Early Intention of Mental Health - Research Proposal Example

UNDERSTANDING EARLY INTERVENTION By Location i. Mental health is an important field of psychology. This is because it determines the way we behave. Studies have shown that mental illnesses are closely associated with violent acts and criminal offences. This has proved costly. Treatment of the illnesses provides remedies but the recurrences of the disorders show it is not as effective. Intervening in the early stages of the illnesses has been shown to successfully prevent the occurrence of the diseases which has been shown to be the best option. Although prevention is recommended, the little research on the issue has failed to show which the best method of early intervention is. This paper seeks to propose research into the issue to determine the best method for early intervention and provide an understanding on the same. ii. Introduction A person’s mental health describes his or her psychological well being level, which affects the behaviour that he or she exhibits. According to the World Health Organisation (WHO), about half of the global population is affected by a mental illness in the course of their lives. However, the types and magnitudes of the illnesses are so diverse that sometimes we do not detect them. In some cases mental illnesses cause individuals to pose dangers to others as well as themselves. This has seen professionals conduct research that is predominantly focused on mental illnesses. The research mostly focuses on the causes of mental disorders and the effects they have. The idea behind this is to provide effective treatment methods to facilitate improvement of the quality of life of people with mental disorders as well as reduce the criminal activities attributed to the disorders. Even so, there are paucities of research on the prevention and reduction of these disorders. With studies showing that mental disorders tend to recur even after patients receive effective treatments, researchers have argued that the best way to deal with them is to try and prevent their occurrence through early intervention procedures. iii. Background information Early intervention is a phrase in mental health used for any initiative targeting a young person without an established mental health condition diagnosis with the purpose of trying to influence the mental health of this person at a later stage (Nicholas and Broadstock 1999, p. 18). However, it may also describe any initiative that seeks to detect and mitigate the recurrence of a mental condition. A meta-analysis of 20 studies showed that psychosis patients had 4 to 5 times the level of general violence associated with the general population with homicide values being 14 to 25 times higher (Purcell et al. 2012, p. 1). This shows the need to treat and prevent recurrence of the disorders. However, a deeper analysis of the studies showed that a sizeable portion of the offences were committed by culprits experiencing their first psychosis episodes. Then there is the intensity of aggressiveness of the patients. While basing his argument on an number of articles, (Purcell et al. 2012, p. 2) claims that the first episode psychosis patient tends to be at a higher risk of violent and aggressive behaviour with 40% of 495 first timers exhibiting this. In the event that one develops a mental disorder, the costs accrued at a personal as well as economic level are immense. These range from the emotional and physical trauma on patients and victims alike to the services of mental health costs and the general costs of health services for physical injuries. Then there is the reduction or total loss in productivity which is humongous considering that around half of the people on the planet are plagued by the scourge at on time in their life. 1.72 million pounds was the estimate for the lifetime cost incurred for every homicide by a mentally ill person in the UK in 2009 (Purcell et al. 2012, p. 2). A consideration of all these factors shows the need to have frameworks to prevent occurrence of new cases of mental illnesses which describes primary prevention. Since these strategies are meant for people who have not developed a diagnosable mental illness, they are known as early intervention. There is a diverse range of clinical early intervention methods used to prevent the development of mental conditions. Studies have shown that these methods are quite effective. However, in some cases, the therapy does not work for example if it is forced. This has raised questions about whether; early intervention by clinical methods is effective on its own? Research has shown that the interactions with others in our childhood and teenage years determine the way we think and therefore our mental health (Camhs 2011, p. 7). Absence of caring adults to provide support creates unrelenting stress that weakens the development of the brain, which deteriorates mental health in the long term. Positive experiences on the other hand enable a good environment, brain development that is almost a guarantee of good mental health. This has seen some sections of forensic mental health professionals argue that the growth and development of a child in a good social and emotional environment is an enough strategy for early intervention. This section proposes that the stepped care model is best for early intervention with the inclusion of forensic mental health professionals, not necessarily (Camhs 2011, p. 8). This means that if a young person develops an early sign of mental illness, a secure and positive relationship with family and the community at large is enough to promote emotional well being that will alleviate the development of a condition. But suppose the protective factors forged by the stepped care are not able to alleviate the risk factors like the media, community, peer factors or individual factors (Nicholas and Broadstock 1999, p. 19), will this mean that the person will develop a mental condition? If so, does this mean that mental health professionals are needed to provide early intervention? So is it necessary to adopt early intervention frameworks that include both sides or are stepped care models sufficient? iv. Method a) Design The research will be done through the provision of a service description and rationale for a forensic mental health clinic that is equipped and staffed with necessary equipment and mental health professionals respectively to enable the offering of early intervention services. The clinic’s services should cater for patients with indicators of small mental conditions like depression as well as major mental disorders like psychosis and personality disorders. The implementation of the research will be through an early intervention clinical programme for around 45 individuals with different disorder indicators and support frameworks over a 12 month period. Clinical, demographic and risk data for the assessed patients will be collected over time for presentation and analysis. b) Participants The research will require around 45 individuals with mental disorder indicators with different support frameworks in the form of family and friends. These will be sourced from a community support centre. Each sex should comprise at least a third of the patients to alleviate gender bias in the findings. However, the selection from each gender should be random. To enable free sharing of information, the patients assessed should partake in the research voluntarily which may be aided by providing the services free. Finally the research needs a forensic mental health consultant to assess and take data on the patients. It is best to use only one