Primary, Secondary and Tertiary Mental Health Care?

Running head:MENTAL HEALTH
MENTAL HEALTH
Name of the student
Name of the university
Author note

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Table of Contents
Introduction............................................................................................................................................ 2
Body...................................................................................................................................................... 2
Symptoms of psychosis, depression, and mania...............................................................................2
Principles of recovery apply to consumers seeking help...................................................................3
Primary, secondary, and tertiary mental health care providers..........................................................4
Restrictive practices.......................................................................................................................... 5
Careers recognition act..................................................................................................................... 6
Mental Health Act 2009..................................................................................................................... 8
Conclusion............................................................................................................................................. 9
References.......................................................................................................................................... 10

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Introduction
Psychosis is a mental condition where anindividualexperiences things that do not exist or
have no connection with reality. Psychosis is not considered as a particular disease. It is an
amalgamation of several mental disorders such as depression, bipolar disorder and many more which
is presented with accurate definitions. A psychotic event is defined by hallucination or delusion, which
has a high impact on the senses of the patient (Frye 2011). Initially, the signs and symptoms of
psychosis are difficult to determine.So, this assignment will shed light on detailed information onsigns
and symptoms of psychosis, depression, and bipolar disorder, which can also be considered as
maniac disorder and the risk factors associated with these. This consideration will help the mental
health care providers to assess the situation and provide the relevant psychotherapy.
The principles of recovery used in history to treat patients with mental disorders will be
highlighted. A small part addresses the approach used to build a therapeutic alliance A better
understanding of how modern therapeutic alliance can be aligned with principles of recovery will be
provided.
The Australian health care system is well organized with three levels of mental health care services.
The clear mention of the role of primary, secondary and tertiary care providers along with the strategy
to support people in the recovery process has been done for better understanding.
Body
Symptoms of psychosis, depression, and mania
The umbrella term for all the mental health illnesses is Psychosis and it is itself not any
disease. The loss of contact with the real world is known as psychosis. The psychotic episode
includesasensoryexperience that has no connection with the real world (Guerrero-Pedraza et al.
2012). A psychotic episode may include delusion or hallucination; that is they hear and see things that
donot exist. These are the potential symptoms of psychosis. The experience leads to a dreadful
situation like hurting or killing themselves or others. A psychotic episode is connected with
schizophrenia spectrum disorders, dementia, Alzheimer’s disease (Lake 2008).
Psychosis is gained gradually whileundergoing repetitive sleep problems, obsessive thinking,
distorted perception, general anxiety, feeling of suspicion and depression (Ganjekar, Desai and
Chandra 2013). When such symptoms hit an individual, he or she seems to have a great tendency to
be affected by serious mental illness shortly. The impact of hallucination can be in any of the senses
such as sound, taste, smell, sight, and touch, while the maximum percentage is affected by auditory
hallucination. The individual experiencing paranoid delusions suspects a person randomly believing
them to cause harm to them (Chan 2017). Individuals possessing delusions of grandeur consider
themselves to be superior, holding the special power. Psychosis generally comprises of three phases-
 Prodrome
 Acute Phase
 Recovery
Prodrome is considered as the first phase which occurs out of the blue. In this phase, changes in
feelings include feeling disconnected, difficulty in screening out distracting information, feeling

