Introduction
Cases of mental illness in many communities has been on the rise in an alarming rate. Requirements and needs in life in different aspects has led to depression and drug abuse disrupting a person's thinking, mood, daily functioning and relationship with others (Hurley & others, 1999). Individuals of different ages are susceptible to this problem if proper care and conducive life conditions are not available to ensure mental stability and comfort to help avoid things such as drug abuse that lead to mental instability in an individual. However, this condition can be cured through varying treatment plans depending with place and the cause of the disorder.
Where did the impetus for change seem to come from in this case? What was the significance of that to the implementation?
Several reasons led to the significant changes in how the medical care and solution to mental illness should be administered to the population of a specific part in which in this case is North Carolina. Among all, report by the State Auditor of 2000 known as the Study of The State Psychiatric Hospitals and the Mental Health Program. A number of recommendations were given which proved to be of great help in bringing change on how mentally unstable individuals are handled in the community(Hurley & others, 1999). The recommendations included; criteria to identify a specific group in need of special services that were according to their requirements, come up with community-based capabilities to help implement the Evidence-Based Practises, manage the finance to ensure appropriate services to a targeted group, and initiate a training programme in the community (Gedds, 1999).
The President’s New Freedom report of 2003 and surgeon General's report was also important in showing that even severe mental illness can be cured if correct procedures and support services can be given to the affected people. The Evidence-Based Practise was one of the important outcomes of this as it catalysed the rate at which mental care facilities implemented EBPs.
Drive force and solutions suggested by this reports led to adoption and implementation of various things by the authorities. The Legislature formed strategies to come up with the planning process for mental care systems improvement which were provided in 2001, 2002 and 2003. These plans included identification of the specific group in a population where services were to be offered, what services needed improvement and the support needed to increase mental stability of the people such as work and transport. The legislature also made the institutions offering the services accountable to them. Accountability of the service providers shifted to the legislators who did follow up ensuring that the service delivered to the people was of good quality by offering regular assessment and evaluation.
What are the strengths and weaknesses of using outsiders (division director and project director) to induce change in mental healthcare delivery system?
Mangement is necessary for implementing any change in a particular organisation. It refers to the structure that ensures the activities of change follow a certain order to achieve a specific targeted goal. In a health facility located in a particular place, managers can come from the same place or brought from another totally different region after consideration of the benefits and disadvantages of doing either of the choice. Respect within a facility is one of the strengths associated with employing outsiders in management. Violence and disrespect among workers is always a major problem in many public service facilities. Introducing new faces and personalities will improve this among the juniors and seniors in an institution that enhances the quality of services rendered to the people. Corruption and favours to specific people is avoided by including outsiders. Management of people in a region where the facility is located may lead to corruption among those who seek favours due to being family or coming from the same region. Accountability is more transparent by the outsiders especially those from other countries due to the fear of punishment that may come due to corruption or irregularities.
Some weaknesses also come in hand with the employment of outsiders in management strategies of mental health care facility. Culture and beliefs of a place play a major role in ensuring an efficient provision of mental health services in the region. Outsiders may not be familiar with the culture and beliefs that links cases of mental disorders of a place to practise culture and routine. Language barrier is another bad effect that can arise by employing outsiders. Communication plays a vital role in the healing period of a patient with a mental disability to ensure continuous recovery and assess things like judgement and relationship to other people in the facility for an inpatient. Trust can also be an issue as people tend not to trust people they do not know or have not been associated with in one thing or the other in their lifetime. Managers of a project from outside run a facility with a set mind of earning a living and in rare cases the need to help individuals in that community arises. Therefore, services provided are entirely based on work and little emotional or sentimental connections are involved which would have improved the services provided.
What is the implication of focusing on a target population for community health centres then organised along 1970s model? What are the implication of that change for existing system?
Great changes are taking place at a fast rate in communities and the world today. Health facilities are designed with consideration of certain factors in a community such as population, feeding habits and culture of the people around. Focusing on facilities and people that were analysed in the 1970s reduces the quality of services provided due to great changes that have taken place since then to date(Perrin & others, 1997). Population has increased which means number of patients has also increased and cannot be accommodated comfortably by the facility built on data from the 1970s. Social and economic activities have also evolved since that time. Feeding habits, how people relate to each other and activities undertaken to earn a living affect their mental stability, and this too has changed. Depression one of the major causes of mental illness is caused by these factors that have evolved with time. Basing on past data, diagnosis and treatment is hard or rather impossible. Technological advancement has also led to improved options available in treating these disorders caused by various reasons(Hurley& others, 1999).
Adjustments on the facilities providing mental care services to the community can be made about the changes that have taken place with t time in different aspects in human life. Larger facilities to accommodate the increased population should also be created bearing in mind the rate at which the population is growing to make sure near future population will be taken care of by the facilities provided. Advanced tools and equipments of current technology should be used to improve the quality of services provided and enhance diagnosis and treatment of the disorders. Collection of data should be done on a regular basis to strategise facility improvement.
Stakeholders consortia are very important in the implementation of changes in the health facilities (Perrin& others, 1997).First they help reach a greater portion of the population in creating awareness to the public by holding workshops and seminars on steps of mental care services. Involvement ensures that the importance of implementation of these steps is well understood making it easier to be adopted reducing the period fully to keep the whole programme running. Knowledge of the people on the steps of EBP and help formulate training programmes improving awareness that will also help improve the speed of initiation and completion if the six processes. Prioritizing between the two types of EBP; ACT and employment support, available is enhanced by consulting the stakeholders to know and understand their taste and preference.
What does this case say about the role of professionals in implementing health care policy initiatives?
Personel with the required expertise in the process of implementation of steps of the process. Knowledge on the timing is very important to ensure the planned process works within the speculated time and resources which make it efficient. Management and timing are vital which is a job done by the professionals in managing the use of available resources and skilled personnel to ensure economy, maximum utilisation and productivity. Collection and analysis of data to be used in strategising the facility should be done by professionals to ensure no relevant information is left out.
Conclusion
Pressure in the world today due to population increase and socio-economic factors has led to a proportional increase in mental illness which without a proper address will constantly be on the rise. The great minds in the community will be wasted and the productive youth wont be fully utilised reducing the general living standards of the population. Improvement of the health care in the community will reduce the situation whereby a mentally ill person is written off or stigmatisation due to cultural beliefs by individuals in a certain community.
References
Bhugra, D., & Malik, A. (2011). Professionalism in mental healthcare: Experts, expertise and expectations. Cambridge, UK: Cambridge University Press.
Geddes, J., Tomlin, A., & Price, J. (1999). Practising evidence-based mental health. Abingdon, Oxon, UK: Radcliffe Medical Press.
Hurley, J. A. (1999). Mental health. San Diego, Calif: Greenhaven Press.
Perrin, E., Koshel, J., & National Research Council (U.S.). (1997). Assessment of performance measures for public health, substance abuse, and mental health. Washington, D.C: National Academy Press.
Quigley, A. (2007). Mental health. Detroit: Greenhaven Press.
