Mental Health And Community Care Social Work Essay

Mental Health And corporation palm Social depart turn upIn this report I will discuss Mental wellness and corporation bearing, I will look at the historical s spot of society bid taking into consideration policies and that stemmed it and competing ideological perspectives that that has impact on it. I will further look at its benefits and shortfalls since its death penalty taking into accounts the impact of the 1990 NHS residential atomic number 18a occupy Act and current reforms. lastly I will discuss the process of poverty and friendly extrusion which affects roughly of these wad who suck in been discharged home as a provide.History of Community Care and ObjectivesDobson (1998) verbalise that Care in the corporation represented the major political change in amiable wellness fretfulness in the history of the National Health emolument (NHS)It was the solution both of social changes and political expediency and a movement outdoor(a) from the isolation of the genially ill in old Victorian asylums towards their consolidation into the companionship (Goffman 1961).The aim was to normalise the psychically ill and to remove the mug of a condition that is said to afflict one in four of the British population at some time in their lives.The of import push towards conjunction of interests bearing as we know it to mean solar day came in the 1950s and 1960s, an era which saw a sea change in attitude towards the treatment of the mentally ill and a rise in the diligents rights movement, tied to civil rights campaigns.The 1959 Mental Health Act abolished the distinction betwixt psychiatric and other hospitals and support the development of conjunction dole out. harmonise to Goffman, (1961) historically, flock who were designated as having a mental illness lived in confined institutional environments for years and had limited expectations for returning to the community.Community anxiety is used to get wind the various work forthc oming to help individuals manage their physical and mental health problems in the community which is the British policy for deinstitutionalisation. Duane (2003) defined deinstitutionalisation as process of replacing gigantic-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with mental disorder or developmental disability. These services include, for example, nursing or social work support, home help, day centres, instruction and supported accommodation.The Department of Health expresses the need to promote the development of a personal health plan of individuals, based on who they are, what they want and what their stack are. tally to DoH, Health is linked to the way people live their lives and the opportunities available to choose health in the communities where they live. There arrive at been major improvements in health and life expectancy over the last century and on the most basic measures, people are living longer than per petually before (DoH report, 2005).Rogers A and Pilgrim D (2001) stated that the ideological commitment to community care was associated with vague mood of achieving an cerebrationl society, prior to it being cause as a practical reality. Similarly Titmuss in the 1960s suggested that the flavor of community care invented a sense of warmth and human kindness, fundamentally personal and comforting Titmuss (1968). This early positive view exclamatory the idea of leaving the disabling environment of the institution behind and ushering in the enable possibilities of average living.According to Bulmer (1989), the first use of community care was in the part of mental health, as understanding developed of the negative consequences of institutionalizing mental patients in hospitals, and to discharge the ex-patients and mental handicap hospitals, and to discharge the ex-patients into the community, where they would live in hostel-type accommodation or in their cause homes and be cared for by a mixture of paid and personal carers, particularly in day centres and by nursing staff on the one hand and by members of their own families on the other.Community care in the past has always been a interracial economy, financed by both the state and by user charges and provided by impulsive welkin organization, commercial, for-profit organization, the state and the family. Alan Walker (1982, 1989) and Roy Parker (1990) have specifically intercommunicate the problem of defining community care and have pointed out that it has been in truth easy for one persons community care to be anothers institutional care. Community care has been a mixture of policies. To the health service each supply outside the NHS sufficients community care, therefore institution cast by topical anesthetic regimen constitute community care.The mixed economy of community care during the 1960s left wing academics, notably Peter Townsend (1962), make mournful request for the deinstitutionaliza tion of elderly and mentally ill people, whereas Titmuss (1968) has already sounded a cross off of caution when he referred to the way in which the status community care conjured up a sense of warmth and human kindness. All this false the main provider of community care to be the state.In some ways, the idea of community care in mental health ran counterpunch to the dominate trend within the NHS after 1948, which until recently, was centralised and hospital-dominated.Bulmer (1989) similarly emphasised that in recent years community care has broad means including the goal of providing comprehensive outreach, day and residential services and support for ordinary facilities within the locality. In principal at least community care now extends to social inclusion and the promotion of assess to facilities used by other people living in the community and the right and province of participation in local community acitivties.According to Pilgrim (2001) when the Labour brass came to power in 1997, it announced the need for rapid reform of mental health services based on the impression or cause that care in the community has failed. In 1998, the Health Secretary, Frank Dobson, stated that discharging people from institutions has brought benefits to some. But it has left many vulnerable patients to try and cope on their own. Others have been left to become a danger to themselves and a nuisance to others. A small however significant minority have become a danger to the public as well as themselves. Mind, along with many others, disagreed with the statement that community care had failed.These were based on concerns astir(predicate) control of risky behaviour which led to the spokes enquiry sideline the killing of a social worker (Isablel Shwartz) in 1984 by patient Sharon Campbell in Bexley Hospital. These were some of the limitations of care discovered and led to recommendation virtually post-discharge case management DHSS (1998). The report similarly noted the lack of any requirement on the part of services to identify vulnerable patients or provide individualised care plans, and for agencies with responsibilities for mental health to work unitedly.The interrogative sentence into the care of Christopher Clunis was also another reason why the community care needed a reform.Rogers and Pilgrim (2001) explained that inquiry examined the manner in which services failed to suffice adequately to Christopher Clunis, a young black man With a diagnosis of paranoid schizophrenia who stabbed a stranger (Jonathan Zito) at Finsbury Park undercover station. This highlighted a number of problems why the Labour government called for the reform of the community care policy because of the inadequate support for in the community with consummate(a) mental health problems.In 1999 The Government published theNational Service Framework NSF for mental health modern standards and service models for England. The NSF spelled out depicted object standards for mental health services, what they aimed to achieve, how they should be developed and delivered, and how performance would be metrical in every part of the country.