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Social Policy On Community Care Mental Health Provision Social Work Essay


Social policy is a governments application for welfare development and social protection completed in the community. The Margret Thatcher's conservative administration and Tony Blair's labor administration had different approaches towards the issue of community mental healthcare policy. The policy made vital steps into the right direction but met obstacles along the way complicating its sustenance and achievement of goals. Generally it is believed that the policy didn't meet its desired goals of helping the mentally ill patients in the communal setting.

Community care is the British policy of, deinstitutionalization treating and looking after mentally disabled people in their homes rather than within an institution or hospital. Institutional care was the mark of widespread criticism prompting the federal government of Margaret Thatcher to adopt a new provision of community mental health care. This was following the Audit Commission published a report called making a Reality of Community Care which outlined the advantages of domiciled care (Baker, 1986).

Social policy is influenced by lots of factors that include needs of the population; demands from groups, priorities of the city, specific societal issues and critical incidents. The major intend of social policy on community care is to keep people in their homes where possible, rather than giving them care in other institutions. "It was almost overlooked that policy was the best option from a humanitarian and moral perspective. It was also thought that the policy would be cheaper" (Baker, 1986). Therefore this paper will concentrate on Margaret Thatcher's conservative government and Tony Blair's labor government to see how their different policy approaches have impacted after the provision of community care of mental health. The paper may also be analyzing the advantages and disadvantages of both parties to ascertain where they have got helped and where they have got displayed poor services. Finally the paper will conclude giving an insight on the impact of the current social policy on community mental health care.

Margaret Thatcher's administration and community healthcare policy

When Margaret Thatcher came to power in 1979, she managed to get clear that she would reduce public expenditure and make drastic changes for the betterment of the united states. She was acutely aware that Britain's welfare state system needed urgent restructuring as it was costing the country excess amount in the case putting the country into financial free fall. Between 1979 and 1990 she successfully introduced changes to social policy, the organization and delivery of services and the role of their state welfare provision. Because of this the era became known as Thatcherism.

In 1983 the Mental Health Act was introduced by Margaret Thatcher's government to put set up safeguards for individuals within the hospital system. Section 117 of that act imposes a duty on district health authorities and social services departments in conjunction with voluntary agencies, to ensure that after Care service is provided for people after discharge from hospital.

The approach taken by the conservative government to social problems was known as the marketplace liberalism or neo-conservatism, which was very influential in the manner it operated. Thatcher believed in creating a 'market economy' allowing people to create their own wealth in the case caring for themselves and their own families without the interference of the government. This approach was evident in medical care and community care reform brought on board in 1990. The purpose of this act was to standardize and improve community care and establish duties for the English Health Authority. This piece of legislations not only led just how in developing the new 'internal market' system in health insurance and social care but divided the business of care into "purchasers and providers of care" thus creating an artificial market to increase efficiency. After that it caused a major development in the 1989 White Paper (Caring for people) as a reply to the Griffins report. This is effectively putting the duty firmly at the doors of medical authorities and families thus freeing up additional money to be placed back into the machine. However, due to flaws within the assessments, insufficient funding and the failing of community care, people were being discharged into the community without proper supervision, care, support and help. As a result of this some individuals became homeless finding yourself on the streets although some are being cared for by overstretched family with financial difficulties.

Despite of the positive approaches on Margaret Thatcher's implementations she had some bad sides too. As a result of these policies, lots of changes started to come in the society, where members of families who suffered mental health had to rely on children to take care of them, which consequently put burden about them triggering isolation, social exclusion also to some degree extreme poverty. Due to these negative impacts and lacking of an effective system set up for home care (proper monitoring and provision of communal health care officials to take care of patients at home), Margaret Thatcher's government was unable to adequately address the issue of community mental healthcare.

Community mental care act 1990

In the act passed in 1990 on community care health services (NHS ACT 1990), individuals with mental problem difficulties could actually stay at their homes while being treated. This state of affairs raised concerns especially after a lot of people with mental health issues were involved with violent behavior against members of the general public. Even though the city has recorded a few murder cases caused by people having mental health difficulties, it is more probable that healthy individuals can as well attack the mentally ill.

Mental Health is actually portrayed in the media as negative but nothing has ever really been highlighted about the way people who have mental ailments are being put through attacks and abused on a daily basis from everyone. It is sad to notice that no person seems to take account of the plight, not the federal government. In order much as this act made it easy for patients to be personally assigned specific community staff to monitor and care for them, it posed a significant risk in the community. These patients were under threat of being abused, attacked, neglected and untreated making the act look inefficient. Mental health patients eventually became uncontrollable ending up on the streets. These issues are usually prompting arguments between the public administration, health services officials and the department of social service on who should be held accountable of the whole matter. One particular lack of help detrimental effect was when Christopher Clunis, a mentally ill patient, stabbed and killed Jonathan Zito, an innocent person, in Finsbury Park tube station. This may have been averted had there been proper home care and supervision provided. These types of cases are common but there appears to be hardly any done to alleviate such tragedy.

