logo

Advancing Professional Decision Making in Health or Health Care Systems

   

Added on  2019-12-03

21 Pages8564 Words107 Views
Advancing ProfessionalDecision Making inHealth or Health Caresystems

INTRODUCTION The health and social care system of England is recently facing a problem of mentalhealth crisis. The problem at NHS is that mental health is not given importance in comparison tophysical health. The mental health system of the nation is being forced to do more with lessresources. According to the conclusion of a 2012 London School of Economics Study mentalillness accounted for 23 per cent of NHS's disease burden. However, it got only 13 per cent ofthe cash (How mental illness loses out in the NHS, 2012). Several reasons explain mental healthcrisis in England. The mental health wards are being shut. There is a national bed shortagePatients have to travel hundreds of miles to obtain treatment or mental health issues. More tothat, the wards are often over crowded. There is an increase in the incidents of violence againstmental health workers. Furthermore, the pressure on the staff as well as the service users hasbeen increased with cuts to community service budgets (Appelbaum, 2003). This is a problem because illness should be alleviated wherever possible. Moreover,mental illness decreases the life expectancy of people and is associated with increased chances ofphysical illness (Aslam and Bhui, 2012). Parity of esteem between mental and physical health isa significant issue because the number of mental health patients is increasing. Mental healthconditions are a common problem in UK. One in every four persons in UK suffers from thisissue every year. According to the results of household survey, 15 per cent adults suffered fromcommon mental disorders, 3 per cent from post traumatic stress disorder while 0.4 per centsuffered from psychosis disorders like schizophrenia (Results of a household survey, 2009). The present essay aims to provide insights into the problem of parity of esteem between mentalhealth and physical health and proposed possible solutions for it. (a) Description of organizational problem and its importance Parity of esteem is a principle by which mental health should be given equal priority tophysical health (Parity of esteem, 2015). This suggests that mental health issues must be tackledwith the same energy as issues of physical health are tackled. However, the situation is not so inEngland. NHS is facing the problem of parity of esteem between mental and physical health.Mental health issues are not being given equal status and importance as is given to physicalhealth problems. 2

The extent of the problem can be judged from the fact that little or no treatment isprovided to 3 in 4 people who suffer with a mental health problem in England. This suggestspresence of large gaps with respect to health outcomes. This has resulted into the issue thatpeople with mental health problems die 15 to 20 years earlier, on an average, as compared to thegeneral population of the country (Bailey and Smith, 2014). Patients of mental health issues areforced to travel long distances for obtaining care and treatment. The number of patients travelingto seek emergency treatment was 1, 301 in 2011 which increased to 3, 024 in 2013. this indicatesthat the number of service users who had to travel to seek care and treatment for mental healthissues has almost more than doubled in two years. The worst affected areas are Kent and Sussex.In Kent, 334 people were sent out of the country in 2013. this number of significant as comparedto just 20 patients being sent out in the year 2011- 2012. in Sussex, the number o patients whosent out of the area increased from 28 in the year 2011- 2012 to 227 in the year 2013- 2014(Buchanan, 2014). Although, some of the trusts of NHS are managing and reducing the numberof patient that are being sent out of area for care and treatment,. However, it is disgrace thatpeople with mental health problems have to travel hundreds of miles away from family andfriends, for receiving treatment. NHS mental health services of the country are in crisis in terms of quality and availabilityof services. Patients are sifted to inappropriate settings even when they are acutely unwell. Anational bed shortage suggests that either they are shunted to a hospital hundreds of miles awayor are left in a bed and breakfast accommodation (du Toit, 2004). Some mental health patientsare admitted to other settings such as deaf ward owing to lack of beds. This makes them feeleven more stressed and anxious. According to Lisa Rodrigues, chief executive of the SussexPartnership NHS Foundation Trust, these issues not increase the number of detained patients butare also responsible for making people stay in hospital for longer (Buchanan, 2014). These alsoundermine the mental health patients' chances of recovery. Moreover, there have beeninappropriate admissions for out – of – area beds. The extent of crisis can be judged from thesituation that people overdosed on order to obtain a bed because according to them it was theonly way to get a bed in mental health trusts. Further to this, people are being inappropriatelydischarged to bed and breakfast accommodation after long spells in psychiatric hospitals. Thelack of acute beds available for mental health patients puts them at serious risk (Gleeson and3

O’Flaherty, 2013). An investigation by Community Care magazine fund that there has been a 12per cent decline in the total beds available. It was also fond that since 2012, 7 people have killedthemselves as they were told that there are no beds available in the hospital for them (Siddiqueand Meikle, 2015). Patients of mental health are held in police custody due to shortage of beds. Manymentally ill teenagers were detained in cells. This is because due to shortage of beds, policecustody was the only setting that could be used as a place of safety for adults when their behaviorwas extreme and could not be managed elsewhere (Hayes, 2006). The question of parity alsoarises with respect to safety of mental health patients. Many of these vulnerable people weredischarged from hospital without proper information about their condition. People who wereadmitted to hospital for being engaged in self harming and suicidal behavior, were offered only acrisis support phone number when they left the hospital (Siddique and Meikle, 2015). The bedcrisis also has significant impact on children suffering with mental health problems. In majorityof the cases, children are sent away from their families. This further worsens their conditions.There has been institutional bias against mental health with respect to waiting timetargets. 18 week maximum waiting time was established in the last decade in England. However,it applied only to physical health. Mental health was not included in it. Whereas patients with aphysical health crisis such as chest pain are usually rapidly assessed and provided appropriatetreatment, patients with mental health issues are not (Hilton, 2015). Even people with suicidaltendencies or those experiencing a psychotic episode have to wait for a long period of time. Eventhen, they are not able to receive adequate treatment and assessment. This indicates that peoplewith mental health problems are not assessed quickly enough. Also, services are not available tothem all the time as and when they need it. There is limited provision with respect to access totreatment for mental health problems. Only 24 per cent of people with a common mental healthdisorder receive treatment (Kirkbride and Jones, 2013.). It is difficulty for people to accesscognitive behavioral therapy, psychoanalysis or long term psychological therapies. There islimited provision of psychological therapies in NHS. The range of evidence based therapies isalso limited. Kids wait for over a period of two years and are then admitted to adult psychiatricwards. 4

