RUNNING HEAD: Mental Health/Illness

MentalHealth/Illness
SW3710
JerlynBrightThigpen
WayneStateUniversity

RUNNING HEAD: Mental Health/Illness

Introduction
MentalhealthisasocialwelfareproblemthatIwillbediscussinginthispaper.
Mentalhealthissomethingthatsocietydoesnttakeseriously.Therearemanypeoplein
thissocietythathaveamentalhealthproblembutdonthaveaccesstoinsuranceto
receivetheproperhelpfromahealthcareprovider.Ibelievethatsomethingneedstobe
donesothattheycanreceivethehelptheyneed.Withouthelpfortheirmentalhealth
problems,theycouldpossiblycauseharmtothemselvesorsomeoneelse.Enteringthe
socialworkfield,Iwouldpresstheissueofhavingenoughinsurancecoveragetoprovide
theservicestheyneedtoovercometheirproblem.
DefinitionandDemographics
Mentalillnessisdefinedasatermthatreferscollectivelytoalldiagnosable
mentaldisorders(Services,1999).TheWorldHealthOrganization(2010)definesmental
healthasastateofwellbeinginwhichtheindividualrealizeshisorherownabilities,
cancopewiththenormalstressesoflife,canworkproductivelyandfruitfully,andisable
tomakeacontributiontohisorhercommunity(WHO,2010,para.2).The
demographicsofmentalhealthareanestimated13millionAmericanadults
(approximately1in17)haveaseriouslydebilitatingmentalillness(NIMH,nid,para.
1).Thisproblemkeepspeoplefromperformingtheirdailylifeactivities.The
demographicsformentalillnessareapproximately16.5%oftheadultpopulationin
SouthAfrica(WilliamsDR,Stein,&SG,2008).Thisincludesthegender,ageandrace.
HistoricalOverview

RUNNING HEAD: Mental Health/Illness

Mentalhealthhasbeenoverlookedthroughoutthecenturies.Frommyprior
knowledge,peoplewithmentalhealthproblemshavebeentreatedandlookedat
differently.Theyhavebeenisolatedandlookedatasanoutcastinsociety.Mentalhealth
problemsdatebackinthe5thcenturyB.C.(PBS,2002).TotheGreeks,Egyptians,
Indians,andRomans,itwasconsideredtobeareligiousorpersonalproblem(PBS,
2002).Inthemiddleages,peoplewithmentalillnesswereseenasbeingpossessedand
neededreligionbecausetheywereseentobepossessedwithdemonsinsideofthemand
religionpracticeswouldhelpalleviatethedemonsfromtheirsouls.
Aroundthe1800s,peoplewithmentalillnesswereputintohospitalsorasylums.
Thehospitalsandasylumsweredesignedtoalienatethementallyillfromsociety.The
conditionsoftheplaceswereinhumane.Frommypriorknowledge,theyweretreated
likeanimals,givenicebaths,putinrestraints,andhaddifferentexperimentspracticedon
them.AccordingtoSegal(2010),itwasstatedthat,DorotheaDixiscreditedwith
bringingnationalattentiontotheneedsandconcernsofpeoplewithmentalillness
(Segal,2013).Byherbringingthistypeofattentionforthispopulation,30statehospitals
wereestablishedbymid1800s(Segal,2013).Ibelievethatmentalhealthproblems
withinapersonarenowbeingidentifieddifferentlythanitwasbackinthe1800seraand
beforethen.Nowtherearemoreresourcesontheawarenessofthispopulation.The
resourcesforthementalillfrompriorknowledgearethesupportgroups,advocacy,
communityprogramsthatspecializesinthatpopulationandeducation.
InSouthAfrica,peoplewithmentalillness,weresimplycalledinsane,mad
orlunatic(Gillis,2012).Theirviewsonthementallyillwerethesameviewsthat

