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Compare and Contrast the service provision for children and adults where mental ill health is a

factor

Introduction

In the current age of technological revolution, the basic necessities of life for every individual constitute of
elements like mental, social and physical health along with primary facilities. With the passing time and
maturity in concepts of human development, it was realized that mental health is vital towards survival and
growth of humans in the context of societies and even nations (WHO 2005). Mental health has been
categorized as a state of mental content and wellbeing which results in life productivity and efficiency. In
the unfortunate turn of events in the last decade, even now mental health isn’t placed at the same level as
physical health across many countries (WHO 2014). On the contrary, mental disabilities and health services
have long been neglected. This paper aims to develop a sound basis for mental health recognition along
with providing a focus on service provision for children and adults having the attributes of mental health.
The awareness along with regulations and laws established by government to pave way for facilitation of
families and patients alike is the key intake of this study. It is high time that mental health and disabilities
be taken seriously with effective treatment and interventions, that need to be readily available for all
individuals. The paper highlights the growing existent gap between the probable actions that are necessary
in this paradigm and what is actually being implemented at the present. Governmental regulation,
international bodies, foundations and even the general community should play their part in dealing with
core issues of service provision in mental health sector. Coming towards the definition of mental health, it
can be regarded as emotional maturity of an individual which reinstates the absence of mental disorder with
development of psychological image that is acceptable to oneself. In other words, mental health refers to
balanced attributes of life between work, love and other activities (Rogers 2014). On the other hand, World
Health Organization (WHO) maintains that mental health isn’t all about absence of disorder but the
realization of all personal abilities and skills to productively move forward in life with a happy intuition
(Slade 2014). On the other hand, the definition of disability characterizes the condition of an individual
which reflects impairment comparative to set standards of the society. The term is used in various
backgrounds from physical impairment to mental illness and disability. Disability at its core is regarded
theoretically as a multidimensional framework for the person involved (Oliver 1995). It might have a drastic
effect on the body parts or towards their interaction with others. Subsequently, the international body has
attributed three dimensions to the term disability; functioning and structure of body parts, motion and
movement, and restrictive participation and interaction. It becomes evidently clear that mental illness
becomes a form of disability for some patients.

History of Mental Health and disability


History of mental illness goes back many centuries as evident from written scripts and record dating back
to even 400 B.C. where Greek scholars and writers began to define and discuss the mental illness attributes,
before that metal illness was usually considered as some form of demonic possession or a punishment from
gods. Moreover, hospitals and asylums for mentally challenged patients were first constructed and
developed by Muslims in 8th Century. In the modern world, mental illness has journeyed through the
segregation and institutionalization of mentally challenged people to moving them towards community.
Discussing the early history of mental disability, European courts granted freedom to mentally ill patients
from all sorts of punishments during Middle Ages. Moreover, in 1600s Europeans worked on isolation of
mentally challenged individuals which were often housed in prisons or dungeons separated from the rest of
population (Benzeval 2004). However, in 1700s some space and rights were ensured for people with
mentally ill conditions and a serious effort was made to rehabilitate them. In 1800s under the reforms
established by US government, 32 state hospitals were developed for the mentally instable individuals but
this didn’t improve the conditions instead it led to overcrowding and mismanagement at these hospitals. In
the 1880s, a German scientist initiated a medical study into mental illness and drafted two separated
dimensions; manic-depressive psychosis and schizophrenia. Coming towards 20th Century, National Mental
Health Association in United States was established which focused on delivery of services and facilities to
mental health patients in an appropriate and humanly manner (Nolan 2000). Preceding years followed a
more interactive and welcoming approach towards treatment of patients with National Mental Health Act
and development of National Institute of Mental Health resulted in medical treatments of mental conditions
which were previously catered through behavioral analysis only. Apart from other treatments, some
foundations such as National Alliance for the Mentally ill (NAMI) were formed which paved way for
research and finance allocation for the mentally challenged individuals. In the current times, psychiatric
medications have been comprehensively utilized in the field and very few people are now placed in mental
hospitals due to more advancement and awareness in the people. Lack of resources and service provision
in some areas continues to be a significant problem towards permanent solution of this framework.

Main Body

There are certainly different perspectives to detail the mental health attributes of patients. Doctors and
scholars alike consider that mental illness can result from a number of factors and its treatment should be
related with its origin. Though the nature and capability of a mental illnesses seems to be evident, its roots
and bodily implications are still widely argumentative in nature. Some scientists state brain impairment as
the possible cause of mental disabilities while other reflect on psychological, behavioral and social
possibilities behind mental disabilities. The treatment of the subjected illness depends on the possible root
causes and their subsequent restructuring towards the disease.
The Biomedical Model of Mental Disorder

