 1.

Kliewer, S. P., Melissa, M., & Trippany, R. L. (2009). Deinstitutionalization: Its Impact on Community Mental Health Centers and the Seriously Mentally Ill. Alabama Counseling Association Journal, 35(1), 40-45.

McGorry, P., Bates, T., & Birchwood, M. (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202(s54), s30-s35.

Mechanic, D., McAlpine, D. D., & Rochefort, D. A. (2013). Mental health and social policy: Beyond managed care. Pearson Higher Ed.

Piat, M., & Sabetti, J. (2009). The development of a recovery-oriented mental health system in Canada: What the experience of commonwealth countries tells us. Canadian Journal of Community Mental Health, 28(2), 17-33.

Rosen, A., O’Halloran, P., Mezzina, R., & Thompson, K. S. (2014). International trends in community-oriented mental health services. Community-Oriented Health Services: Practices Across Disciplines, 315.

Shen, G. C., & Snowden, L. R. (2014). Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform. International journal of mental health systems, 8(1), 47.

Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., ... & Whitley, R. (2014). Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.

Sodhi?Berry, N., Preen, D. B., Alan, J., Knuiman, M., & Morgan, V. A. (2014). Pre?sentence mental health service use by adult offenders in Western Australia: Baseline results from a longitudinal whole?population cohort study. Criminal Behaviour and Mental Health, 24(3), 204-221.

Wexler, D. B. (2013). Mental health law: Major issues (Vol. 4). Springer Science & Business Media.