Adult Mental Health And Professional Practice Social Work Essay Essays

Adult Mental Health And Professional Practice Social Work Essay Essays Adult Mental Health And Professional Practice Social Work Essay Essay Adult Mental Health And Professional Practice Social Work Essay Essay Within my assignment I will show my apprehension of mental wellness and the direct correlativity to my professional pattern. I will clearly specify and critically measure two of the dominant positions which are important in mental wellness theory and pattern, the biomedical and the societal causing position. By explicating my pattern with respects to the instance scenario 1 Ahmed, I will confirm my apprehension of both positions, analyzing the advantages and disadvantages of each by sing how I might set about and assessment and how I might turn to issues identified from the instance scenario including the impact of favoritism and the importance of anti oppressive pattern. I will grounds my cognition and apprehension of relevant issues including reflecting the position of the person, by pulling up an intercession program, including placing clearly my apprehension of the legal model within which I would pattern. Issues of mental wellness are approached from a assortment of different positions and utilizing a assortment of different nomenclatures. Many have the greatest assurance in scientific or biological attacks, whilst others prefer more holistic or societal attacks. The biomedical medical theoretical account of mental wellness has been dominant merely because the dominant profession is psychopathology. Psychiatrists are medically trained and hence tend to see the chief intent behind their work as the diagnosing and intervention of unwellness or upset ( Rogers and Pilgrim,2005 ) .The simplistic position of cause and consequence whilst good if you have broken your leg or have diabetes, is non the same for mental unwellness. There are organic encephalon diseases or unwellnesss such as epilepsy and huntingdon s chorea which may attest in symptoms frequently associated with mental unwellness ( Rethink,2007 ) and therefore it is critical that the possibility of underlying physical causes are examined. The bio medical theoretical account utilises thoughts of a individual underlying cause and hence intervention of the cause will take to a return to the pre bing province ( Wade and Hallingan,2004 ) .Another premise is of a normal bing province, and hence an ability to mensurate grounds of abnormalcy therefore reasoning with a diagnosing. Traditional bio medical theoretical accounts focus on the pathology of the unwellness instead than understanding the unwellness whether it is biological, societal or psychological. Criticism of the biomedical theoretical account is that it is a simplistic theoretical account in a really complex sphere. Reductionist accounts of mental wellness cut down mental wellness issues to the smallest possible factors, simplistic but clearly flawed ( Crossley,2006 ) . One of the most prevailing statements is the engagement of environmental factors in determining our behavior. A individual s environment can determine their behavior and this is a changeless procedure. An person may be born with certain cistrons but environmental factors such as society and a individual s household can determine farther behavior ( Nettleton, 2006 ) . In cut downing a construct to its constituent parts and simplest footings many of import facets are overlooked. Individual factors are difficult to explicate under reductionism, because reductionist accounts generalise behavior. Each person is alone and responds otherwise. A reductionist account would be genetic sciences, but the same behavior in two people could be caused by separate environmental and biological factors and hence restricting the reductionist account ( Crossley,2006 ) . Reductionist accounts can be utile, by cut downing complicated constructs to their constituent parts but sometimes this offers a simple solution to an otherwise more complicated job. For illustration giving anti-depressants to person who is depressed may look like the most favorable solution, but this may overlook the existent job such as mourning, fiscal or work jobs. Iatrogenesis is another sphere that is debatable for the bio medical theoretical account. Iatrogenisis is frequently associated with inauspicious effects ensuing from medical intercessions ( Heller et al, 1996 ) but can and is viewed as the direct consequence of the intercession which impedes a individual s recovery, and hence could include psychopathology which is the prevailing force in the bio medical theoretical account. Labeling with respects to mental wellness diagnosing is another unfavorable judgment of the bio medical theoretical account. Scheff ( 1999 ) understands mental unwellness as a consequence of social labelling. Simplistic put, society has positions on what is socially norm and acceptable, any divergence from these norms, consequences in a label of mental unwellness. The societal causing theoretical account suggests links between societal disadvantage and mental wellness jobs. These societal disadvantages are prevelant in many countries instruction, wellness, employment, income and societal inclusion. Poverty and societal category have been determined as the two important factors of societal causing and the nexus to mental unwellness ( Murali and