This study attempts to conduct a qualitative analysis of the efficiency of mental health care homes in the UK. The study will be based on semi structured interviews of some residents in one such institution in Manchester Suburbs, aged between 10 and 18. A detailed literature review will also be carried out on the topic.
The study aims at pin pointing major problems which young residents of mental health homes are facing. It also aims at highlighting the hindrances faced by young males while living in a residential home with reference to what they have already gone through. It is hoped that this study will come in useful for such facilities to improve their services in the future.
It is the duty of mental health care homes to assess and evaluate their patient services from time to time and to inform the authorities about them so that some action might be taken for improvement.
Mental health care residencies in UK have a lot of limitations. These include lack of well trained staff, a general lack of empathy among the staff, lack of proper resources to cater the special needs of its residents and lack of proper communication with the residents. These problems are even more enhanced when it comes to male patients. Males usually don't contact social support systems such as residential mental health care programs unless and until they feel that now their situation is out of their control. This magnifies the problems because males in such institutions are usually less than females, but are more chronic.
Since this is a qualitative study, it will employ qualitative methods of data collection. Best method for such a study is that of semi structured interviews, because such a schedule provides an opportunity to the interviewer to obtain maximum information of diverse nature out of the subject.
In the Information bulletin (2007) of Centre for health service development, the Author states:
'Semi-structured interviews focus on a list of key themes or questions that the interviewer wants the respondent to address'.
This is a very suitable method of data collection for this research since it attempts at exploring the topic. The researcher is not looking for any specific answers; rather an attempt is being made to find out whatever there is to know about the effectiveness of mental health care residential institutes for males, and to have an insight of service user perspective.
Literature Review:
Mental health problems can affect the whole life of individuals. Many studies have been conducted in the past, investigating different issues related to mental health. Following is a review of some such studies:
Franz and Barker (2009) conducted a study to identify different Barriers to Care for Primary Care Physicians Treating Patients with Alzheimer Disease. They concluded that the main problems were access to and communication with mental health specialists, poor reimbursement policies, and uneven geographic distribution of well trained staff in such facilities.
According to the World Health Organization:
'Gender bias occurs in the treatment of psychological disorders. Doctors are more likely to diagnose depression in women compared with men, even when they have similar scores on standardized measures of depression or present with identical symptoms. Gender differences also exist in patterns of help seeking for psychological disorder. Women are more likely to seek help from and disclose mental health problems to their primary health care physician while men are more likely to seek specialist mental health care and are the principal users of inpatient care'.
There is considerable amount of bias against people with mental health problems among the health service providers. As cited in the 'Science daily', Dr Alex Mitchell and his team conducted a study in 2009 to investigate hindrances in access to proper mental health care services. They found out:
'Despite similar or actually more frequent medical contacts, there are often disparities in the physical healthcare delivered to those with psychiatric illness with frankly poorer care offered to (or accepted by) those with pre-existing mental health problems.'
Patients are also a bit biased about mental health issues. They usually avoid seeing a mental health professional. Many of them address their mental health problems to their physicians rather than some mental health specialist. Vivian Kovess and colleagues conducted a study in 2007 to investigate the motivating factors in seeking professional help for mental health issues. They found out that:
'More than half of the sample would see their general practitioner first and often would continue with the general practitioner for follow-up. Mental health professionals were mentioned far less than general Practitioners'.
They also found out that factors like age, education and social support also affect the seeking of professional mental health services .they concluded: 'General Practitioners are often the point of entry into the mental health care system and need to be supported. Public information campaigns about mental health care options and treatments are needed to educate the public, eliminate the stigma of mental illness and eliminate prejudices'.
Due to gender roles assigned by society, among patients with mental health problems, women are more likely to report as compared to men. In 2009 a research was conducted by Bader and Sinha. Their study was manifold and was conducted on an Iraqi sample. One of their many findings were:
'Interviewees reporting displacement as a cause for needing mental health services were twice as likely to be female'.
HARP conducted a DH funded study in 2003. Its purpose was to identify Bridges and Barriers into mental health of asylum seekers. They concluded:
'The majority of the male participants in the community consultations felt that men in their country of origin faced specific pressures that did not facilitate the self-acknowledgement of emotional or mental health problems and that early socialization in most cultures did not encourage men to talk about their problems'.
A study (as cited in Dr Anderson Stanciole's article) on 'Quality of and access to health care services' was conducted by HEALTH QUEST under the European Commission. This was aimed at analyzing the barriers of access to mainstream health care services for people at risk of social exclusion. Eight countries were studied in depth. They found out that there was a very complex situation in providing health care facilities to migrants. One issue was of multicultural setting. The migrants had communication issues. They couldn't understand instructions or tell their problems properly. Second problem was that the professionals had no information of their medical history and also no way to attain it. So, along with bias, cultural issues like language and brought up style also pose a barrier in providing health care services.
Sometimes the mental health providing facilities have so complicated procedures of admission, that the help seeker is discouraged automatically.
