International Journal Of Mental Health Nursing: Promoting Mental Well-being For Aging Australians

Background

Discuss About The International Journal Mental Nursing Health.

Mental health issues indirectly or directly affect the Australians at some stages in their lives. There is a strong link between ageing and health problems that includes physical and mental illness. The mental health issues are quite common where about 45% of them are experiencing recurrent or severe illness that has influenced the older Australians, their family members and carers (Slade, Teesson and Burgess 2009). According to Australian Institute of Health and Welfare (AIHW) 2015, about 8.5 million people were affected by mental disorders and one in five (20%) had experienced mental illness (Slade et al. 2009). There is lack of effective and appropriate timely access to treatment and non-clinical mental health services that is important for healthy ageing (Australian Institute of Health and Welfare 2012). As a result, it is affecting their ability to live independently and complicating the picture of older people’s mental health in Australia. Therefore, policy implementation is important for prevention, early detection and delivery of appropriate mental health services to older Australians.

Australian government has made guidelines and policies to reform mental health condition for their people. Among these, The National Mental Health Policy 2008 was developed with a strategic vision to promote mental health and well-being, prevention of mental health problems development and illness (Health.gov.au 2018). It is also aimed at reducing the impact of mental illness like stigmatization and promoting recovery of older Australians. Furthermore, this existing policy assures to protect the rights of the people with mental illness and disorders so that they are able to participate in society meaningfully (Health.gov.au 2018). Therefore, this policy is envisioned to reform the mental health system providing connected and seamless care, recovery-oriented while supporting older people to participate in community activities to their full potential (Health.gov.au 2018). 

The National Mental Health Policy 2008 was developed to promote mental well-being, prevention, early detection and recovery among the older Australians. This policy recognizes that life stages like old age are associated with increased mental health risk and those who are experiencing mental illness. This policy has a renewed approach towards mental health where older Australians should have better access to mental health services, improved service delivery and accountable and more robust legislation (Groom, Hickie and Davenport 2003). This policy greatly reaffirms good mental health among older people and not just reduction or absence of mental illness in the community. The services should greatly meet the clinical needs of the older people so that they actively participate in their own care promoting collaboration and participation in the society (Health.gov.au 2018).

The National Mental Health Policy

This policy has a positive impact on the older people. Mental health problems make older people vulnerable to human rights violation and subjected to discrimination and stigma. This policy is directed to de-stigmatization and assisting older Australians to become independent, emotionally resilient so that they cope with their negative experiences and participate fully in their community activities. The policy is also aimed at reducing the risk of suicide by minimizing the risk factors and improving resistance to mental illness and problems. It also helps to create awareness by promoting mental health well-being related to prevention and recovery of mental illness among aged population in Australia (Health.gov.au 2018).

Over the past decade, Australian government has developed series of mental health strategies and plans; however, there is critical gap in literature and knowledge for mental illness, policy planning and practice. There is also lack of accountability and limited healthcare systems data along with issues of policy monitoring and evaluation. According to Grace et al. (2015) in Australia, the mental health reform that was implemented has received unprecedented attention in levels: regulation, organization, community education, payment and finance. Although, national mental health policy 2008 is a whole government approach enabling recovery, early intervention prioritization and full access to mental health services, this policy is a failure of implementation and not a failure of policy. The levelers include poor administration, accountability, lack of government commitment and failure to achieve quality delivery of mental health services in the Australian community (Grace et al. 2015). Therefore, the current policy needs to acknowledge and direct major areas like rights and responsibilities of people with mental illness, mental health promotion and awareness, prevention of mental health problems and suicide risk reduction, early intervention, access to right care, participation and social inclusion.

Workforce issues have gained greater prominence in terms of innovation, research and sustainability. Since the inception of this policy, it is recognized as a major challenge as the recruitment and retention of workers is of great concern. Despite persistent effort, the distribution and supply of mental health professionals in various areas of community like old aged care homes is scarce and as a result, there is lack of broad approach towards addressing of mental health problems of older Australians (Clinton and Hazelton 2000). There is lack of adequate training among the professionals in providing quality mental health services to the older Australians.