3MENTAL HEALTH
overloaded, depressed mood, sleep disturbance. The acute phase is considered as the second phase
where delusions, hallucinations, disorganized behaviorare observed in the patient. Next comes the
Recovery phase which starts after the treatment and the symptoms gradually disappear.
A combination of psychological, biological and social distress that involves body, mind and
thoughts, leading to loss of interest in any activity, is characterized by depression. It is considered as
a great contributor to the psychotic event (Jauhar et al. 2019).Depression doesnot comprise of any
physiological signs. Symptoms might comprise of eating disorders, sleep disorder,alterationin body
weight, fatigue. On an emotional level, depression includes despair, sadness, minimized energy,
mood swings, self-hatred, decreased memory, sense of emptiness (Mata et al. 2015). Periods of
euphoria or extremely excitable mood contribute to maniac behavior (Jahangard et al. 2014).
However, it is associated with bipolar disorder. Bipolar disorder has two distinct mood swings that
include emotional highs that are mania or hypomania and emotional lows that is depression
(Mondimore 2014). The symptoms include Bipolar I disorder, cyclothymic disorder, bipolar II disorder
and other types (Vieta et al. 2018). Bipolar I disorder includesamanic episode that is followed or
preceded by hypomanic or depressive episodes, whereas Bipolar II contains one depressive episode
and a hypomanic event with no maniac event (Beiwinkel et al. 2016). Consumption of drugs or alcohol
leads to a Cushing disease that hasagreattendency to get affected by bipolar disorder (Di Florio,
Craddock, and Van den Bree 2014). The major maniac and hypomanic symptoms are increased
energy, increased activity, an abnormal upbeat, exaggerated sense of euphoria and well-being,
distractibility, insomnia, and poor decision making (Young and Eberhard 2015). Early impaired social
interaction appears to represent a potential risk for psychosis. Other than this, three usually psychotic-
associated prodromal syndromes: brief frank insanity, attenuated psychotic symptoms and genetic-
risk functional regression. Depression can turn into a period of unhealthiness.The symptoms related
to depression can lead to diabetes and other serious illness. It can create suicidal tendency, addiction,
homicide self injury and reckless behaviour. Mania carries with it specific dangers of disinhibition, bad
judgement, risk-taking and violence at times.
Mental health clinicians play a huge role in achieving high-quality outcomes for patients with a mental
disorder. Meeting the patients and listening to their model of illness and make them understand in
their language is the basic role of the clinicians (Thistlethwaite, 2016). They are responsible for
instilling the client’s trust, including them in all decisions, establishing concrete goals, and recognizing
the barriers and help in problem-solving (Farrelly and Lester 2014).Apart from this psychotherapy is
the most recommended combining with or without medication for treating mental disorders. The
psychotherapy helps the clinicians to understand the ideas, behaviors and the mental status of the
clients and act accordingly to solve it. This therapy also helps to retrievea sense of control and
pleasure in life. The therapy becomes effective if clinicians are capable enough to draw the attention
of the client while proceeding with some approaches of psychotherapy is psychodynamic therapy,
cognitive-behavioral therapy, dialectical behavioral therapy and interpersonal therapy through
psychotherapy was considered as the gold standard for treatment the advent of neuroleptic
medication dominated markedly over psychotherapy (Fox 2017).

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Principles of recovery apply to consumers seeking help
The recovery movement in mental health care is based on a vision of the community's customers
actively engaging in their treatment with compassionate mental health practitioners whose job is to
help facilitate healing and rehabilitation and not to perpetuate disease and psychopathology
(National Mental Health Commission, 2015). In short, the rehabilitation movement is focused
on the idea that a person with a serious mental disorder should aspire to accomplish life goals similar
to those without a severe mental health problem (Coie et al.1993). There is a movement at the
national level to turn the mental health system into a consumer-focused treatment program. The
patient may initially benefit from a therapeutic alliance; however, evidence shows that mental health
professionals will also benefit from a strong relationship with customers.
The concepts of recovery-oriented mental health practice are applicable to all 10 national frameworks
that extend to the entire mental health care system and the mental health service sector of the non-
government society(Jacobson and Curtis, 2000).
The 10 standards are:
 Standard 1: Rights and responsibilities
 Standard 2: Safety
 Standard 3: Consumer and carer participation
 Standard 4: Diversity responsiveness
 Standard 5: Promotion and prevention
 Standard 6: Consumers
 Standard 7: Carers
 Standard 8: Governance, leadership and management
 Standard 9: Integration
 Standard 10: Delivery of care
In an individual's viewpoint of mental illness, rehabilitation involves gaining and maintaining hope,
recognizing one's strengths and limitations, participating in an active life, social identity,personal
autonomy, meaning and intent in life, and feeling a strong sense of self.Recalling that recovery is not
synonymous with cure is relevant (Kidd, Kenny and McKinstry 2015). Recovery refers to both the
internal circumstances faced by people who identify themselves as recovering–hope, redemption,
strength, connection and external factors that promote recovery–human rights compliance, a
supportive redemption community, and recovery-oriented programs (Lloyd, Waghorn and Williams,
2008). Recovery-oriented mental health design standards ensure that mental health services are
provided in a manner that facilitates customers ' recovery from mental health (Stromwall and Hurdle
2003). Recovery-oriented principles for mental health practice are:
1. Uniqueness of the individual
 Recognizes that rehabilitation is not just a matter of cure, but of having opportunities
for choices, of living a positive, rewarding and purposeful life and of becoming a
respected community member

