Comprehensive Report: Mental Health Service Delivery and Trauma

This report delves into various aspects of mental health, encompassing factors contributing to discrimination, early intervention and promotional programs, and the complexities of service delivery models. It explores the limitations and purposes of advanced directives and wellness plans, outlining different types and discussing relevant concepts. The report also examines trauma-informed care, including key principles, attitudes toward interpersonal violence, and the roles of flashbacks and triggers. Furthermore, it investigates the links between self-harm, interpersonal trauma, and suicidality, while also discussing the nature and impact of trauma. Finally, it covers practices of trauma-informed care and mitigation strategies for AOD issues, providing a comprehensive overview of mental health-related topics.

Mental health
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TABLE OF CONTENTS
1. Factors contributing in discrimination.....................................................................................3
2. Early intervention and promotional programs.........................................................................3
3. Factors affecting service delivery models and their association with mental health...............3
4. Limitation and purpose of advanced directives and wellness plan..........................................4
5. Types of wellness plans...........................................................................................................4
6. Discussion of concepts related to wellness..............................................................................4
7. Trauma informed care..............................................................................................................5
8. Key principles..........................................................................................................................5
9. Attitude towards interpersonal violence..................................................................................6
10. Role of flashback and triggers...............................................................................................6
11. Link between self-harm, interpersonal trauma and suicidality..............................................6
12. Nature of trauma....................................................................................................................6
13. Impact of trauma....................................................................................................................7
14. Practices of trauma informed care (TIC)...............................................................................7
15. Mitigation strategies for AOD issues....................................................................................7
REFERENCES................................................................................................................................8
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1. Factors contributing in discrimination
The first factor is economic and racial factor which keeps the discrimination in pace in
society. The wide gap between income can affect access to health care services for particular
groups. In addition to this racial or gender stereotypes are also key factors leading to
discrimination. The education level can enhance the discrimination or easiness to approach
health services due to increased structural complexities (Pilotto and et.al., 2017). There are
certain political factors such as regulations for migrants or refugees as well as health care
policies can also make it different for each community and individual to have access to health
services and thus to face discrimination or different challenges.
2. Early intervention and promotional programs
Early intervention aims at minimising health consequences of condition which has been
initiated. Thus counselling, cognitive therapy, medications, social work or physio and
psychological therapies can assist people to make their condition improve. In addition to this
community seminar and visit by professionals in community events can make people aware
about certain health risks and their management strategies. The health promotional events gain
massive attention of population so that health awareness can be created in more efficient and
improved way.
3. Factors affecting service delivery models and their association with mental health
Health care legislations and framework are influenced by variety of factors such as
education level, political factors, demography, income gap between communities, cultural beliefs
and available technology or services in health care infrastructure of the country. For instance, the
people who have drug, gambling or alcohol addiction needs rehabilitation and counselling along
with medications. Thus their service models essentially comprise of this element. For the
individuals suffering from family violence along with the emotional support service model also
need involvement of social laws and jurisdiction system so that violence can be avoided (De
Marchis and et.al., 2019). The people suffering from disability, grief or chronic conditions may
need emotional support to deal with the continuous pain. They may also face discrimination from
the society due to their reduced mental capabilities.
For providing treatment to people suffering from such conditions it is necessary that health
care provisions also include collaboration with the legislations. It ensures that such people does
not face any kind of injustice in social system. The educational gap also demands for need of
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health awareness and promotional campaigns so that people can be aware about the causes and
management of chronic health conditions. If health promotional events are not integrated with
service delivery model, then it ca enhance the complexity of the service delivery system (Elliott
and et.al., 2018). If people are not aware with the strategies or decisions followed by health care
professionals, then it can have adverse impact upon recovery and outcomes of expected health
results and efficiency for the people suffering with trauma or critical health conditions.
4. Limitation and purpose of advanced directives and wellness plan
The key purpose of advanced directives is to make pre planned decisions about the
situations which might occur in future so that a better care objective can be achieved. The
wellness plan helps individual to follow the interventions which can improve their health
condition. However, the key limitation of such planning and directive is that though they are
documented but it is not necessary that they will be accessible in practice. Also due to change in
critical situations it is also possible that family members or health professionals may not follow
it.