To address the issue of workforce, appropriate training of the professionals in the mental health workforce is of paramount importance. This sort of training must equip education opportunities that can be helpful in attracting and retaining sufficient qualified workers and ongoing education options. This workforce should be trained in promoting prevention of mental health issues, early intervention, detection and recovery. Adequate delivery of services that can be helpful in meeting the needs of older people with mental health issues remains a challenge regardless of their living conditions (Burgess et al. 2012). The improvement in the current policy can be made through amendments in the existing policy and updating with new information. The changes made in the existing policy will focus on the early detection, recovery and quality mental health service delivery by skilled mental health professionals having proper knowledge and awareness about mental health issues among older Australians. Executive staffs help to promote mental health well-being among the older Australians will review the new policy draft with proper evaluation and monitoring of changes in the policy. Furthermore, the final policy will be updated and released that can reduce the prevalence and impact of mental health conditions among the older people in Australia. Therefore, the identification of mental health risk factors, promotion of mental health well-being, prevention, early detection and recovery are searched through literature review in the subsequent section.

Impact of the Policy on Older Australians

The Australian population is ageing and they face mental and physical health challenges that need proper recognition. Older population experience life stressors like decline in functional ability, loss in capacities and independence. The risk factors for mental health issues also include neurological disorders like anxiety and depression along with physical illness and mental trauma as outlined by World Health Organization 2012. There is reduction in mobility, frailty, chronic pain and other health problems that require aged long-term care. Furthermore, there are several conditions like retirement, bereavement and decline in socio-economic status that increases the risk for mental health problems among the older population. These factors result in loneliness, isolation and psychological distress among the older people demanding long-term mental healthcare (Holt-Lunstad et al. 2015).

According to Masi et al. (2011), risk factor for mental health issues among older people is elder abuse like neglect, abandonment and severe losses of respect and dignity. Elder abuse not only causes physical agony, but also causes long lasting emotional and psychological consequences like anxiety and depression. The knowledge regarding identification of risk factors can be helpful in preventing the older people from severe mental health issues. The identification of mental health risk factors can be helpful in recognizing the people at risk of developing mental health issues. The National Mental Health Policy highlights the need for identification of mental health risk factors among older people through early and preventative intervention activities. According to Corrigan et al. (2012), the community awareness by mental health professionals through mental health promotion can help to reduce discrimination and stigma experienced by older people. It can also be helpful in increasing opportunities for early intervention and prevention as updated by the policy. This is one of the main parts of the existing policy as it recognizes the risk factors like social exclusion experienced by vulnerable groups like older population.  The early interventions outlined in the policy can be helpful in identifying the individuals at risk and those who are experiencing mental health issues for the first time.

The mental health services should acknowledge and work in accordance with the mental health needs of the older people. They should have access to necessary mental health services without any social exclusion, stigma and discrimination. The mental health workforce should maintain their dignity, respect and deliver fair standards of care that are directed towards their recovery, safety and well-being. Mental health promotion should support older people so that they participate in community activities maximizing their ability (Tudor 2013). According to () mental health promotion seeks to increase understanding and awareness of mental health conditions reducing discrimination, stigmatization and as a result, encouraging help-seeking behaviour among older people at the individual level (Thornicroft et al. 2016). This also helps to reduce vulnerability and increase in emotional resilience through development of self-esteem and personal skills leading to supportive social inclusion.

Critical Gaps in Mental Health Policy

According to Tew (2012), early intervention of mental health condition during initial or possible early phase or during any episode can be helpful in minimization of duration and severity of such conditions and reduction of broader impacts. Specially targeted mental health intervention programs can help to address the emerging mental health issues and awareness of risk factors. The access to mental health services at right time with response to needs of the older people can help to promote positive health outcomes and facilitation of sustained recovery (Patel et al. 2013). Moreover, this approach shows clear benefits facilitating social inclusion and participation of older people experiencing mental health problems.  

Therefore, the recent literature highlights the enhancement of mental health sector in addressing knowledge gaps and improving service delivery through evaluation attention, dissemination and continuous monitoring. The evidence based knowledge and influential information dissemination can be beneficial for older people with poor mental health outcomes. The early intervention, prevention and governance of mental health services need to be directed towards reinforced uptake of service provision that is evidence-based.