Oyebode, 2004 ) . Lynch et Al ( 1997 ) found people populating with fiscal troubles on a long-run footing, were much more likely to endure from clinical depression than those who did non. Studies into mental wellness suggest there are stressors associated with low position and this creates an environment for increased hazard of developing mental wellness jobs. Payne ( 1999 ) in the 1999 PSE survey provides grounds that people who live with assorted facets of poorness, want, unemployment and societal exclusion are more likely to hold mental wellness jobs, although the relationship between hapless mental wellness and these facets are complex. I will analyze employment in more item. Research shows that less than 40 % of employers would see using a individual with a mental wellness issue ( Rethink, 2009 ) .Consequently the bias and favoritism people face as a consequence of a mental wellness diagnosing nowadayss jobs in itself. In 2002/ 2003The Citizens Advice Bureau conducted research sing societal exclusion and mental wellness and their consequences were blunt. 60 % of people with mental wellness jobs gave up work as a consequence of favoritism, bias and stigma. 61 % per cent of male grownups with a psychiatric upset are in full-time or parttime employment. Whereas the figure is 75 % of work forces with no psychiatric upset ( Mind,2010b ) . If an person has maintained a occupation or found employment so if they are affected by backslidings this once more impacts financially. With these statistics in head it is clear to see that many who experience mental wellness issues will besides be affected by economic adversity. Populating on province benefits and sometime s less, as a consequence of an inflexible benefit system, can besides ensue in a barbarous circle of want and poorness in all facets of their lives, non merely economic but in wellness, societal activity and engagement. The societal causing theoretical account defined within the societal theoretical account demands to be understood by practicians as it acknowledges the experiences of persons, every bit good as being the springboard for disputing the socio political environment which contributes to societal jobs, which in bend impact on an person s mental wellness. This is cardinal for practicians as one of the cardinal functions of societal workers is to dispute and defend societal and political alteration ( Horner,2006 ) .According to Rogers and Pilgrim ( 2006 ) race, gender and age are all countries of disadvantage than can be investigated via societal causing. This would back up the findings of several surveies which highlight the relationship between some of the identified countries and hapless mental wellness. Examples to exemplify these links are, Irish work forces have three times higher psychiatric admittance rates than the general population ( Fitzptrick, 2005 ) ; adult females are more lik ely to be treated for mental wellness jobs than work forces ( Mental Health Foundation, no day of the month ) and in research by Beecham et Al ( 2008 ) it was identified that fewer than 10 % of older people with clinical depression were referred to specialist mental wellness services compared with approximately 50 % of younger grownups. These blunt derived functions question the footing of these statistical differences and one account is societal causing. In recent old ages at that place has been a displacement in Mental Health statute law. Although the Mental Health Act 1983 remains the primary statute law, there has been the add-on of the Mental Capacity Act 2005 which provides a legal model to protect persons who lack, or may miss capacity. The Mental Health Act 2007 amended the MHA 1983 and the MCA 2005. Along with these amendments to statute law at that place has besides been a extremist displacement in policy paperss from cardinal Government. These policy displacements demonstrate the demand to understand mental wellness in a more holistic context. The accent is switching from strictly medical positions with a acknowledgment of how the societal position has an impact on a individual s mental wellness good being. A overplus of policies from authorities such as Undertaking Health Inequalities ( DOH, 2001 ) ; Working Together UK Action Plan on Social Inclusion ( DWP, 2008 ) and Child Poverty Review ( H.M. Treasury,2004 ) have been designed to undertake societal inequalities such as wellness, income, work and instruction every bit good as a acknowledgment for the demand for more individual centred attacks to presenting services. This does non take away from the clear message from statute law that hazard and public safety are of paramount importance. The arguments about attention or control and rights versus hazard are of all time present peculiarly with high profile instances such as Christopher Clunis and Michael Stone were polar in the alterations to the Mental Health Act in 2007. The Mental Health Alliance ( 2006 ) maintain that legislative reforms which enables persons to entree services within the mental wellness sphere when they need it, as opposed to enforcing intervention, would be a more feasible option and turn to the issue of hazard in a more proactive manner. The Mental Health Act 1983 still remains the overarching statute law sing mental wellness in the England today and is the lone piece of statute law that permits the detainment of an person before they have committed