5. Types of wellness plans
The first type of wellness plan which is employed by mentally ill people is stress reduction
programs such as meditation or counselling sessions. The programs which encourages the
physical health such as weight loss, smoking cessation or rehabilitation programs. The nutritional
education and regular health screening and risk assessment is also considered as good option for
the people suffering from the psychological issues (Woo, Lee and San Tam, 2017). Some
wellness plan also involves community or family engagement so that emotional needs of patient
can be addressed and they can show quick recovery from the health issues.
6. Discussion of concepts related to wellness
The first form of advanced directive is living will in which a legal document is used by
individuals to state the decisions. This will describe the type of medical treatment or services one
may ask for access. POLST and durable power attorney laws are also used commonly to pre-
planned the wellness. The purpose of statement of capacity states that individuals have enough
capacity to understand the treatment given to them. It helps professionals to make informed
decisions or identify the need to involve family members or advanced directive document if
person is not capable to make decisions to health conditions. The witnesses play important role
so that it can be assured that advanced directive is applied and followed in the desired and
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planned manner. For people suffering from mental health issues necessary care home services,
counselling services and wellness initiatives for maintaining distress are available. For dealing
with crisis there are certain legislations such as capacity act or equality act are implemented
which prohibits discrimination against such people.
7. Trauma informed care
Trauma can be defined as an unpleasant event which can cause emotional, physical,
psychological or spiritual harm. General population such as women or children used to face lot
of traumatic events in terms of physical or sexual violence. Individuals can also face trauma due
to some emotional loss or grief. Thus its prevalence is very high and almost everyone faces some
kind of trauma in their life for short or long duration. The complex trauma can affect the physical
as well as mental development and ability of individuals (Sfantou and et.al., 2017). If not treated
it can cause long term disabilities or even self-harm tendencies. The development process
particularly for children experiencing trauma can be stopped. For individuals who faces
interpersonal violence are at more risk of facing traumatic experience. Thus it is very essential
that individuals facing any kind of trauma emotional or physical must seek help form health or
social care services or from their family members. Re-traumatisation can occur if individuals
have not completely recovered from trauma or if they are regularly exposed to such situations. It
can be treated by accessing professional help for healing traumatic experience.
8. Key principles
The first key principle of trauma care is that service provider must understand the
significance and cause of trauma. They must not be judgemental about the patient. During care
practices it must be assured that no physical or psychological harm is caused to patient. While
interacting with trauma patient’s cultural beliefs must also be taken into consideration because it
can affect the comfort level and communication with patient. There must be collaboration
between patient, their family members and service provider so that healthy and supportive
relationships can be fostered (Pomare and et.al., 2019). During the care practice it is the
responsibility of the professionals to ensure that autonomy and privacy of patient is maintained
and they are assured that they can be recovered by means of safe and quality practices. Though
trauma persons are suffering from psychological issues but they must also have right to choose
the best decision for their safety and recovery.
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9. Attitude towards interpersonal violence
The most common attitude towards individuals suffering from interpersonal violence is
that they might have done something wrong and thus they deserve violence or punishment. In
some traditions or culture, it is assumed that some groups such as children or women or disabled
are weaker and thus they can be easily targeted for violence (Sfantou and et.al., 2017).
Particularly in cases against women it is assumed that men have right to harm women and it is
duty of women to silently face the pain. Thus such violence is totally accepted by some sections.
This kind of attitude has negative impact on care quality because with acceptance to
interpersonal violence people are not allow to access the care services.
10. Role of flashback and triggers
The flashback or triggers can increase the anxiety and pain of person. They may begin to
become suspicious for every one and in the wake of fear and stress can also become physically
violence for themselves as well as for others. In the case when a person undergoes into re-
traumatisation then it can make them completely broken emotionally. It can have vital impact on
their mental health and they can undergo into permanent and non-reversible psychological
damage. For the persons who have higher tendency of being victim again (re-victimisation) used
to live an abnormal life which is full of constant fear and stress. They may experience tendency
of become too violent or too isolated from others.
11. Link between self-harm, interpersonal trauma and suicidality
There has been strong relation between interpersonal trauma and self-harm. The regular
fear or flashbacks or traumatisation can make individual panic and anxious to an extent that they
may cause harm to themselves in order to protect themselves from flashback or re- victimisation
(Watson and et.al., 2020). It is also possible that individuals may develop tendency of self-harm
when they are traumatised. In order to express the anger people may begin to harm themselves.