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 Acknowledges that recovery results are individual and special and go beyond an
exclusive focus on health to include emphasis on social inclusion and quality of life
Empowers people to know that they are at the forefront of their treatment.
2. Real choices
 Supports and enables individuals to make their own decisions as to how they wish to
lead their lives, and acknowledges that decisions need to be meaningful and
imaginative (Tew et al. 2012)
 Encourages people to draw on their abilities and claim as much responsibility for their
lives as they can
 Makes sure a balance between the obligation to protect and the responsibility to help
individuals take constructive chances and explore new opportunities.
3. Attitudes and rights
 This includes listening to, learning from and acting on messages from individuals and
their caregivers on what matters to individuals
 Encourages and safeguards the constitution, citizenship and human rights of
individuals (Corrigan, Powell and Michaels, 2014)
 Assist people in the maintenance and advancement of social, recreational,
occupational and vocational activities that are important to them
 Instills confidence in a person about their future and their ability to lead a meaningful
life.
4. Dignity and respect
 In all situations, includes being courteous, polite and truthful
 It requires empathy and respect for each person, especially with regard to their
values, beliefs and culture
 challenges discrimination wherever it occurs within our own services or within the
wider community.
5. Partnership and communication
 Recognizes that every person is an expert in his or her own life and that rehabilitation
includes working in collaboration with individuals and their caregivers in a manner
that makes sense to them
 Importance of exchanging relevant knowledge and the need for direct contact
 Engaging with people and their carers in constructive and practical ways to help them
understand their own dreams, ambitions and expectations.
6. Evaluating recovery
 Organizations show they use the treatment experiences of the patient to guide
strategies for quality improvement.
 The mental health network reports on main outcomes showing rehabilitation. These
findings include housing, jobs, schooling, social and family relationships, well-being
and wellness.
 People and their carers should keep track of their own growth.

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Mental wellbeing is a state of well-being where individuals in their chosen group can succeed,
progress through hardship, fulfill their needs, and find meaning and purpose in their lives.Allowing
access to programs that help people in the community to heal would have long-term benefits to
patients, families, neighborhoods, and governments.Although South Australia provides a variety of
high-quality mental health care services, it is not always available to those who may need it at a time
and place (Hyde 2013). Accessibility and service type can also depend upon where people live.
Customers will wait to see long times, encounter service shortages and follow-up and be harmed by
the system when unnecessary pressure is applied that could have been prevented. The Mental Health
Services Plan (the Plan) offers an opportunity to build on what worked well and reconsider how to
access and deliver programs in the future and promote improved results for clients and staff. This sets
the future course for mental health and wellness programs provided by the state government and
rebalances the program towards collective solutions as well as the empowerment of customers and
carers.This articulates standards of best practice for improved infrastructure and provides better
results for all, including people living in rural and remote areas.The Plan focuses on the vision and
direction given by the 2017–2022 Strategic Plan for Mental Health in South Australia, released by the
2017 SA Mental Health Commission. The Plan describes 11 results underpinned by three high-level
objectives:
Personalised care and support
1. Those seeking services are actively interested in their care as partners
2. Perinatal, babies, children (0-12) and families have increased access and involvement with
and support for mental health services.
3. Young people (12-24) have access to supportive mental health resources and early
intervention programs for any potential mental health issues
Integrated Care
1. Citizens get prompt and appropriate mental health services and support for well-being and
diversity
2. Mentally disabled people should have improved physical health and will live longer
Safe and high quality Care
1. Improve protection and quality of mental health services in order to minimize damage, uphold
human rights and encourage inclusion
2. Mental health programs encourage diversity, equality, tolerance and justice in all interactions
(Sahealth.sa.gov.au, 2020)
The recovery movement which identifies that people with mental diseases can take
part in society stems from diverse factors such as longitudinal data displaying the majority of mental
health sufferer’s recovery from their illness over time (Lally et al. 2017). The principles of recovery-
based practices of mental health provide mental health services in a manner supporting the recovery
movement that occurred in history and inculcates the perspectives of the individual seeking
help(Jacob 2015). It is based on the theory to retain hope, understand the strengths and weaknesses
of the patient, taking an active part in the society, realizing one’s identity and purpose of life to gain an