an offense and strictly on the footing that they might present a menace to themselves or others ( Golightly,2008 ) .The alterations in 2007 allowed for sanctioned mental wellness professionals instead than the traditional sanctioned societal workers. One could reason that if this is obliteration of the societal worker function and the move to further medicalise mental wellness ( as the sanctioned mental wellness professional can be wellness background instead than societal attention ) . The Mental Capacity Act 2005 might be viewed by some as beliing the Mental Health Act 1983. After all a individual suspected of holding a mental unwellness may carry through the subdivision 3 trial of capacity under the Act, and under the rules of the act is able to do unwise determinations, but the Act makes no judicial admission sing these unwise determinations. Clearly perpetrating a condemnable offense is an unwise determination and a individual perpetrating the offense could clearly cognize and understand their action and face effects laid down under condemnable justness statute law. Under the Mental Health Act a individual is non required to hold committed an offense to be detained, a intuition of possible injury to self or others is adequate to justify a subdivision 2 appraisal for nonvoluntary admittance. This sphere has been addressed with and the Mental Capacity Act 2005 amendment to the Mental Health Act 1983 whereby an person can non decline intervention if that intervent ion is deemed necessary under the conditions of the Mental Health Act in that the MHA efficaciously overrides the MCA if the individual is or deemed to be mentally sick. This is a contradiction sing any other signifiers of medical intervention for a physical status such as intervention for malignant neoplastic disease or extremist surgery ( if a individual meets the capacity appraisal standards ) , a individual can decline intervention for any other physical wellness status but non for mental unwellness as a individual can be detained to mandatory dainty. New Horizons is a transverse authorities programme which was launched in 2000 which identified non merely the demand of improved mental wellness services but the acknowledgment the importance of keeping good mental wellness and good being for everyone and screens childhood to old age ( DOH,2009 ) . It clearly recognises the impact of societal factors taking to turn to societal inequalities placing wellness, instruction and employment as of import factors in an person s well being and the impact on mental wellness. The Mental Health Act 1983 is the primary statute law which covers the appraisal, detainment, intervention and rights of people with a mental wellness status. Following the psychiatric theoretical account the practician would necessitate to do an appraisal of Ahmed s operation place the marks and symptoms which he is exhibiting for Ahmed these would be his twenty-four hours to twenty-four hours working he has rent arrears, public-service corporations have been cut off ; personal attention grounds suggests he lives on takeouts ; societal operation he is a lone wolf and he goes into the town Centre shouting seemingly aggressive ; ideas he appears to be holding psychotic beliefs that his female parent is non his existent female parent, and perchance hallucinations evidenced with him shouting, but non directed at anyone. The psychiatric theoretical account uses opinions of normal which are non nonsubjective, but on in agreement criterions of normal within a cultural and societal context ( Esyenck,1994 and Giddens,1997 ) . But the inquiry has to be who is the prevailing force in that society and how does this impact on persons from differing cultural backgrounds in the nipple of normalcy. Although the instance survey has non specified Ahmed s cultural background it is an country which needs due consideration. There are treatments sing psychopathology as being coloring material blind and civilization blind . Fernando ( 2002 ) examines the principle for these constructs in relation to hearing voices, and explains possibly cultural stereotypes which do non see multi cultural dimensions are responsible. Fernando ( 2002 ) draws upon the surveies associating to high proportions of British African Caribbean work forces being labelled as aggressive, possibly due to the visual aspect or reading of symptoms taking others to specify the symptoms within the mental wellness sphere ( Nazroo and King, 2002 ) . Fernando ( 2002 ) expounds farther by explicating this could besides be related to society norms. The norms are dictated by the predominant forces within society. When persons do non conform to societal norms they are capable to countenances in order to guarantee conformance this is apparent within the legal justness system a individual commits a offense a penalty a all right or community ser vice order or prison sentence is served. The analogues for mental wellness could be seen that if a individual does non conform so admittance to infirmary, intercession and intervention may be viewed as the countenances to diverting from those perceived norms. Risk direction is a extremely politicised country with the primary aim in the political sphere to pull off hazard, whilst improved results for persons appears to be in secondary ( Holloway,1996 ) . Holloway ( 1996 ) goes on to state in order to understand and hence pull off