consultant to prevent differentiated data from different opinion that may jeopardise the findings. c) Procedure A forensic mental health clinic that meets the requirements will be contacted and asked to allow the research to be conducted in its facilities. This will also involve asking for a recommendation for a forensic consultant. Then a community support centre that helps reduce risk of offences and violent behaviour due to mental instabilities among young people will be consulted to refer patients who meet the research specifications to the clinic. The centre should also provide risk assessments as well as descriptions of the conditions of the volunteers. This should be filled in tables that resemble those below. When all these are ready, the forensic consultant should meet twice with around 35 of the patients for consultations on a week per month basis. During the consultations, a standardized risk assessment needs to be filled with the volunteer getting recommendations on how to manager his or her risk behaviour. The consultant may meet with a volunteer’s case manager for consultation on the patient and clarification of issues. The case managers will be in charge of finding out if the recommendations are utilized. The forensic consultant should record the developments in the volunteers’ behaviour for analysis. The patients should not be informed of their progress to avoid distortion of results. The assessment of the patients should continue over the 12 month period intended for the research to ensure each of the patients gets 24 hours of consultation and assessment. At the end of the research, all of the data for each of the patients should be collected for analysis. As a control experiment, 10 of the participants of the research who have support from friends and family that consists stepped care should not be offered clinical services. Name Gender Age at referral Employment status Education level Family involvement Family and friend support Table 1. patient demographics Name Mental disorder indicator History of deliberate self-harm History of suicide attempts History of suicidal ideation Family history of mental illness (specify) History of emotional abuse History of physical abuse History of sexual abuse Past psychotropic medication prescriptions Current psychotropic medication prescriptions Substance use history (specify) Clinical support Table 2. Clinical characteristics of patient d) Statistical analysis On completion of the experiment, different individuals will register different findings due to the difference in risk factors and support structures. It is also expected that there will be differences due to improvements in the use of different early intervention methods. In order to provide a clear demonstration the findings will be grouped into three different groups based on the method used; clinical intervention, stepped care model as well as clinical and stepped care intervention model. This will illustrate the improvements or deterioration in the risk behaviours of the volunteers as a result of use of different intervention methods. The effect will be to show the magnitude of the impacts of the different models which will answer the research questions. v. Discussion A significant portion of the population has a mental condition of one type or the other. However, due to ignorance and the magnitude of the disorder, most of the conditions go on unnoticed for a long time. The result is the development of mental health patients who rely on medication and constant visits to mental institutions. The delayed treatment also results in the conditions recurring even after effective treatment is administered. The largest portion of people with mental conditions is not violent or serial offenders (Purcell et al. 2012, p. 6). However, studies have shown that some mental conditions cause people to be violent with mental patients having four to five time higher tendencies of violence compared to the general population. This means that early treatment of the conditions may be beneficial to society as a whole. However, prevention of the conditions through early intervention has proved to be the best method of mitigating the effects. There are several methods of early intervention with stepped care and clinical methods recommended as the best methods (Nicholas and Broadstock 1999, p. 18). Nevertheless, the best way to mitigate and alleviate the effects of mental illnesses is to use the best early intervention method. This means choosing the best among the two. This creates a paradox as opposing sides claiming that the defects of the other make it the weaker option. With the subject being only a small part of the mental health research, there is insufficient literature to use in addressing this question. This creates a need to conduct a research to provide a proper understanding of the issue of early intervention in the forensic mental health field. This research involves a procedure that involves early intervention of mental disorders through both of these frameworks. This means that the findings will show the effectiveness of each model which will help in determining which is best. As such the proposal will play an important role in furthering the field of psychology. Although the research will involve patients or individuals who have volunteered, there are some ethical aspects that need consideration before during and after the research. First, the research procedures as well as the participants of the research need to be discreet when it comes to the patient information. This is because the information is shared in confidentiality. Even if a patient poses a danger to society, it is not in the place of the researcher to share that information as it may lead to victimisation. The best method would be to use code names for the research to hide the identities. Then there is the issue of victimisation of the patients. No matter how bad their deeds, the patients should not be made to feel inferior. The strengths of the proposed research stem from the fact that the participants are willing to share information about their conditions and are seeking help. This means that there are reduced hindrances to data collection. It also means that the recommendations offered will be implemented, hence bringing out the true effect of the model. The research may contribute significantly to the forensic outreach model development and mental health field, but that does not mean it is foolproof. First, the changes and development in risk behaviours are not measurable and one has to deduce them which introduce errors to the process. There may also arise errors in recording the information from the research. Another fault is the fact that there is no concrete evidence to back the claims by the volunteers and one has to rely on their word. Further research on the issue is necessary to develop better models of early intervention. I propose the compilation of different articles under one cover to provide easy access to information regarding the issue. Bibliography Camhs 2011, Child and Adolescent Mental Health Services: A Service Model. Northern Ireland Department of Health and Social Services. Nicholas, B and Broadstock M 1999, Effectiveness of early interventions for preventing mental illnesses in young people: A critical appraisal of literature, NZHTA, Christchurch, New Zealand. Purcell, R., Fraser, R., Greenwood-Smith, C, Baksheev, G, McCarthy, J, Reid, D, Lemphers, A and Sullivan, D 2012, Early Intervention in the Real World: Managing risks of violence in a youth mental health service: a service model description, Wiley Publishing Asia. Read More