Australian+mental+health,+how+can+we+move+beyond+the+social+stigma?


 * Topic: Green, Gold, and Blue: How Well does Australia deal with Mental Health in 2011? What is working, what isn’t, and what should be done? **
 * By Samuel Clough (n8292507) **
 * Tutor: Emily Mann **

Image retrieved from the Global Mental Health's Photo Gallery – WHO gallery, this can be found at [|www.globalmentalhealth.org/gallery.php]


 * Artefact**

The artefact above depicts two people incarcerated in a mental hospital for having a mental illness. Both of these people look dirty and the cell looks no bigger than a small ten square meters or a small bedroom. There appears to be no toilet or beds to speak of and the room looks spartan, boring, with nothing pre-occupy the patients. The fact that these people are behind metal bars suggests that these people are to be locked up and kept away from normal society, going off the appearance of thse people, society has abandoned these people to squalor and shame.


 * Public Health Issue**

This artefact represents stigma associated with mental illness around the world. When asked “How is Australia dealing with mental health in 2011?” it is relatively easy to contrast the above image and examples throughout throughout Australian history and see how far we have come from segregating people into asylums to treating people at home to cope with mental illness. Currently in Australia, there is still a stigmatisation of people with a mental illness and according to many sources, mental illness attracts much less attention, public sympathy and more distrust that other forms of illness, especially physical illness or injury (DoHA, 2009; Jorm, 2000; Hocking 2003). This can lead to a sufferer to be denied job opportunities, relationships and other essential services that a mentally fit person would normally take for granted (DoHA, 2009; Hocking, 2003). This essay will examine where western culture, in particular Australia, UK and the USA, and see where the stigma of mental illness is in relation to the culture of public and professional society. There will also be discussion into the history of how treatment of mental illness has changed through the past 100 years and contrast our current level on a global scale.


 * Literature Review**

Mental illness is common all throughout society with an estimated 3.2 million Australians affected in 2007, accounting for twenty percent of the population (AIHW, 2011). According to the World Health Organisation, mental health is a state of wellbeing, where an individual knows their strengths and weaknesses and can successfully cope with the normal stresses of life, can work productivily and can contribute to their community and society (WHO, Sept 2010). Without these abilities, there is a far greater risk of a individual to develop a mental problem, which can lead into a mental illness if treatment is not sought after.

Jorm (2000) in his review found that the public in western nations, such as the USA, UK and Australia don't understand the labels and terms associated with metal illnesses. He developed a term 'mental illness literacy', defined as “knowledge and beliefs about mental disorders which aid the recognition, management or prevention”. The author also found that whilst the public general health literacy was good, mental health literacy, was relatively poor and the general public didn't understand how these conditions develop and how they affect an individual, in which leads to false assumptions and furthering the stigma attached to mental illness. The author discusses at what 'level' the public's perception into mental illness was, in particular relation to depression and schitzophrenia and found that the public without an education in psychology, generally believed that these conditions develop through the inability to cope with the social stressers of everyday life, whilst psychologists and psychiartrists see stressful life events as a trigger, rather than a cause of mental illness. There is research into how western culture tries to receive helpm with mental illness, and discusses how people from western civilisations show reluctance in discussion into their personal mental illness, but will try and undertake self-help, via exercise, new hobbies and things to preoccupy time and remove themselves form triggers of their conditions. Jorm concludes that if the publics mental health literacy doesn't improve, this will hinder any attempts that a mental illness sufferer will try and seek help, professional or from friends and family. Thnis will only serve to reinforce the stigma and increase it rather than improve the situation.

Piddock (2001) researched into the change in thinking towards the treatment and causation of insanity, distinguishing between emotional and biological causes. This lead to the creation of lunatic asylums in South Australia and Tasmania, later New South Wales, Queensland and Western Australia leading to the segregation, chastisation and stigmatisation of people with a mental problem, with separating them from society for their treatment. It wasn't until the 1960's,70's and 80's, that these asylums were shut down or renamed due to the controversial treatment, confinement and living conditions in which was discovered the patients had to tolerate when they were institutionalised. This segregation allowed for the separation of patients with a mental illness from normal society, allowing for the development and expansion of the stigmatisation, which still exists to this day.

Wynaden (2005) explains that after the shut down occurred, the mental health program became streamlined into the current healthcare program, allowing sufferers to seek treatment with the support of family and friends, rather than being locked up in a mental health clinic. This allows sufferers to continue to contribute to society and understand their own weaknesses to such an extent, where the self help as described by Jorm (2000), will be benefitial in their own understandings of their own conditions and improve upon their condition, decreasing the effects of mental illness according to the mental health definition supplied by the World Health Organisation.