the hazard so as a practician you need a really elaborate apprehension of the person. Good pattern sing hazard direction is about a clear foundation for the determination and an outlook for the proposed result, every bit good as proviso for alteration if the intended result does non happen ( Petch,2001 ) . A treatment with Ahmed sing voluntary admittance for appraisal and intervention would be deemed appropriate given the appraisal. The Mental Health Act 1983 clearly provinces in subdivision 131 that voluntary admittance should ever be used if the individual is willing. Should Ahmed defy intervention and admittance to hospital so it would be necessary to turn to the demand for detainment under subdivision 2 of the act. This proviso is made with the understanding of 2 physicians ideally one who knows Ahmed possibly his GP, and an sanctioned mental wellness professional ( AMHP ) . Under the Mental Health Act 1983 subdivision 2 allows nonvoluntary admittance to infirmary for appraisal and intervention. Under subdivision 2 Ahmed does non hold the right to decline intervention. Once Ahmed is admitted to hospital so appraisal for a diagnosing would be paramount. The two diagnostic and categorization tools used in modern psychopathology are the DSM IV codifications and ICD 10 codifications ( Bolton, 2008 ) . Although there are differences in these codifications, the premiss for these codifications and results are the same. These codifications represent the bio medical theoretical account, the decrease of the unwellness to marks and symptoms to which a head-shrinker can find a diagnosing and intervention based on that diagnosing. Whilst this may be utile for organic encephalon upsets for the bulk of mental wellness jobs where there is no unequivocal biological status, the diagnosing merely reflects the person s contemplations on how they think and feel. The intervention program would be developed based on the assessment result ( diagnosing ) . Often intervention scopes are limited with a high accent on drug intercessions, where the primary aim is to brace Ahmed s mental wellness status in an attempt to return him to a functional province. This medicalised response and the usage of drugs could be viewed as a agency of societal control ( Rogers and Pilgrim, 2005 ) . By pulling on the theory of societal causing this would enable me to back up Ahmed to analyze the issues he is confronting in a non judgemental manner. Oppression and favoritism is observed in the lives of people from marginalised groups ( Dalrymple and Burke,1995 ) and as practicians we have an duty to dispute favoritism and subjugation. Personal experiences are clearly associated with societal, cultural, political and economic divisions and hence understanding these countries in context to the person is critical in understanding and disputing the subjugation and favoritism they may meet ( Adams et al, 2002 ) . The stigma attached from holding mental wellness jobs can non be underestimated. Research by the Department of Health Attitudes to Mental Illness in 2007 showed that whilst many of the negative pre conceived thoughts and beliefs held by society about people with a mental wellness unwellness were decreasing, but the alterations twelvemonth on twelvemonth were non important. T his may be due to instruction and apprehension of mental unwellness and the apprehension of the effects of favoritism and stigma. The Time to Change Programme ( 2008 ) is by its ain admittance, nationally and globally the most ambitious program to stomp out favoritism faced by people with mental unwellness. Stigma poses a menace to all facets of an person s life if diagnosed with a mental unwellness, they contribute to societal isolation, hurt and troubles deriving and keeping employment. In a study by Crisp and Gelder ( 2000 ) discovered there were consistent subjects of perceptual experiences of people who had a mental unwellness. Some positions were common amongst the several diagnosings, viz. they were hard to speak to and they were unpredictable to premises of being unsafe. Completing a Community Care Assessment in conformity with the NHS and Community Care Act 1990 would be necessary in order to place Ahmed s demands and how those demands would be best provided for. The appraisal would include information from Ahmed every bit good as important others where applicable and determine demand on a short and / or long term footing ( Sharkey, 2007 ) . The appraisal does non take away from the demand of some immediate intercession, to work straight with Ahmed to turn to some of the immediate issues such as his rent arrears ( which would instantly cut down the menace of eviction ) and acquiring his public-service corporation services back in topographic point. Acute and crisis services and intercession were designed to offer support in a less restrictive and stigmatizing manner than traditional formal of intercession such as mandatory admittance ( Golightly,2008 ) . Crisis intercession is a theoretical account of intercession which ideally prevents the state of affairs from deteriorating farther and physiques on bing resources and strengths in order to better the state of affairs ( Ferguson,2008 ) . This could help Ahmed s mental wellness and good being every bit good as his environment and other societal factors i.e. relationship with Dendranthema grandifloruom and neighbors. The intercession allows a