Social_Problems_-_Mental_Health_Issues_in_Australia

1. Describe how this group experiences social exclusion and inequality. The group that I have chosen to focus on is people with disabilities, and in particular people with mental health issues. The National Survey of Mental Health and Wellbeing (ABS, 2007) found that one in five of Australian adults experience mental illness in any one year. Based on these rates, we can conclude that over 4.2 million Australians had a mental disorder in the past 12 months including conditions such as anxiety, depression and substance abuse. The social problems faced by these people with can be varied, however the report (ABS, 2007) states that the major social factors highly associated with having a mental disability are unemployment and homelessness. These factors are somewhat integrated and are the main cause of social exclusion and barriers to equality for people experiencing a mental disability. They can be excluded from employment which in turn gives them inequitable opportunities to access adequate housing. When it comes to unemployment levels those who suffer from a mental disability are the most seriously disadvantaged. Of those suffering from psychotic disorders, the unemployment level is around 75 per cent, and for those suffering anxiety or depressive disorders, the rate is 47 per cent (Richardson, 2010). It may be very difficult for those suffering mental disabilities to gain employment due to employer’s perceptions of mental illness and ability to undertake work consistently. There is also a strong link between unemployment and homelessness. In a report commissioned by the Brotherhood of St. Laurence (Lawler & Perkins, 2009) it was found that 60 per cent of homeless people have a mental illness and are reliant on the disability support pension. This group of people often find that they are excluded from affordable and secure accommodation as they cannot find housing within their means. The report found that most accommodation is far above the pension rate which automatically discriminates against these people, and that the only affordable accommodation is shared rooms type which then creates inequality issues such as lack of privacy and security concerns. 2. What social and cultural factors contribute to this group’s experiences' There are many social and cultural factors which contribute to the experience of people with mental health disabilities in turn can determine quality of life. However, the main social barrier faced by this group is their tendency to have inadequate access to health care services. The National Survey of Mental Health and Well Being (ABS, 2007) found that only 38 per cent of those surveyed with a mental disorder had accessed health services. This suggests that 62 per cent of people with a mental disability are either receiving no assistance, or are depending on informal sources of support from carers and families. The Mental Health Council of Australia (MHCA, 2004) believes that although many of the barriers will be shared by people living with other disabilities, there are additional difficulties faced by those people living with mental illness who come from a culturally and linguistically diverse background, who live in remote and rural areas, and who are living with additional disabilities. For example: a. People living with mental illness are more likely to have a low income, be reliant on a pension, or live in poverty, and face greater barriers to education about health care issues. They are often unaware of how to access mental health care or even what options are available. b. People with a disability also face high costs of health care due to increased need to seek health care, increased costs of specialists, and additional costs of medication. In some cases the most appropriate drugs for a mental disorder are not affordable as they are not covered by the Pharmaceutical Benefits Scheme. c. People with mental illness are often limited to health providers who bulk bill and may not be able to access specialist services due to financial concerns. d. People living with mental illness often face significant difficulties in travelling to health services due to either their illness or the side effects of medication. This is a particular problem in remote and rural areas where public transport is limited or unavailable. e. People living with mental illness may also experience difficulty in absorbing complex information due to illness or medication side-effects, which can affect their understanding of the illness, treatment, and monitoring of their health. In summary, mental illness often goes undiagnosed and untreated in people with physical or intellectual disability due to the social factors that produce inadequate access to mental health services. 3. What is the effect and consequence of this inequality and exclusion on the health and wellbeing of: The Individual People with mental illness have more physical illness than the general population. Coghlan, Holman & Jablensky (2001), said that people with mental illness are at a higher risk of having a physical illness, and of that physical illness going undiagnosed and untreated. The consequences of this are severe. For example: They found that death rates from all main causes amongst people with mental illness are 2.5 times higher than the general population, yet hospitalisation rates are lower for many conditions. The Family The families of people with mental health issues also face enormous pressures which often go unseen. The National Family Carers Voice conducted a survey of over 1000 carers in 2004 (MHCA, 2004) which identified serious consequences for family and carers, in particular. The lack of services available for family carers themselves is a significant problem, and as a result their health and quality of life are severely impacted upon. Insufficient support for family and carers can also have a flow on effect to the health and welfare of children of parents with mental illness and other family members. The Community An important aspect of social inclusion is the opportunity to get a job. Having employment