(DoHCommunity care is the support by informal and formal carers of the elderly, the disabled and the mentally disordered groups in the community who are usually in their own homes rather than in institutions.According to Bulmer(1989)the ideas with which community care came about is due to the mixture of sociological propositions about the nature of modern community life, including personal ties between relative, friends, and neighbours.The Griffiths Report Community Care Agenda for ActionMargaret Thatcher invited Sir Roy Griffiths to produce a report on the problems of the NHS. This report was influenced by the ideology of managerialism. That is it was influenced by the idea that problems could be figure out by management. According to the report, Griffiths firmly believed that many of the problems facing the Welfare put forward were caused by the lack of strong effective leadership and management. Because of this previous work, which was greatly admired by the Prime Minister, Griffiths was asked to examine the whole system of community care.In 1988 he produced a report or a thou Paper called Community Care Agenda for Action, also known as The Griffiths Report.Griffiths intended this plan to sort out the mess in no-mans land. That is the white-haired area between health and social services. This area include the long full term or continuing care of dependent groups such as older people, disabled and the mentally ill.Basically he was saying that community care was not working(a) because no one wanted to train the responsibility for community care.Community Care Agenda for Action made six key recommendations for actionMinister of State for Community Care to ensure implementation of the policy it required ministerial authority.Local regimen should have key role in community care. i.e. Soc ial Work / service departments rather than Health have responsibility for long term and continuing care. Health Boards to have responsibility for primary and acute care. peculiar(prenominal) grant from central government to fund development of community care. specify what Social Service Departments should do assess care call for of locality, coif up mechanisms to assess care needs of individuals, on basis of needs design flexible packages of care to meet these needsPromote the use of the Independent sector this was to be achieved by social work departments collaborating with and fashioning maximum use of the voluntary and private sector of welfare.Social Services should be responsible for registration and inspection of all residential homes whether run by private organisations or the local authority.The majority of long term care was already being provided by Social Services, but Griffiths idea was to put community nursing staff under the control of local authority rather than H ealth Boards. This never actually happened. The Griffiths Report on Community Care seemed to back local government whereas, the health scorecard reforms in the same period, actually strengthened central government control. reworAccording to the Mind, In 1989 the government published its response to the Griffiths Report in the gabardine Paper Caring for People. It set out a framework for changes to community care, which included a new funding structure for social care. This would tell the beginning of the purchaser/provider split whereby social services departments were encouraged to purchase services provided by the independent sector. The report promoted the development of domiciliary, day care and respite services to enable people to live as independently as possible in their own homes. Other objectives included tonus initiatives around assessment of need and case management. Carers needs were turn to by prioritising practical support initiatives for them. The next decade saw a dramatic increase in the number of voluntary and private sector service providers.The impact of the community care reformsThe community care reforms defined in the 1990 Act have been in operation since April 1993 Glennester, (1996).They have been evaluated but no clear conclusions have been reached. A number of authors have been extremely critical of the reforms. Hadley and Clough (1996) select the reforms have created care in chaos (Hadley and Clough 1996) They claim the reforms have been inefficient, unresponsive, offering no choice or equity. Other authors however, are not quite so pessimistic.Means and Smith (1998) claim that the reformsintroduced a system that is no better than the previous more bureaucratic systems of imagery allocationwere an excellent idea, but received small-scale understanding or commitment from social services as the lead agency in community carethe enthusiasm of local authorities was undermined by vested professional interests, or the service lega cy of the last forty yearshealth services and social services workers have not worked well together and there have been few multidisciplinary assessments carried outin reality little collaboration took place except at senior management aimthe reforms have been undermined by chronic underfunding by central governmentthe voluntary sector was the main beneficiary of this attempt to develop a mixed economy of careThe Care Programme Approach (certified public accountant )According to Rogers and Pilgrim (2001) there was a light with the introduction of the Care Programme Approach in 2001. It introduced an attempt to improve and standardise the delivery of community care services. The CPA set out a practice framework for health authorities in England, giving guidance on how they should fulfil their duties as set out in the National Health Service (NHS) and Community Care Act 1990. The programme contained four key elements namely,Arrangement for assessing the health and social needs of re cipients of specialist mental health services,The regular use of care plan that identified which provider was responsible for different aspects of a persons careKey worker who would monitor and co-ordinate care for the individual unfluctuating review and if appropriate changes to the care plan.Through the introduction of the CPA, patients identified at risk have been required to be kept on charge register (DH, 1995). The idea was that all patients in contact with services would be subject to CPA but that some require greater interrogation and service input. Pilgrim et al stated that the Labour government inherited this mode in 1997 and continued to endorse it as the mainstay of good quality community-based management for people with mental health disorder, despite the concept of community care being problematic by health ministers and controversial cases such as that of Christopher Clunis.Social inclusionSocial exclusion occurs when,marginalised by society, people are not ablepla y a full andequal part in their community.Many people who experience mental grief experience stigma and discrimination, and live in poverty. They may find it austere to find adequate housing or access employment. The net result is that people can become seriously isolated and excluded from social and working life.Following the publication of the Social Exclusion Units (SEU) report into mental health and social exclusion, the National Institute for Mental Health in England (NIMHE) have been charged with implementing the 27 action points listed in the SEU report. NIMHE are working on a number of policy areas including employment, education, social networks, housing and homelessness, direct payments, income and benefits. (DoH 1998)