RUNNING HEAD: Mental Health/Illness

Americanshad.JustlikeinAmerica,theywerealsoisolatedandputintomentalhospitals
andasylums.
PoliciesandServices
ThefirstpolicyonmentalhealthwascalledtheNationalMentalHealthAct.This
actwaspassedin1946withtheinvolvementofthefederalgovernment(Segal,2013).
Thisactprovidedlimitedfundstostatestodevelopcommunitymentalhealthcenters.
Withthisact,theNationalInstituteofMentalHealthwascreated(Segal,2013).
Anotheractpassedin1955calledtheMentalHealthStudyAct.Accordingto
NIH,itcalledfor,anobjective,thorough,nationwideanalysisandreevaluationofthe
humanandeconomicproblemsofmentalhealth(n.d.).In1963,Congresspassed
anotheractcalledCommunityMentalHealthCentersActof1963(Segal,2013).With
thisact,legislatorshadprovidedfundingforbuildingthesecenterstoperformservices
forthementalhealthpopulation.
TheMentalHealthSystemActwasfoundedin1980.Thisactprovidedimproved
servicetopeoplewithmentalillness(NASW,MentalHealth,2012).Anotheract
designedtoaddressmentalhealthwastheOmnibusBudgetReconciliationActof1981.
Thisactrepealedthementalhealthservicesactandwithdrewthefederalgovernment
involvementinserviceprovisionbytheAlcohol,DrugAbuseandMentalHealth
administrationsconsolidationoffundingintosingleblockgrantstoeachstate(NASW,
MentalHealth,2012).AnotherimportantactwastheAmericanswithDisabilityAct.This
actwasfoundedin1990(NASW,MentalHealth,2012).Itprohibitsdiscrimination

RUNNING HEAD: Mental Health/Illness

againstpeoplewithdisabilitiesincludingmentalillnessinemployment,transportation,
publicaccommodation,communicationsandgovernmentalactivities(Americanwith
DisabilitiesAct,nid).MentalHealthInsuranceParityActtookalongtimetobepassed
byCongress.Itwaspassedin2008andcameintoeffectin2010(Segal,2013).Theact
providedequalcoverageforphysicalandmentalhealthservices.
Thefirstpolicywasdevelopedin1997(WorldHealthOrganization,2007).
Accordingto(WorldHealthOrganization,2007),thedocumentdidnotfollowthemore
recentlyadoptedpolicydevelopmentprotocolsandwasnotpublishedfordissemination.
Inotherwords,thepolicywasnotconsideredtoofficialduetonotfollowingtheproper
protocolforittoberecognizedinthecountry.Thedocumentincludeddeveloping
communitymentalhealthservices;downsizinglargementalhospitals;developinga
mentalhealthcomponentinprimaryhealthcare;humanresources,involvementofusers
andfamilies;advocacyandpromotion;humanrightsprotectionofusers;equityofaccess
tomentalhealthservicesacrossdifferentgroups;financing;qualityimprovement;anda
monitoringsystem(WorldHealthOrganization,2007).Alsostatedinthereport,2
provinces(FreeStateandNorthWest)havedevelopedtheirownprovincialmentalhealth
policies,usingtheMentalHealthCareAct(2002)asaguide(WorldHealth
Organization,2007).

Recipientsoftheservices/Impact
Peoplewhoreceivetheseservicesaretheoneswhohaveamentalillness/problem
thatisdiagnosedbyamedicalprofessional.Thepolicieshelpthembecausetheywere