provides benefits like higher income and greater self-esteem, but it can also help connect people with the community by establishing friendships and support networks. However, the rate of employment of people with disability and mental illness is still well below that of people without disability. In 2003, the labour force participation rate of people with disability aged 15 to 64 years was 53.2 per cent and the unemployment rate was 8.6 per cent, compared to 80.6 per cent and 5.0 per cent for those without disability (ABS, 2003). Also, education participation rates for people with disability are lower than for people without disability. In 2003, 29.6 per cent of people aged 15 to 64 years with reported disability had completed Year 12, and 12.7 per cent had completed a bachelor degree or higher, compared to 49.3 per cent and 19.7 per cent for those without disability (ABS, 2003). Additionally, mental illness is far more prevalent in people detained by the police for criminal behaviour than in the general community and it is unfortunate that these people end up in jail instead of receiving mental health care. Of the 385,100 people who reported they had ever been imprisoned in 2007, 41 per cent had a mental disorder (ABS, 2007), which is more than twice the number of people who reported they had never been imprisoned. Research has also indicated that the accompanying risk factors of mental illness such as poverty, unemployment and lack of family support lead the mentally ill to situations of high exposure to substance abuse (Draine et al., 2002). The research indicates that people with a mental illness are at a higher than average risk of committing non violent crimes, not because of mental illness, but because their condition leads to a higher than average prevalence of substance abuse which is the causal factor that leads to committing the crime. 4. Give an example of one social policy that impacts on this group In 2009, the Rudd Government released the National Mental Health and Disability Employment Strategy (DEEWR, 2009) which sets out a number of priorities to help Australians with disability, including mental illness, into employment. A major focus is the importance of education and training and the role of employers in increasing employment opportunities for people with disability. The strategy is part of the Government’s Australian Social Inclusion Agenda which aims to address the barriers faced by people with disability, including mental illness, that make it harder for them to find and maintain employment. Some of the main elements of the strategy are as follows: a. Establishing a new Disability Employment Services to give job seekers immediate access to personalised employment services better suited to their needs of people with a disability. b. Better and fairer assessment and support for people with disability by changing the assessment process to ensure that people on Disability Support Pension who want help to find work will no longer have to worry about losing their disability pension which has been the case in the past. c. Establishing an Innovation Fund which will help more people with disability into jobs by funding innovative community projects that remove barriers to employment. d. Developing an enhanced JobAccess website to increase awareness among employers of the services available to support both people with disability and mental illness. e. Developing a National Disability Strategy to increase the social, economic and cultural participation of people with disability, to eliminate the discrimination they experience and to improve disability support services for families and carers. 5. Consider your chosen group in relation to one major social institution. The Legal System. People with a mental health disability have differing needs and many barriers when it comes to accessing the legal system which may mean they do not have equal access to advice and representation which results in higher levels of incarceration (ABS, 2007). Some of these include: * People with a mental illness tend to have lower levels of participation in education and employment, and they lack basic knowledge of legal issues and the ability to find out about this information (Karras et al, 2006). * A Department of Family and Community Services study on barriers to service provision for people with mental illness found that not turning up to appointments with health professionals was a particular problem for this group. This could be due to disorganisation, or effects of medication (Szirom, King & Desmond, 2004) * The symptoms of mental illness can make it difficult for a person to communicate easily with others and for lawyers to understand what their client’s problem is and what they require. Communication problems can act as a barrier to accessing legal assistance, as a solicitor may not be able to gather the right information from a client and therefore may not be able to assist them effectively. (Karras et al, 2006). * Some mentally ill clients can be difficult, and in some circumstances exhibit quite threatening behaviour. If a legal service provider does not feel physically safe with a client, they may not be able to provide them with legal assistance. (Karras et al, 2006). * People with a mental illness are less likely to be able to afford private legal representation and to be dependent on legal assistance and advice from Legal Aid. However, a number of studies (NCOSS, 2004) have found that Legal Aid is under-resourced and that the limited availability of legal aid may prevent some people with a mental illness from accessing legal advice and representation. In some states in Australia these barrier are recognised and addressed once the person gets to court. In NSW for example, the Statewide Community and Court Liaison Service was set up to provide psychiatric expertise and advice to magistrates when mentally ill people appear in court. The aim is to divert group of people to appropriate treatment programs and to prevent unnecessary imprisonment. It is provided in 7 metropolitan and 7 rural courts in NSW and is available to those who are charged with relatively minor offences at the local Magistrate’s Court. During the first 14 months of operation, approximately 1,600 people were referred. 