Consumers Perspectives on Mental Health Care - Essay Example

?Introduction Mental healthcare is a serious concern and crucial part of general healthcare due to two reasons. First, the latest statistics indicatethat neuro-psychiatric conditions are not only highly prevalent but rank among serious diseases in projected morbidity and mortality by the year 2015 (Mathers & Loncar 2005, pp. 51,121). Secondly, mental illnesses worsen the impacts of all other diseases as indicated by WHO (2007, p. 16). A question that arises is the importance of involving the mental illness patients in the entire process of diagnosis, treatment and care by health professionals. This is known as consumer participation and simply refers to participation of consumers (mental illness patients) in the formal or informal development of plans, models of delivery, implementation and appraisal of the entire realm of activities that form mental health care. What really are the benefits and limitations of consumer participation in provision of mental health care? This study seeks to provide the answers to this question and the approach undertaken will be a review of literature focusing on the perspectives of researchers, policy makers, nursing text and relevant consumer accounts. This will be followed by a summary of the findings which will inform the conclusion of the essay. Benefits and Disadvantages of Consumer participation in Mental Healthcare The best way to study this is to establish the perspectives of the various stakeholders in mental healthcare i.e. consumers, carers, researchers, policy makers and health professionals. Timimi (2011, p. 4) weighs the importance of the psychotherapeutic model adopted by healthcare professionals in terms of positive outcomes and indicates that the outcome is not significantly related to the psychotherapeutic technique selected instead stating that a strong therapeutic alliance with the patient is of primary importance. This is evidence-based as opposed to traditional expertise that places primary importance on mental healthcare under the paradigms of making a diagnosis and implementing treatment. Of particular note is that both biomedical and psychological aspects (for instance use of antidepressants and cognitive behaviour therapy respectively) have been studied and found to bear similar improvements on patients and no significant differences in terms of outcomes regardless of the technique used. One such study involved groups of depression patients treated with CBT, Interpersonal Therapy, antidepressants and placebos and the results indicated significant improvements in all the cases and no significant differences between the first three versus the placebo group. The underlining factor evidenced by this study was the quality of the relationship between the therapist and the patient as perceived by the patient in the early phases of treatment. The conclusions from such studies and meta-analyses is that the treatment is important in placing the consumer in a given psychological state that is important for their healing especially as evidenced by the fact that such treatments are efficacious across several conditions regardless of diagnosis. The important cross-cutting factor during treatment instead lies in the therapeutic alliance between the patient and the therapist. Hence a good relationship with the prescribing doctor is far more important for a positive response to the treatment implemented than just merely offering the drug (Timimi 2011, p. 5). This study importantly points us to the role of the patient in treatment and thus participation. Griffith and Jenkins (2004, pp. 41-50) conducted a study to find out the perceived advantages and disadvantages of consumer participation in mental healthcare research and inferred a number of pros and cons based on the views of the various stakeholders. The general view across all groups was an agreement that consumer participation led to improved health outcomes and improved services to the patients. Involving consumers was found to result in consumer empowerment through acknowledgement of their expertise, provision of a voice in mental healthcare provision and provision of opportunities for consumers to contribute to society in the light of the fact that mental illnesses have severe impacts on lives. Besides these, consumer participation is important in contributing to the destigmatisation of mental illnesses as is viewed by the society. The main disadvantage identified by this study was the lack of knowledge on the part of consumers hence inhibiting their reliability. The influence of illness on their objectivity is also another disadvantage to consumer participation. Clarke and Brindle (2010, pp. 25) establish the domains in which consumers can participate in healthcare as policy i.e. research, education, organisation, and provision of individual care. The two authors state that the benefits of consumer participation include the trust built between therapists and patients. Patients are also a resource for feedbacks and solutions, higher quality services, sensitisation of staff, empowerment of consumers; all of which lead to better services. Some of the disadvantages identified when consumers are involved in mental healthcare provision include the patient’s illness, lack of competence, delays due to health impairment, poor objectivity, lack of the desirable knowledge and skills, lack of representatives and increased cost of health projects. The health and wellbeing of the consumer may also be aggravated due to increased pressure and workload from involvement in all the stages of mental healthcare provision (Justice Action Discussion Paper 2011, pp. 13-14). The importance of consumer participation in mental healthcare provision is recognised by the consumers themselves and their carers as evidenced by representative views on a forum such as the Meagher and Burger (2004, pp. 1-3). The views of these two parties on their involvement in development, implementing and evaluating mental healthcare are centered on the establishment of elements of trust, accountability, advocacy, opportunity equity and support, responsiveness of healthcare services, shared ownership and dissemination of accrued knowledge. This forum lists the advantages of consumer