12. Nature of trauma
Traumatic event may be defined as the experience of witnessing death, sexual violence,
injury or emotional loss. Events such as long term illness, lack of emotional support, separation
from the love ones and wars which leads to injuries can be potential reasons for causing a
trauma. Certain events such as wars or conflicts or lack of emotional support in childhood can
also pass from one generation to other. When individual experience any trauma and when they
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observe or re-experience the same trauma again then they may face its serious implications in the
form of self-harm or severe psychological consequences (Adams and et.al., 2018).
13. Impact of trauma
Traumas can affect all dimensions of wellbeing and health. It can develop anxiety, stress
induced chronic health conditions as well as self-harm tendencies. The regular exposure to fear
and loneliness also make individuals vulnerable to mental health issues. Due to trauma
individuals always live in fear and thus they are always afraid of expressing their needs. It also
affects the relationship of people with their service providers. Traumatised people does not find
it easy to trust service provider as well and thus professionals needs more holistic approaches for
ensuring quality and safe care practices.
14. Practices of trauma informed care (TIC)
TIC aims at providing safe and trustworthy environment to individuals so that people can
overcome their fear and trauma. Thus these are key principles in care practices. The approach
also aims at working in collaboration so that trauma patient can be empowered and vicarious
trauma situations can be minimised by means of support from others (Becker-Blease, 2017). For
promoting the TIC at workplace individuals are encouraged to build a cooperative environment
in which each individual feels safe and comfortable. To encourage trauma patient for accepting
change they must not be forcefully imposed decisions. Instead professionals must communicate
and win their trust for applying interventions.
15. Mitigation strategies for AOD issues
The first mitigation strategy which can be used with individuals dealing with AOD issues
is education and awareness programs. People must be regularly informed about the adverse
implications of alcohol and how they can be controlled. For this purpose, emotional support from
family and friends can be very crucial. Thus service providers must ensure that AOD mitigation
strategies involve the community role (Coimbra and et.al., 2020). It is also recommended to
control and monitor the event which can encourage the consumption of drug. The engagement of
patient in more productive work and use of counselling and anti-drug therapies can also help to
cope up with the risk factors associated with AOD.
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REFERENCES
Books and Journals
Coimbra, R. and et.al., 2020. European Society of Trauma and Emergency Surgery (ESTES)
recommendations for trauma and emergency surgery preparation during times of
COVID-19 infection. European Journal of Trauma and Emergency
Surgery, 46(3), pp.505-510.
Becker-Blease, K.A., 2017. As the world becomes trauma–informed, work to do.
Adams, R.D., and et.al., 2018. Beliefs and expectations of rural hospital practitioners towards a
developing trauma system: A qualitative case study. Injury, 49(6), pp.1070-1078.
Watson, M.F., and et.al., 2020. COVID‐19 interconnectedness: Health inequity, the climate
crisis, and collective trauma. Family process, 59(3), pp.832-846.
Sfantou, D.F., and et.al., 2017, December. Importance of leadership style towards quality of
care measures in healthcare settings: a systematic review. In Healthcare (Vol. 5,
No. 4, p. 73). Multidisciplinary Digital Publishing Institute.
Pomare, C., and et.al., 2019. A revised model of uncertainty in complex healthcare settings: a
scoping review. Journal of evaluation in clinical practice, 25(2), pp.176-182.
Pilotto, A., and et.al., 2017. Three decades of comprehensive geriatric assessment: evidence
coming from different healthcare settings and specific clinical conditions. Journal
of the American Medical Directors Association, 18(2), pp.192-e1.
Elliott, J., and et.al., 2018. Coordinating care for older adults in primary care settings:
understanding the current context. BMC family practice, 19(1), pp.1-10.
De Marchis, and et.al., 2019. Identifying food insecurity in health care settings: a systematic
scoping review of the evidence. Family & community health, 42(1), pp.20-29.
Woo, B.F.Y., Lee, J.X.Y. and San Tam, W.W., 2017. The impact of the advanced practice
nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in
the emergency and critical care settings: a systematic review. Human resources for
health, 15(1), pp.1-22.
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