recent Cochrane reappraisal found that place attention crisis intervention, coupled with an on-going place attention bundle, was a feasible option to hospital admittance for crisis intercession for people with serious mental unwellnesss and likely more cost effectual ( Joy at Al, 2006 ) . Working straight with Ahmed utilizing a undertaking centred attack would be ideal as it is a really practical based attack. The work is clip limited, structured and job focused ( Parker and Bradley, 2007, p.93 ) . An illustration for Ahmed might be: Result: Pay off rent arrears so no longer in debt. Rationale: this would instantly cut down the hazard of eviction every bit good as promoting Ahmed to take duty for his state of affairs in a supportive and empowering manner. Stairss: Agree a payment program with Ahmed that is manageable within current budget ( ?10 every 2 hebdomads ) Once program agreed Ahmed to see lodging supplier to hold payment program and bespeak an update every month on arrears. Pick up benefits every 2 hebdomads, on a Tuesday, and instantly pay 2 hebdomads rent at paypoint in station offices along with in agreement ?10 arrears and obtain reception. For the intent of this assignment I have listed some of the actions which could be identified in order to back up Ahmed. Pay off rent arrears. Benefits appraisal to guarantee Ahmed is claiming his benefit entitlement. Tenancy support worker in order to back up with occupancy related issues such as rent, public-service corporations and keeping a occupancy understanding. Support worker to help with increasing his contact and cut down societal isolation. This could be merely traveling out for a java or some other activity which Ahmed identified. To research if Ahmed has concerns sing psychopathology, and his reluctance to run into with the head-shrinker this is critical it may merely be he bury about the assignment or farther issues sing his construct of psychopathology. To work with Ahmed to research his ideas sing his female parent and measure the foundation for his ideas that she is non his female parent. To derive understanding on any other important relationships in the yesteryear ( there is reference in the instance survey of kids ) and the possibility of re-connection with his kids and wider household connexions. Re-connection with community whether this would be using self aid groups, categories which may keep a peculiar involvement or active battle in community/ voluntary undertakings to construct self esteem and assurance and develop a sense of intent and battle. Explore developing / employment options To back up Ahmed to get down a life narrative book or see psychological science intercession. To offer support to analyze Ahmed s current schemes of get bying recognizing his abilities through the strength theoretical account and back uping him to place any forms and how to cover with them. To develop a contract for future work in order to be clear of professional boundaries and outlooks from both parties and how intercession might look in the hereafter should this be required. Should the fortunes non better or go on to deteriorate so there is a possibility of seeking infirmary admittance either, voluntarily or in conformity with the Mental Health Act 1983. More people than of all time are being detained in infirmary under compulsory orders. Admissions to hospital under the Mental Health Act 1983 have risen by about 30 % in the past decennary in England. Harmonizing to a study from three national mental wellness charities, Rethink, Sane and the Zito Trust, this figure is a distressing contemplation of the attention for people with mental unwellness ( Kmietowicz, 2004 ) . A sobering idea for any professional. As a practician I have learnt that causes of mental wellness issues are frequently complex and can affect a combination of biological exposure, environmental factors, societal stressors, societal webs, supports and relationships, psychological orientations and learned behaviors. Coppock and Hopton ( 2000 ) province: each position on mental hurt and curative intercession has its ain internal logic ( p.175 ) and emphasize the importance of recognizing the options, otherwise, practicians are in danger of going a stiff in their patter n, non work in a individual centred manner. Having a critical position and apprehension of the assortment of theoretical positions and attacks sing mental wellness is good. It is clear that these positions whether biomedical or societal have added to our apprehension of mental wellness. The comparative virtues of the assorted positions are invariably argued, most characteristically by indicating out the restrictions of the differing positions. Such reviews can be productive but are merely a measure in a larger undertaking to develop broader positions that can be fruitfully integrate the different utile penetrations reached from each of a assortment of different points of position. A individual centred attack to mental wellness would look the optimal attack when analyzing mental wellness issues. It recognises the singularity of persons and histories for all the possible variables and their interactions from societal causing, emphasis exposure, gender etc. which would enable practicians to analyze issues within a broader holistic context, alternatively of stiff simplistic procedures of bio medical theoretical account ( Freeth, 2007 ) . Word Count: 4007