"A key challenge some groups of asylum seekers face is correctly undertaking the process of applying for protection". (Guylim Croucher 2007)
A study by Gordon Paul, conducted in 1988, cited in Neal & Davison (Ninth edition) suggests that even in the best residential mental health care homes, the Patients do not have optimum contact with therapists or psychologist. The clinical staff spends what is even less than one fourth of their total working hours with the patients.
Discussion:
Service provided to young males in mental health care institutions in UK is not as good as it is expected to be.
"We have seen many cases where the provision of health care to asylum seekers has fallen significantly short of what would be accepted as a minimum standard of care under international human rights standard"
(Joint Committee on human rights: evidence. P.173)
Mental health is a very vast term and residential mental health care professionals need to focus on all the aspects of mental health.
For instance, some of the males who were interviewed during the study pointed out that they had difficulty in reaching the mental health care professionals. Residents in such institutes require proper guidance and counseling. They will not benefit from the facility if a professional is not available for them most of the time.
Some patients who are not native have also pointed out language issues. The residency should hire proper professionals and possibly an interpreter for such patients.
Bias among the staff was also reported in some of the semi structured interviews. If the professional mental health staff will be biased against people having mental health issues, then there is little chance for a life time betterment of patients. Such young males are already subjected to a lot of bias and criticism that can have a lasting effect on their lives. They deserve a bias free environment at least inside the facility.
One good thing about the mental health care institute is that the professionals over there arrange meetings with the patient's relatives and care takers from time to time to educate them about mental health issues that their dear ones are facing.
Conclusion:
In light of literature review and above discussion, it can be concluded that despite providing mental health care and facilities to young males, mental health care residential homes need to be improved. Hiring of professional, un-biased staff is required.
Availability of and access to well trained psychologists and psychotherapists is a must. Young males are more open to therapy as compared to medication, so counseling sessions should be encouraged.
Some residential mental health care centers do not fulfill the needs of the patients. They should increase their funding to meet the basic needs of the residents.
On the whole it can be said that these institutes have both, merits and demerits. Some issues like biased attitude, availability of professionals, enough psychotherapy sessions and physical requirements in such facilities need to be addressed.
References:
Anderson E. Stanciole, Manfred Huber; 2009. Access to health care for migrants. Policy Brief. (Internet). Available at: http://www.euro.centre.org/data/1254748286_82982.pdf. (Accessed: 20 may 2009)
Bader F, Sinha R; 2009. Psycho-Social health in displaced Iraqis'. Pubmed. (online). Available at : http://www.ncbi.nlm.nih.gov/pubmed/19806555. (Accessed: 20 may 2010)
Croucher, G. 2007. The challenge of helping asylum seekers. ASPA Conference. (Internet). Available at: http://docs.google.com/viewer?a=v&q=cache:tdsC0kpPXDAJ:arts.monash.edu.au/psi/news-and-events/apsa/refereed-papers/au-nz-politics/croucher.
(Accessed: 20 May 2010)
Fraz, C.E & Barker, J.C 2009. When help becomes a hinderence. American Journal of Geriatic Psychology.(online).Abstract from Geriatic Psychiatry Database. Available at: http://journals.lww.com/ajgponline/Abstract/publishahead/When_Help_Becomes_a_Hindrance__Mental_Health.99920.aspx. (Accessed 20 may 2010)
Gender disparities and mental health: The Facts. World Health Organization.(online). Available at: http://www.who.int/mental_health/prevention/genderwomen/en/ (Accessed: 20 May 2010)
HARP, 2003. DH. (Internet) Available at: http://www.networks.nhs.uk/uploads/06/03/refugeeconf/lane.ppt (Accessed 20 May 2010).
Joint Comitee on Human Rights.Provision of health care 10th report of session 2006-2007. (Internet) Available at: http://books.google.com.pk/books?id=p_m-YfqqPmsC&pg=PA173&dq=problems+faced+by+mental+health+care+seekers&hl=en&ei=2KD1S5ycGMufrAeNgIX3Cg&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC4Q6AEwAA#v=onepage&q=problems%20faced%20by%20mental%20health%20care%20seekers&f=fals(Accessed: 20 may 2010)
Mitchell, A 2009. 'People With Mental Health Problems Receive Inadequate Medical Care'. Science Daily. (internet).June 4, 2009. Available at: http://www.sciencedaily.com/releases/2009/06/090602083721.htm
(Accessed: 20 May 2010)
Neal & Davison 1997. Abnormal Psychology. (Ninth Edition). Available at: www.wiley.com/college/davison (Accessed: 21 may 2010)
Taylor & James 1977. Secret of life album. (Internet). Available at: http://mentalhealth.about.com/cs/stressmanagement/a/whatismental.htm (Accessed 21 May 2010)
Viviane,K & Delphine,S 2007. Motivating Factors for Mental Health. BMC Public Health. (Online). Available at: http://www.medscape.com/viewarticle/563591. (Accessed: 20 May 2010)
Qualitative research methods. Information Bulletin, CHSD.(Online).Vol I. available at: http://libweb.anglia.ac.uk/referencing/harvard.htm?harvard_id=34#34
(Accessed 20 May 2010).