The biomedical model assumes that mental illnesses and disabilities like depressive disorder, schizophrenia
or other diseases are biologically induced brain diseases and not entirely linked with psychological and
social aspects. The fundamental principles of biomedical model illustrate that mental abnormalities are the
resultant on biological factors with brain at its core and that there shouldn’t and actually isn’t any difference
between mental and physical aspects of diseases when it comes to their identification and treatment from
medicinal point of view (Andreasen 1985). Moreover, in case of mental disorder in any patient, biological
treatment of disease should be prioritized over mental reconditioning through other procedures. The
treatment undertaken for mental disorders revolves around construction of therapies that revolve around
targeting of biological dysfunction in brain. Medical model emphasizes on identification of specific
therapeutic agents which work on organs and their processes without harming the actual system (Moncrieff
2008). Psychiatrist George Engel (1977) illustrated the significance and working of medical model as the
one being based on molecular biology. It lays its foundations of working on the normal standards of human
body operations and any deviation from the standard working is considered as an accountable framework
for mental disability. Biomedical model not only demands mental diseases to be treated as independent
entities free of social behaviors and attributes but also describes that abnormal societal interactions of the
patient can be explained owing to disturbed biochemical processes in body. Although the modern
biomedical model supporters pay due attention towards behavioral analysis and treatments, the principle of
segregation adapted by Engel remains an appropriate approach in many parts of the world. The biomedical
model of disabilities minimizes the context of behavior and psychology towards disorders and actually
characterizes the eliminative position where the possibility of root causes is shortlisted and eliminated one
after the other to focus on only few or one attribute (Lilienfeld 2007). The same framework was established
by American Psychiatric Association (APA) where occurrence of mental disorder was related with
biological processes in brain. Currently, the world of mental illness and its treatment is dominated by
American health institutes and their research. Mental illness has been categorized as a form of disease by
National Institute of Drug Abuse and National Institute of Mental health along with other relevant bodies.
Most of the treatments undergoing mental disorder include chemical imbalance situation in the brain where
hormones play a significant role in identification and treatment.

The Social Model of Mental Disorder

In relation to the result of activist’s efforts in British Disability Movement of 1960s, the social model of
disability was recognized and established. The primary reasoning behind adaption of this model seem to be
the shortcomings of the medical model of disability. As per social model principles, mainly society is
responsible for the sufferings of impaired individuals and in essence it’s not the disabled individuals but
the society that needs special attention and fixation in their behaviors and attitudes (Beresford, 2002).
Individual rehabilitation of patients doesn’t carry any significance unless broader parameters of society
aren’t considered. The primary principles of social model of mental disability include the framework that
mental disorder is a socially enabled phenomenon which is originated and propagated by the society itself
(Kawachi 2001). The social model presents a different yet comprehensive definition of disability which
states that disability is a framework influenced by societal elements whose treatment requires behavioral
and social interventions on the part of society. The limitations imposed by the environment and society on
mentally challenged individuals further restricts their entire disease paradigm (Williams 1981). Social
activists and propagators of this particular framework have defined disability as disadvantage caused
through systematic social organization rather then medical or physical impairments. Social model scholars
state that the specific term ‘individuals with mental disability’ is integrated into the scheme of medical
model and thus disabled individuals better manifests the societal intrusion and stress faced by mentally
challenged people. Purtell (2013) relates and characterizes that people with mental disorder and disabilities
are actually ‘disabled’ by the society itself and the infrastructure of thoughts and attitudes developed in it.
Usually mental disability and illness is a reaction of the social methodologies adapted by general
population. The barriers to participation constructed and formulated around mentally challenged individuals
drafts as the key component of social model. The fundamental principle concerning the efforts of social
model revolves around the understanding and transformation of the term disability. Social policy and
regulations adapted at international and national levels have a crucial role with regards to social model.
While biomedical model concentrates around the treatment and identification of mental disorders from
medicinal point of view, the social model constructs around the behavioral treatment and practices that
cater the physical needs of the patients. The treatment of metal disorders in social theology revolves around
the concept of oppression elimination in society. Apart from psychological treatment of patients, his/her
environment, social circle and life in general also comes under the radar. In the last, social model scholars
argue that some form of disability might be related to medical reasons and the role of medical model can’t
be denied but the significance of social model must remain prioritized during the treatment of mental
disorders.

Mental Health Professionals

A mental health professional is a broad category of healthcare practitioners who utilize their skills and
knowledge to improve the mental health of individuals through its treatment and identification (Slade 2009).
Initially, this concept was initiated for community workers in 1970s who dedicated their time for assistances
in mental health revival of patients. Over the years, the field has widened to include professional attributes
of working class. From Clinical and School psychologist to social workers and professional counselors, the
whole working class revolves around identification and treatment of mental disorders. Some of these
workers such as psychologist and counselors can provide therapy but not medications while on the other
hand Psychiatrists can prescribe medications for the patients but can’t treat through therapy thus
establishing a clear demarcation between social and biomedical models of mental disability.