7MENTAL HEALTH
overall positive meaning of one’s life. The principles of recovery originating from this theory of the
recovery movement include real choices, uniqueness of the individual, dignity and respect, attitudes
and rights, partnership and communication, evaluate recovery (Donald et al. 2017). These principles
hold a critical position in the delivery of service and quality service management for mental health
workers in today’s world. The implementation process of these principles varies among the different
states and individual service providers. It is implemented in each state by its own set of regulations
and accreditation standards(Webb, 2012).
Moreover, in different practice settings, the type and level of care provided to the consumers
seeking help vary depending on the circumstances and the extent of complexity faced by the
consumer and related legislation(Osborn and Stein 2017). For instance, a consumer as a voluntary in-
patient receives a less restrictive treatment than those admitted to an involuntary hospital
setting(www1.health.gov.au,2020).The healthcare professionals apply different approaches to build a
therapeutic alliance with the patient. One common approach is targeting the client’s expectations and
capitalizing on it (Bickman et al. 2012). This approach has proven to be exceptionally useful in
incorporating the recovery principles of patient opinions in the treatment plan (Smith et al. 2016).
The main aim of health care is the physical health of the mental health users. Knowledge and
understanding of customer views on access to and delivery of services is critical, particularly given the
identified service gaps in mental health and physical health services (Slade et al. 2015). According to
a study by Clossey and Rheinheimer (2014) consumers raised serious doubts about the amount and
nature of their physical health issues, as echoed in the clinical and epidemiological literature on
mental illness. Instead of diagnosing physical health issues and subsequent mutual follow-up
partnerships between physician and patient, reports of disempowerment and alienation (nowhere to
run to) and even (re)traumatization from the health care system have emerged (Price et al. 2015).
The consistency of the patient-therapist partnership is known as therapeutic alliance. The
therapeutic relationship defines the degree of trust and dedication between a patient and his / her
care team.Therapeutic partnership work explores the relationship between patient and therapist, the
level of consensus between the two parties on treatment objectives and therapeutic activities, and
how these factors affect the effectiveness of care (Stanhope et al. 2013).The therapeutic relationship
is of great significance for the rehabilitation process of those pursuing addiction and mental illness
treatment.Evidence has shown that maintaining a stable therapeutic partnership indicates positive
results for the therapy (Corso et al. 2012).Positive therapeutic relationship is associated with higher
self-efficacy rates, and research has shown that self-efficacy is an significant factor in achieving
positive improvement in behaviour, such as decreased use of drugs. Thus these early results indicate
a strong therapeutic partnership is helping to set people up to succeed (Bickman et al. 2012).
Primary, secondary, and tertiary mental health care providers
In South Australia, the consumers go through a three-tiered healthcare system according to
the intensity of the disease. Primary healthcare is the first line of contact who can be a doctor, nurse,
clinicians, pharmacist (Meadows et al. 2015). The secondary health providers are known to be those
who donothavethe first contact with the patients. The consumer is not referred from the primary
healthcare providers and the secondary health care provider’s which includes a psychiatrist, social