There should be no contentment therefore in ensuring good quality community care for patients with mental problems. "The main challenges to the policy of the rundown traditional psychiatric hospital will be the concern that homelessness has been increased among the list of mentally ill and the fear of public safety because of homicides by psychiatric patients" (Mathews, 2002). Other issues involve appropriate assignment of social personnel who would be mindful and monitor these patients. During the last couple of years activists towards community care have diverted their aggression to the concern of public safety. These has prompted the federal government of Britain to put into practice a key review on mental health policy. It is also apparent that issues on public safety are the ones driving the review.

Tony Blair's government's approach on community mental health care

When Tony Blair was elected the people had high expectation that he'd devote order the NHS system. Although he didn't have any viable alternatives to the prevailing policies of Margaret Thatcher, he ridiculed them. He even used the same technique to in his campaign producing a NHS historian, Charles Webster, calling it "the meanest spending package on the health service since the second world war". His promise to the people of the united states was that he'd not cause any structural upheaval to the NHS but he'd perform some reform which would be gradual involving consultation and experimentation.

Unlike the decentralization that Margaret Thatcher adopted in her era that was from the 'nanny state' mentality, the approach adopted by Tony Blair was that of the democratic society. Despite his belief that the government should play a greater part in monitoring what goes on in the society and intervene when essential to ensure that fairness, he was tolerant with the thought of free enterprise.

It has been a decade since Tony Blair's government vouched that they would tackle the NHS mental health service with vigor promising that equal priority would be given to mental medical issues as that of heart disease and other ailments. This is exactly what was explained by the then health secretary Frank Dobson in 1999. The National Services Framework for mental health 1999 (a decade plan) promised seven standards of care and treatment, these standards included primary care, access to services, prevention of suicide and caring about careers.

Regardless of the the labor government under Tony Blair made some changes within the health service. His successor Gordon Brown is worse as he has not made much with the NHS. He set his sight on more cuts and closures which effectively caused more damage to an already damaged NHS. He has not completed the National Service Framework 1999 that had been promised by the labor government, so together they may have failed to effectively implement the policies even though they have been around in power considerably long. Their failures are also manifested further as the national frame improve mental health deadline expired last month yet it still did not meet its targets. However the department of health announced a package of measures in January 2009 for the design and development of single sex accommodation within the health system. This will include a 100 million Privacy and Dignity Fund for improvements and adjustments to accommodations. The new initiative arrived to effect by April 2010 that was a big part of ensuring privacy needs of male and female patients are fully met.

Still some changes have been created by the two previous governments and their respective leaders (the Margaret Thatcher's conservative party (1979) and Tony Blair's 1997 labor party), based on the implementations of the Mental Health Act 1983 the NHS and Community Care Act 1990, and the National Service Framework Act 1999. Though it still appears that not much has been done to help especially members of the ethnic minority groups. You may still find disparities in the manner services are being distributed and how they are being treated as patients in comparison to their white counterparts. For instance, they may be discriminated against more and will be given higher dosages of anti-psychotic drugs or sometimes even placed into seclusion.

The Community Care Act 1990 was set up mainly as an inexpensive measure, thereby moving people who have mental medical issues out of hospitals in to the community. However, many people are still not receiving the necessary care that was promised by the government, although to some extent they may be being empowered when you are encouraged to be more proactive in their own assessment and care plans. Of late these provisions are ineffective as they don't meet the required specification.

The organization of health services concerned with mental problem was simple previously before the current NHS and social reforms arrived to play. The federal government was responsible of the NHS and managed fund allocation, functionality, and supervision of the health services. Local government played a very small role in the care for mentally ill individuals, there main was at housing and social work sustenance. Initially, it was the responsibility of sanatorium community divide.

In the 1980s important reforms were made to both the NHS and social services. These reforms were largely aimed at changing the management arrangements for delivering health and wellness care in the NHS and at reforming the community care of seniors provided by social services. Little thought was apparently given to the way the reforms would affect the care of mentally ill people. We think that these changes, each which on their own might have been valuable, have combined to damage provision of care, at least for severely mentally ill patients (Mathews, 2002).

Mental health policy defines the vision for the future mental health of the population, specifying the framework which is put in place to manage and stop priority mental and neurological disorders.

Therefore as shown in this paper the method of the social policy on community care and mental health should focus on communal mental health issues and generate solutions for curbing these predicaments. The principal goal of this policy is to identify the most readily useful and efficient measure to successfully address these issues. On other hand the bringing of new policies in the mental health sector has totally transformed mental community care provision. "Simple systems have been replaced with complicated organizational and financial structures requiring almost impossible feats by local health and social service staff to coordinate care for patients to whom continuity of care is crucial for his or her survival locally" (Mathews, 2002). Critical mentally ill folks are ensnared by these problematical issues. The formation of a community care authority that is localized which is in charge of the issue accessible could be the best solution.









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