Mental Health Service Provision

Mental Health Services provision in many countries is dependent on the health infrastructure available for
general public because as per modern standards both the physical and mental health issues are identified
and treated on the same principles (Caplan 1970). Professionals working in the health sector associate their
patients and environment along the same spectrum while providing same attention to all form of diseases.
Overall the system designed by Mental Health Association in affiliation with governments has recognized
many of the shortfalls available in the previous institutionalized service provision. The service provision
structure works on the basis of categorization from the national level. Each geographical sector in the
country has a dedicated mental health team with support of inpatient wards. Though the mental health wards
are integrated into the structure of general hospitals in each area, there line of work and management is
completely different from rest of the hospital. Mental health service is an independent entity established
within each general hospital of the country. Moreover, each area in the UK has the presence of community
mental health teams that has the responsibility for community and out patient management of individuals
with mental disorders. The subjected team works from community health sector that comes under the
domain of closest general hospital. Usually the team comprises of a nurse leader and other health
professionals. In addition to above mentioned tiers, a supplementary yet crucial part of the mental health
system is assertive outreach and crises resolution teams. Assertive outreach teams with various
professionals, work on the grassroot level to engage patients with mental abilities and crises resolution
teams works in mental health sectors. Both the teams adapt a different model of service provision where
they remain in touch with patients throughout their treatment period. Towards the last, government has
ensured the presence of mental health day centers where all individuals can walk in get facilitated with
regards to mental health. All these services provision centers specially developed and constructed for the
treatment and identification of mental disorders cater the needs of all population including adults and
children of all ages.

Mental Health Legislations

In United Kingdom, there are various legislations that support and provide policy measures for the mental
health patients. The two primary pieces of acts that administer the mental care treatment and environment
in the country are; Mental Health Act of 1983 which was updated in 2007 and the Mental Capacity Act
drafted and implemented in 2005. The Mental Health Act (MHA) relates to the conditions and parameters
surrounding the admission, detainment and handling of patients with mental challenges against their desires
(Bowen 2007). The Act illustrates the safeguarding of the rights of such patients in all subjected cases. The
legislation configures that any treatment of mental patients should always be in full compliance of
international standards and safeguards adapted by United Kingdom in the Code of Practice. Official
appealing along with detention and treatment is observed closely by Care Quality Commission. On the
other hand, the Mental Capacity Act confers the power of decision making to someone on behalf of the
patient. The subjected person in this case should be aged 16 or above and this can be done if the person
with mental disorder lacks the capacity to make a rational decision (Act 2005). Such decisions involve life
changing circumstances and attributes including person’s interaction with public and his/her freedom. The
Act ensures that all such decisions comply with the standards and safeguards set out in the Code of Practice
which is again measured and observed through Care Quality Commission. The responsibility of compliance
with the above-mentioned acts usually rests in the hands of hospital and professionals working with the
patient. Moreover, the acts also provide support and service insurance for families that reach out to
independent advocates to pursue their relevant cases. It is pertinent to realize the significance of Care Act
2014 which promoted the social health care services to the grassroots level (Act 2014). The responsibility
was shifted from the general population towards the local councils to ensure health and mental stability of
all its residents. In short, the Care Act of 2014 shifts the responsibility of health coverage from individuals
to health centers and councils. Children Act 2004 is another vital piece of legislation that is fundamental to
provision of mental health services for children in UK. The Act is largely an amendment of Children Act
1989, but it provides the assistance to local authorities to offer intervention for betterment of children. The
purpose of this act remains safety as top priority for children of all ages while rendering protection towards
mentally challenged children. Children and Adolescents Mental Health Services (CAMHS) is an NHS
provided service for children of all ages who have emotional and mental issues with regards to interaction
and society in general. It remains a four-tier system working with general consultation, specialists,
multidisciplinary teams and highly specific services for children. This four-tier system works towards
mental health establishment and treatment for children of all ages and throughout the United Kingdom.

Funding of Mental Healthcare in United Kingdom

During the period of 2017/2018, NHS planned to spend around 11.9 Billion Pounds on mental health
infrastructure. This accounts for an increase of 4% as compared to the previous fiscal year (Marks, 2018).
The funding associated with mental health largely comes from clinical commissioning groups (CCGs),
which are actually the health professionals working in a particular area and who buy health services for
residents of their region. The rest of fund is spent on specialized mental health services provided on national
level. NHS has established a five-year plan referred as five forward view which relates to upgradation of
existing structures and mental health services rendered at each level. The plan focuses on improved care of
children and teens with emphasis on reduction of travel distances to nearest health facility (England 2018).
Moreover, better mental healthcare for new mothers and increase in therapies are the objective outlined for
enhancement of service provision in United Kingdom.

Conclusion

Mental Health Provision is one of the most crucial and significant part of health infrastructure in the modern
world. The escalation of mental stress and diseases in the past few decades have provided more attention
to the problem of mental disorders, their identification, treatment and handling. Service provision structure,
which has evolved to much extent in the last few years owing to efforts of activists and foundations, focuses
on quality and specialized mental healthcare through various tiers of system. From general hospitals to
community teams and crises teams, all the professionals working in the domain comply to Care Act of 2014
and ensure services provisions to all segments of the population.

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