8MENTAL HEALTH
worker and psychologist (Kidd Kenny and McKinstry 2015). The tertiary healthcare provider is
generally referred from a primary and secondary health professional (Fadare et al. 2014). They can
be a mental health nurse, a psychiatrist, social worker or occupational therapist (Hensel and Flint
2015). The location of primary health care providers isageneral practice, allied health center, NGO,
Aboriginal and community-controlled health service. The secondary healthcare providers are located
in a specialist clinic, hospital outpatient department, or community setting that is private psychiatry or
psychology. The location of the tertiary healthcare providers is in a specialty unit of a hospital, forensic
mental health service, community mental health service and psychiatric inpatient facility ( Kuo et al.
2016).
Primary Health Care (PHC)
According to WHO the primary health care is defined as the care provider that forms the frontline
of prevention and promotion, cure and care simultaneouslyin an effective, safe and productive way
(Day, 2015). The goal of the PHC movement is to position people at the center of health care, to
make services more effective, effective and equa l.According to the Australian Medical Association,
care is stated as universally accessible, socially appropriateand scientifically sound care that is
provided by trained clinicians considering ethical laws and gives priority to the individuals who are at
utmost need maximizes community and individual self-reliance and is involved In collaboration with
other sectors (Nagel, Hinton and Griffin 2012).The primary healthcare comprises of
 Health promotion
 Illness prevention
 Advocacy
 Community development
 Early intervention
The primary care provider is the first line of care that conducts screening, provides medication along
with providing medical assistance by collaborating with a care coordinator, care managers and helps
the patient to maintain a stable behavioral state (Brophy et al. 2014).Primary health care focuses on
patient-centered care; thus, it is regarded as the Patient-Centered Primary Care Home (PCPCH)..A
behaviorist classified under primary healthcare providers who assist in managing the emotional and
behavioral aspects of chronic disease self-management and preventive care (Thistlethwaite, 2016).
The secondary care provider-The patients who need mental health treatment services beyond that,
is offered in the primary health setting. The primary care directly refers to these patients to service or
patient initiate care without any referral (Hickie et al. 2014). Two programs are their under Secondary
health care which are:
Specialty mental health Outpatient program and specialty substance abuse programs. The specialty
mental health outpatient programs include psychiatric crisis for adults those who are critically ill, adult
outpatient, child or youth outpatient, peer service programwhile the specialty substance abuse
program comprises of adult opiate medication-assisted treatment, detox, adult mental health
outpatient. These programs provide a continuum of services that address addiction, mental health,
and recovery issues for children, youth, and adults(Stromwall and Hurdle 2003).

9MENTAL HEALTH
Tertiary care provider- Patients with critical conditions require inpatient care. Thus they are treated
by tertiary care providers. The condition of the patients might be such that he or she could hear a
voice that tells them to harm themselves or harm others. These patients are at imminent risk and have
life-threatening symptoms (Cranwell, Polacsek, and McCann, 2016).
Chronic Care Act covers long-stay residence in mental-health institutions, which are not
covered by the Exceptional Medical Expense Act now.Healthcare Insurance Act covers the first three
years of sufferers stay in a mental health institution and completing that it falls under the Chronic Care
Act (Tumlinson, Burke and Alkema 2018).
The Mental Health Services also describes broad service areas so comprehensive descriptions can
be given for each particular service area in South Australia. The service areas are generally described
as follows, in line with the system used for reporting under the National Mental Health Strategy:
Ambulatory mental health services offer mental health care to non-admitted patients, including
outpatient hospital and non-hospital community mental health facilities, crisis or mobile consultation
facilities, and day programs. The services are accessed by age group.
Acute inpatient mental health facilities, typically on a short-to medium-term and irregular basis,
offer mental health care to admitted customers. The services are shared by age group.
Non-acute, outpatient mental health programs offer long-term mental health care to enrolled
patients and provide a specialist recovery aspect for treatment. Some of those programs were
historically known as expanded treatment / care services.Services are shared by age groups e.g.
Centers for intermediate care, centers for community recovery, facilities for hospital recovery and
facilities for crisis response.
Conclusion
From this assignment, it can be concluded that psychosis is a mental disorder that causes
impairment from the real world. It is an umbrella term for a mental disorder that has a detrimental
effect on the patient. An accurate definition of psychosis, depression and mania has been given
which is supported by the symptoms of the patient with the respective. Identification of these
symptoms helps the mental health clinicians to assess the mental disorder and treat them
accordingly. The relevant risk issues associated with each issues has been covered in this
assignment. Different approaches to psychotherapy have given proven results and have increased
the patient outcome which is mentioned in this assignment for clear understanding. Along with this the
principles of recovery has been mentioned for sound understaning. A recovery method used in
ancient history has been applied to help consumers. A part of the section talks about the approach
used to establish a therapeutic alliance along with that a therapeutic relationship that suits with
principles of recovery has been developed. The three-tiered Australian healthcare system that is
primary, secondary and tertiary healthcare providers has been evaluated in this assignment.

10MENTAL HEALTH
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