The implementation plan can be helpful in identifying the individuals who are at risk for developing mental health problems as highlighted in literature. Moreover, the review also illustrated that delivery of timely mental health services can facilitate recovery with better health outcomes.

The improved mental health conditions among older people in Australia can be a measure of success of new policy. This would help to clarify the policy effectiveness and survey after every one-month regarding delivery of mental health services in Australia. The continuous evaluation and monitoring of efforts can help to review the understanding of mental health staffs related to use of new and updated policy. Clinical auditing can be helpful in evaluating the understanding of prevalence and incidence of mental health problems with improved interventions. Proper documentation of risk factors that increases the incidence of mental health problems among older people by skilled professionals can also be considered beneficial for better mental health outcomes. The evaluation and monitoring of updated policy changes can also be helpful in promoting mental health well-being and increased participation in aged care services.

Conclusion

The amendments made in the existing policy are beneficial in reducing the incidence and prevalence of mental health problems in Australia along with improved health services for older people. After the policy review, it was noted that it require changes in terms of workforce issue, poor administration, inadequate delivery of services, lack of commitment and accountability. This has negative impact on the mental health conditions of older people as there is poor understanding of specific mental health conditions. Prior to policy implementation, there should be focused research on the enhancement of mental health sector capacity so that they are able to address gaps and provide improved service delivery through utilization and dissemination of new knowledge. Mental health professionals including carers must be involved in evaluation and monitoring activities. The reviewing of National Mental Health Policy 2008 and amendments made in the existing policy was knowledge enriching and intriguing.

Workforce Challenges

References

Australian Institute of Health and Welfare, 2012. Australia’s Health 2012: In Brief. AIHW.

Burgess, P., Coombs, T., Clarke, A., Dickson, R. and Pirkis, J., 2012. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN). International journal of mental health systems, 6(1), p.4.

Clinton, M. and Hazelton, M., 2000. Scoping the Australian mental health nursing workforce. International Journal of Mental Health Nursing, 9(2), pp.56-64.

Corrigan, P.W., Morris, S.B., Michaels, P.J., Rafacz, J.D. and Rüsch, N., 2012. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatric services, 63(10), pp.963-973.

Grace, F.C., Meurk, C.S., Head, B.W., Hall, W.D., Carstensen, G., Harris, M.G. and Whiteford, H.A., 2015. An analysis of policy levers used to implement mental health reform in Australia 1992-2012. BMC health services research, 15(1), p.479.

Groom, G., Hickie, I. and Davenport, T., 2003. ‘Out of Hospital, Out of Mind!’: A Report Detailing Mental Health Services in Australia in 2002 and Community Priorities for National Mental Health Policy for 2003-2008. Mental Health Council of Australia.

Health.gov.au. 2018. National Mental Health Policy 2008. [online] Available at: https://www.health.gov.au/internet/main/publishing.nsf/content/B4A903FB48158BAECA257BF0001D3AEA/$File/finpol08.pdf [Accessed 26 May 2018].

Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T. and Stephenson, D., 2015. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), pp.227-237.

Masi, C.M., Chen, H.Y., Hawkley, L.C. and Cacioppo, J.T., 2011. A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15(3), pp.219-266.

Patel, V., Belkin, G.S., Chockalingam, A., Cooper, J., Saxena, S. and Unützer, J., 2013. Grand challenges: integrating mental health services into priority health care platforms. PloS medicine, 10(5), p.e1001448.

Slade, J., Teesson, W. and Burgess, P., 2009. The mental health of Australians 2: report on the 2007 National Survey of Mental Health and Wellbeing.

Slade, T., Johnston, A., Oakley Browne, M.A., Andrews, G. and Whiteford, H., 2009. 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australian & New Zealand Journal of Psychiatry, 43(7), pp.594-605.

Tew, J., Ramon, S., Slade, M., Bird, V., Melton, J. and Le Boutillier, C., 2012. Social factors and recovery from mental health difficulties: a review of the evidence. The British Journal of Social Work, 42(3), pp.443-460.

Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., Koschorke, M., Shidhaye, R., O’Reilly, C. and Henderson, C., 2016. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), pp.1123-1132.

Tudor, K., 2013. Mental health promotion: Paradigms and practice. Routledge.

World Health Organization, 2012. World Health Day 2012: ageing and health: toolkit for event organizers.

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