71 per cent were found to be mentally ill or disordered, and more than half were diverted to community-based mental health services rather than prison settings (Greenburg & Nielson, 2003). 6. Identify one organisation that is working to address the social exclusion or inequality experienced by your chosen group and answer the following. The organisation I have chosen is the Mental Health Council of Australia. What activities are undertaken by this organisation to address the exclusion' The Mental Health Council of Australia (MHCA) was established in 1997. It is a national body that represents and promotes the interests of the Australian mental health sector. It is committed to addressing exclusion by undertaking the following activities:  Educating Australians on mental health issues.  Conducting research into mental health issues.  Reforming Australia's mental health system. The mission statement for the organisation is “ To ensure all Australians have accessible, affordable, quality mental health services and to provide national leadership on mental health reform and policy.” How effective is this organisation in dealing with the exclusion on an individual level a community level. The MHCA addresses exclusion on many levels. For example in the MHCA Annual Report 2008-2009 (MHCA 2009) the organisation promoted advocacy for people with mental health issues at many different levels. Some of these directly affected the individual and their right of access to services, eg. working with the insurance industry to increase access to insurance for people with a mental illness. Others were aimed at community projects such as supporting increased community mental health organisations through a grants program. At a policy level they monitored and evaluated the Government’s national mental health reform agenda which will impact both individuals and community. I believe that this organisation is effective in dealing with exclusion as it has credibility with the Australian Government, the media and the Australian community and is an accountable organisation which meets governance standards. Give details of one social policy that the organisation utilises to shape its work' On 17 March 2010 Government launched the National Compact between the Australian Government and the Third Sector which is a social policy that sets out how the government and not-for-profit organisations will work together to improve the lives of Australians. The aim of the National compact is: “…. to work together to improve social, cultural, civic, economic and environmental outcomes, building on the strengths of individuals and communities. This collaboration will contribute to improved community wellbeing and a more inclusive Australian society with better quality of life for all.” Crosbie, (2010) The Mental Health Council of Australia (MHCA) is a member of the National Compact Sector Advisory Group which advised the Government on an implementation strategy and will be part of the movement to implement the Compact across Australia, so effectively will shape the work that the MHCA does in the future. The CEO of the MHCA (Crosbie, 2010) said that the Compact would guide the way government and communities relate to each other and that it would strengthen the role of both individuals and organisations and the way they connect to each other to support health and well-being. He said, “It is therefore a great honour to be part of the movement to implement the Compact across Australia. I look forward to contributing to real change in the way we all value and engage with our communities. Through the Compact I hope we will be able to both acknowledge and build on the wonderful work”. References: Australian Bureau of Statistics (ABS). (2003). Disability, Ageing and Carers: Summary of Findings, 2003, ABS Report Number 4430.0, Canberra: ABS Australian Bureau of Statistics (ABS). (2007). National survey of mental health and wellbeing: summary of results. ABS CatNo. 4326.0. Canberra: ABS Coghlan R, Lawrence D, Holman CDJ, Jablensky AV, (2001) Duty to Care: Physical illness in people with mental illness. Perth: The University of Western Australia. Crosbie, D, (2010). National Compact will boost Third Sector and social inclusion. Media Release, Mental Health Council of Australia.Viewed 12th July, 2010. http://www.mhca. org.au/MediaReleases/2010/National%20Compact.pdf Department of Education, Employment and Workplace Relations, (DEEWR). (2009). National Mental Health and Disability Employment Strategy. Viewed 6th July, 2010. http://www.workplace.gov.au/NR/rdonlyres /6aa4d8ad-b1a6-4ead-9fd5-bfffebf77bbf/ 0/nhmdes_paper.pdf Draine, J., Salzer, M., Culhane, D.P. & Hadley, T. R. (2002). Role of social disadvantage in crime, joblessness, and homelessness among people with a serious mental illness. Psychiatric Services, 53, 5, 565-573. Greenburg, D. & Nielson, B., (2003) Working Together for Mental Health NSW Statewide Community and Court Liaison Service. Council of Social Service of NSW (NCOSS). Karras, M, McCarron, E, Gray, A & Ardasinski, S. (2006). On the edge of justice: the legal needs of people with a mental illness in NSW, Law and Justice Foundation of NSW, Sydney Lawlor, J. & Perkins, D. (2009). Integrated support to overcome severe employment barriers. Viewed 6th July, 2010. http://www.bsl.org.au/pdfs/LawlorPerkins_Integrated_ support_ employment_barriers.pdf The Mental Health Council of Australia, (MHCA). (2004), Access to Health Services by People with Mental Illness. Viewed 2nd July, 2010. http://www.hreoc.gov.au/disabilityrights/ Richardson, S. (2010). Unemployment in Australia. National Institute of Labour. Viewed 5th July, 2010. http://www.ssn.flinders.edu.au/nils/publications/Unemployment.php Szirom, T., King, D. & Desmond, K., (2004). Barriers to Service Provision for Young People With Presenting Substance Misuse and Mental Health Problems. National Youth Affairs Research Scheme, Department of Family and Community Services, Canberra.