RUNNING HEAD: Mental Health/Illness

abletogethelpthattheyneeded.Thepolicieshadabigimpactonthispopulation.
Withoutthesepoliciesbeingimplemented,peoplewouldstillhavetheirproblemsand
wouldntreceivethehelpthattheyneeded.Morepeopleinsocietywouldstillviewthem
asdangerstosocietyandoutcasts.
InSouthAfrica,theyhavefacilitiesthatprovideservicesforthementallyill
populationofthecountry.Thereare3,460outpatientmentalhealthfacilitiesavailable
(WorldHealthOrganization,2007).Accordingtothereport,1.4%ofthesefacilitiesare
madeforchildrenandadolescentsonly.Itwasstatedthatthesefacilities(outpatient)
treats1660usersper100,000generalpopulationsannually(WorldHealthOrganization,
2007).Itwasalsostatedthat,thereare80daytreatmentfacilitiesavailableinthe
country.TheSouthAfricaFederationformentalhealthprovidedthesedayfacilities.In
thedaytreatmentfacility,thepercentageofuserswas41%.Inthe41%,theuserswere
female(WorldHealthOrganization,2007).
Stigma
Therearemanystigmasthatcomealongwiththispopulation.Thishasbeen
happeningforaverylongtimeandtomeithasntchanged.AccordingtoServices
(1999),it(stigma)wasbeingmanifestedbybias,distrust,stereotyping,fear,
embarrassment,anger,and/oravoidance(Services,1999).Whenpeoplesawaperson
sufferingfromamentalillnesspopulation,theyjustlookedatthemwithdiscriminatory
looksandtreatedthemdifferently.Forexample,Iworkwiththispopulationnowand
whenwetakeourresidentsoutonanouting,peopleinthepublicstareatthemandmake

RUNNING HEAD: Mental Health/Illness

snidecommentsaboutthem.Anotherstigmaisfeelingdiscouragedinreceivinghelpbya
medicalprofessional(Services,1999).Anothersourceofstigmawastheseparationof
healthservicesbetweenthemainstreamandmentalhealthtreatmentsystem(Services,
1999).Thisaffectsthepolicybecauseitdoesntgohandinhandwithitduetothe
stigmasthatwerecreatedagainstthem,anditwonthelpthemgetthehelptheyneed.
ThestigmaofthementallyillinSouthAfricaisthesameinAmerica.According
toPauw,peoplelivingwithmentalillnesscanalsobeguiltyofstereotyping,prejudice
anddiscrimination,therebystigmatizingthemselves(Pauw,2011).ThetermthatPauw
usedwascalledselfstigma.Itwasstatedthatmanypeopledoesntreceivehelporget
treatmentbecauseofthestigmatheyhaveanddontwanttolookedatdifferently.(Pauw
&Botha,2011).
Discrimination
Discriminationagainstthispopulationisstillpervasive.Itisdonealmost
anywhereinmyopinion.Althoughtherearelawstopreventdiscriminationagainstthem
itstillhappens.Forexample,thereistheAmericanswithDisabilitiesActthatI
previouslydiscussedprotectsthemfrombeingdiscriminatedagainstinanyformifthey
wanttoworkorjusttobetreatedfairlylikeeveryoneelseinAmerica.
DiscriminationinSouthAfricaisprevalent.Peoplewhoarediagnosedwitha
mentalillnesshavethesametreatmentofthepopulationinAmerica.Theyaredegraded
asaperson.Shamecomeswithit.Forexample,peopledontwanttoadmittheirillness
becausetheyareashamedofit.Theydontreceivethesamegoodsandservicesasthe

RUNNING HEAD: Mental Health/Illness

personwhoisntmentallyill.Forexample,theycantgetagoodformofeducation,ajob
orservicesthatprovidedforthemsolely.Also,theyreceivepoorgeneralhealthcare
becausetheyarementallyillandcouldbefalsifyingtheirsymptomsthattheyarehaving.

ComparisonandContrast
Althoughthesetwocountriesdifferinsomanyways,whenitcomestomental
illness,therearesomesimilaritiesanddifferences.Somearepositiveandsomeare
negative.Onesimilaritywouldbethestigmaandthediscriminationthattheyposeonthe
mentallyill.Bothcountrieslookatpeoplewiththisillnesslikeanoutcast.Another
similaritywouldbethelackofparticipationfromthepersonwhentheyfoundoutthat
theyarementallyillandwontreceivehelpthembecausetheyfeelshamedandnot
normallikethenextperson.Anothersimilaritywouldbethatintheearlyeraaround
16001700s,theybothbelievedthatdemonicspiritspossessedthem.Onedifference
wouldbethatSouthAfricamentalhealthpolicywasntofficialbecauseitdidntfollow
theproperprotocol.AnotherdifferencewouldbeSouthAfricahavementalhospitalsthat
arestillupandrunning.
RelationstoSocialWorkValuesandEthics
Therearealotofrelationstothetreatmentofthisissue.Iwouldliketodiscuss
twoofthem,socialjusticeanddiscrimination.AccordingtoNASWcodeofethics
(2008),Socialworkerssocialchangeeffortsarefocusedprimarilyonissuesofpoverty,