participation as including the development of better quality and cost-effective open services that lead to overall improved health outcomes for the patients. The therapists also gain in terms of provision of new insights and perspectives. The ultimate benefits of consumer participation are enhanced recovery for the consumer and staff satisfaction. Consumer Focus Collaboration (2001, pp. 2-10) agitates for consumer participation in mental healthcare service provision with the view that consumers recognise their involvement in decision making leading to improved health outcomes, access to quality information and insights, increased accessibility and effectiveness of health services. Consumers are of the view that their active involvement at all the stages (development, implementation and evaluation) of mental healthcare is integral to the overall success of such programs, policies and strategies. They also reckon that evidence indicates that improved health outcomes have been observed in chronic diseases in cases where the consumers have been involved in development of self-management tools and decision making besides the fact that participation is also part of the rights of the consumer. Perhaps the best perspective can be derived from consumers’ own experiences in healthcare service provision and what they reckon as the best approach or what they deemed as being particularly helpful for their recovery. In Arnold and Walsh (2007, pp. 22-57), Arnold reckons that illness behavior is important in treatment of mental illnesses such as an eating disorder. In her case, the first cycle failed to achieve any treatment because she did not want to get better. She recognises attitude alongside a supportive relationship with the staff as being central to healing. She also states that not all medical practitioners may fully understand your condition as several practitioners claimed she had no eating disorder and failed to listen to her instead diagnosing her with a thyroid disorder. This indicates that she had to be involved in the treatment and gain insightful information on her condition before the treatment became effective. Snyder, Gur and Andrews (2007) detail Snyder’s mental illness addressing his entire journey including treatment and rehabilitation for schizophrenia. Although Snyder endorses the antipsychotic medication for his treatment and is committed to it, he highlights the personalisation in his treatment as being important for recuperation which suggests that patient involvement is a crucial part of the healing process. Boyles (2004, pp. 36-37) found it hard to take the antipsychotic medications provided and resorted to limit their intake to only bed time indicating that disconnect with the staff can result in ineffective therapy since the consumer will not adhere to instructions of treatment. After accessing another psychiatrist and relating to him about reading self-help books alongside his thoughts of being punished for disobeying God, the psychiatrist pointed out that most other individuals should also be suffering if that was the order of life. Boyles claims that this stuck with him eternally as it had not previously dawned on him. This indicates a scenario in which a non-technical approach by the staff had far much impact than the technical approach. Jones’ (2005, p. 42) is an account that provides much insight since the consumer in this case was also a doctor hence both perspectives are sourced from one individual. The doctor tells of emptiness after being attended by his own doctor and receiving antipsychotic medication which ultimately failed to help him and how self treatment may be catastrophic due to skewed judgment. This is an indication of a situation requiring cooperation between the staff and consumer as both are unable to give the necessary medical help. Conclusion The main benefits accrued through consumer participation in mental healthcare include higher quality patient care resulting from better diagnosis and prognosis when the patient themselves are involved in all the domains of mental healthcare. It also helps in destigmatisation and empowerment of the consumer hence contributing to quality healthcare. In terms of disadvantages, there is lack of objective judgment and delayed delivery of services due to the illness besides the fact that consumers lack the necessary competence and knowledge to engage in meaningful deliberations in mental healthcare. This however does not weaken the argument that consumer participation is integral to quality mental healthcare as the effectiveness of psychopharmacotherapy is largely dependent on it. References Arnold, C & Walsh, BT 2007, Next to nothing: a firsthand account of one teenager’s experience with an eating disorder, Oxford University Press, New York. Boyles, DC (2004), My punished mind: a memoir of psychosis, USA, iUniverse Inc. Clarke, M & Brindle, R 2010, Straight from the source: a practical guide to consumer participation in the Victorian alcohol and other drug sector, APSU, viewed 26 September 2011, . Consumer Focus Collaboration 2001, The evidence supporting consumer participation in health, LaTrobe University, viewed 26 September 2011, . Griffiths, KM & Jenkins, A 2004, Promoting consumer participation in mental health research: a national workshop, The Australian National University, viewed 26 September 2011, . Jones, P 2005, Doctors as patients, Radcliffe Publishing, UK. Justice Action Discussion Paper 2011, The extra bit: measuring the benefit of consumer participation, viewed 26 September 2011, . Mathers, CD & Loncar, D 2005, Updated projections of global mortality and burden of disease, 2002-2030: data sources, methods and results, WHO, viewed 26 September 2011, . Meagher, J & Burger, J 2010, Issue: consumer and carer participation – key issues and benefits, NMHCCF, viewed 26 September 2011, . Snyder, K, Gur, RE & Andrews, W 2007, Me, myself, and them: a firsthand account of one young person's experience with schizophrenia (Adolescent Mental Health Initiative), Oxford University Press, USA. Timimi, S 2011, Campaign to abolish psychiatric diagnostic systems such as ICD and DSM, CAPSID, viewed 26 September 2011, . WHO 2007, Ten statistical highlights in global public health, viewed 26 September 2011, . Read More