Psychiatry is treated as a lesser branch of medicine by some medics. Also, some mentaldisorders are dismissed as not in the category of real illnesses. A & E, maternity services, canceretc. are considered to be a priority to mental health. Care Quality Commission report indicatesthat children and young people suffering from mental health problems do not receive the careand support they need (Kisely, 2005). 10 per cent of children and young people suffer from amental disorder. There are many more of them who are dissatisfied or unhappy with their lifeand need support. However, due to lack of parity between mental and physical health, a largeproportion of these people are not above to obtain the required support at the time when they firstneed it. As a result of this, they do not come to the attention of service until they reach a crisis(Knudsen and Thornicroft, 2006). The problem o parity between mental and physical health at NHS is important. Mentalhealth includes psychological, emotional and social well being. It is important area in heath careas it determines how a person handles stress, makes choices and relates to health. Whileexperiencing mental health problems, a person's thinking, mood and behavior could be affected(Lasonen, 2006). Positive mental health is essential for a person to realize his full potential, copewith stresses of life, work productively and be able to contribute to the community in ameaningful way. However, it has been a longstanding criticism in the health and social caresystem in England that people suffering from mental health problems fail to receive sameservices and quality of care as compared to people with other types of illnesses. (b) Root causes of problem Rising demand for mental healthThe demand for mental health health services is rising. An average of more than 1 millionantidepressants were prescribed by doctors per week in 2013. this is double the number ofmedicines prescribed a decade ago. Since the year 2003, there was a 14. 8 per cent increase inthe overall Net Ingredient Cost (NIC) of prescriptions. Moreover, the number of patients gettinghelp for severe mental illness was 1.75 million in the year 2013- 2014. this suggests that therewas a 10 per cent increase in the number of adults seeking mental health services last year (Lees,Procter and Fassett, 2014). Another reason for the increase in number of mental patients wasdetention under Mental Health Act. There was a 5 per cent increase in the number of MentalHealth Act detentions to hospitals. In the year 2013- 2014, the Act was used 53, 176 times to5

detain patients for longer than 72 hours (McNicoll, 2014). there has also been an increase in thenumber of children admitted t hospitals for self harm. Admission of girls aged 10- 14 increasedby 93 per cent from 3090 in 2009- 2010 to 5953 in 2013- m2014. Similarly, there was a 45 percent rise in the number of boys (Kotecha, 2014). cut on budgetsOne of major root cause for the problem of parity between mental health and physical health isthe cut on budgets. After a peak of funding for Child and Adolescent Mental Health Service(CAMHS) in 2010, there was a decrease in the funding by £50 million in the first three years ofthe coalition. In year 2015, it was revealed by ITV news and children mental health charityYoung Minds that there was a total funding cut of £85 million from mental health budgets oftrusts’ and local authorities’ for children and teenagers since the year 2010. this indicates a dropof £35 million in the lest year. 75 per cent of trusts admitted that they had cut their mental healthbudgets between 2013- 2014 and 2014- 2015 (Siddique and Meikle, 2015). This trend iscontinuing in all areas of mental health. There has been a fall in the average proportion of totalbudgets allocated to mental health. It can be analysed that a change of 1 per cent in the mentalhealth is a big number (Limb, 2014). This is to be compensated in the form of less staff andremoving whole services. Disparity in funding is now considered to be of critical importance. This results into bedpressures, longer waits for children etc. It is due to this that 92 per cent of people with physicalhealth problems are available to receive the care they need as compared to only 36 per cent withmental health problems (Millard and Wessely, 2014). Moreover, the funding picture in NHS isalarming. Funding for mental health trusts as decreased by 8 per cent during Coalition's reign.The mental health trusts are responsible for provision of most of the mental health hospital andspecialist care. It was also found that there was an 8 per cent decrease in the spending onchildren's mental health between the years 2010 and 2013 (Miller, 2015). further to this, councilspending has been slashed. CAMHS budgets have been frozen or cut down by over half ofcouncils in England since the year 2010. This has majorly impacted the services within thecountry which have to be closed. Mental health receives around 13 per cent of the NHS budget. However, mental illnessesaccount for a quarter of the disease burden. Most of the GP have to deal with the mental health6

End of preview

Want to access all the pages? Upload your documents or become a member.

Related Documents
Improving Physical Health of People with Mental Illness: A Critical Reflection
|5
|920
|377

Stigma and mental illness Report 2022
|9
|2225
|27

Forensic Mental Health and Criminal Psychology
|11
|3322
|24

Understanding Health and Social Care Report 2022
|9
|2090
|25

Mental Health issue in the United States
|3
|673
|16

Treatments and Therapies for Mental Health: Psychodynamic, Somatic, and Behavioural Approaches
|2
|1284
|238