RUNNING HEAD: Mental Health/Illness

unemployment,discrimination,andotherformsofsocialinjustice(NASW,2008,para.
3).Theycanhelpthetreatmentofthisissuebyreducingthenegativeviewsthatcomes
alongwithbeingapersonwithmentalhealthproblems/illness.Anotherethicwouldbe
discrimination.Socialworkersshouldnotpractice,condone,facilitate,orcollaborate
withanyformofdiscriminationonthebasisofrace,ethnicity,nationalorigin,color,sex,
sexualorientation,genderidentityorexpression,age,maritalstatus,politicalbelief,
religion,immigrationstatus,ormentalorphysicaldisability(NASW,2008,para.2).
Thisisrelatedtothisissuebecausewithworkingwiththispopulation,being
discriminatoryisntanoptionduetothefactthattheyarealreadyfacingthatissuefrom
others.Comingtoasocialworkerthatisbeingdiscriminatorywouldnthelpthematall.

RUNNING HEAD: Mental Health/Illness

10

References
Gillis,L.(2012).ThehistoricaldevelopmentofpsychiatryinSouthAfricasince1652.
SouthAfricanJournalOfPsychiatry,18(3),7882.doi:10.7196/sajp.355
NASW. (2012). Mental Health. Retrieved October 26, 2013, from Social
Workers:
http://www.socialworkers.org/pressroom/swMonth/2012/toolkit/standar
ds/Mental%20Health.PDF
NASW. (2008). NASW Code of Ethics (Guide to the Everyday
Professional Conduct of Social Workers. Washington, D.C.
NIH. (n.d.). National Institute of Mental Health-Organization-The NIH
Almanac. Retrieved October 26, 2013, from National Institute of
Health: http://www.nih.gov/about/almanac/organization/NIMH.htm
NIMH. (n.d.). NIMH Statistics. Retrieved October 26, 2013, from
National Institue of Mental Health:
http://www.nimh.nih.gov/statistics/index.shtml
Pauw, I., & Botha, U. (2011, October). The Stigma of Mental Illness.
Retrieved from Health 24: http://www.news24.com/heath24/MentalHealth/Living-with-mental-illness/The-stigma-of-mental-illness20120721
PBS. (2002). "Timeline: Treatments for Mental Illness". Retrieved
October 26, 2013, from PBS Online:
www.pbs.org/wgbh/amex/nash/timeline/index.html
Segal, E. (2013). Health care policy. In E. Segal, Social Welfare Policy
and Social Programs (3rd Edition ed., pp. 315-317). Belmont, CA:
Brooks/Cole.
Services, U. D. (1999). Introduction and Themes. In U. D. Services,
Mental Health: A Report of the Surgeon General (pp. 3-10). Rockville,
MD: U.S. Public Health Service.
USDOL. (n.d.). Americans with Disabilities Act. Retrieved October 26,
2013, from U.S. Department of Labor:
http://www.dol.gov/dol/topic/disability/ada.htm
WHO. (2010, September). Mental health: strengthening our response.
Retrieved October 26, 2013, from World Health Organization:
www.who.int/mediacentre/factsheets/fs220/en/

RUNNING HEAD: Mental Health/Illness

11

Williams DR, H., Stein, D., & SG, H. (2008). Twelve-month mental
disorders in South Africa: prevalence, service use and demographic
correlates in the population-based South African Stress and Health
Study. Psychol Med , 38 (2), 211-20.
World Health Organization. (2007). WHO-AIMS Report on Mental Health
system in South Africa. Cape Town: WHO Country for South Africa.