Dublin and Fink (2005) discuss that whilst this has done wonders for some of the population, the stigmatisation of mental illness still exists, with the assumption that they are weak willed, dangerous and responsible for their own plight. They demonstrate the actual stigma associated today with mental illness though forcing the reviewer to reflect upon their own prejudices upon mental illness. This is done through demonstrating how people would respond in real life with asking two contrasting questions related to physical and mental health.

//If you saw someone laying on a bench at night, would you help them? //
These questions are designed to test your preconseptions towards mental illness, it is true that not all people who sleep on benches at night have a mental illness, but most people whould walk past someone in distress on the bench, ignoring the victim, compared to calling an ambulance for the physically injured party.

Overall, as explained by Chiu (2000), the stigma today is common throughout all societies around the world, many eastern cultures found in areas such as Hong Kong, Haiti, Africa, Singpore and Malaysia believe that some mental illness are the result of spiritual possession. This can be heavily looked down upon as shown in the artefact at the start of the essay, these people usually go to a spiritual healer and partake in rituals before partcipitating in medical intervention. In Western Cultures, as explained by Jorm (2000), the stigma is still there, but people more try and seek self help before going to professional help, This is mainly due to the stigma attached to mental illness remaining from when sufferers were segregated from society. Without community awareness intervention projects, such as Beyond Blue, and the National Mental Health Awareness week, the stigma will not be removed, which will only further impact upon the ability for people with mental illness to try and seek help without the feeling of embarrassment or ridicule by the general population.

Image sourced from Turrell et al (1999).
 * Sociological and Reseach Analysis**

Accoirding to Turrell et al, the socioeconomic deteminants can have a great impact upon the health of an indiviual. Through creating a framework that distinguioshes between different levels of determinant factors, we can relate what levels of society can be used to address the issues of mental illness and the stigmatisation attached to this. In Turrell et al's research, there are three factors, upstream factors such as government policies and external forces. Psychosocial and health behaviours are examples of mid-stream factors, and downstream factors determine the end results of the higher up factors. When using this framework we can see that for a change in the perception, stigma and stresses associated with mental illness, we need better up stream factors, such as education, employment and working conditions before we can address the ability to change the stigma and misconceptions of mental illness. For this to work there is also a need for a change in government policy to allow for proper research and education, this will allow for discovery for new techniques for treating people with mental illness and also make the population more aware and accepting of people with a mental illness. Without this acceptance by the population, this will only lead to further segregation and stigmatisation of people with a mental illness.

Emile Durkheim was a sociologist that contrasted the risk of suicide with the level of intergration that an individual has with their community. Durkhiem (1897) through the studies of suicides in Europe, estabulished a relationship, where the decline in birthrate and the increasing suicide rate, he found that this was a direct correlation between the increasing alienation of the underclass and the egotistical nature of society. If a community segregates and stigmatises a group, namely people with a mental illness, there cannot be any improvement in the ability to improve their condition. Durkheimian theory suggests that this segregation will only make the situation worse for people with mental illness by making a larger divide between the community, which will only further harm these people.

To put this theory into real practice, the above research of Piddock (2001), Jorm (2000) and Wynaden (2005), all agree with this theory. Piddock and Wynaden both suggest that by closing the mental asylums in the 1960's-1980's this segregation was dramatically reduced, by forcing society to deal with these people rather than hide them in the hospital. The closure of these hospitals allowed for the public healthcare system to accept these patients and it also allowed for people to seek self-help outside of a hospital or GP whilst living a normal live, contributing to society and build up on relationships, all in which are paramount to a healthy mental health status, as according to the definition by World Health Organisation. Jorm suggests that if the public had better education in reguards to mental illness, then both the public and sufferes would be better off, as the stigma, caused by misunderstanding would be reduced, resulting in better rates of people seeking treatment and also people would seek help earlier before their mental problem turns into a mental illness.

These concepts will unite a community, rather than segregate and not only will it reduce the suicide associated with mental illness, it will also bring down the rates of mental illness in the communities, remove the stigma associated with mental illness and increase the quality of life of the community as a whole.


 * Reflection and Personal Development**

The artefact above of two people incarcerated because of a mental illness represents how behind some countries are with dealing with the mental health issue. In this topic, it served as a good representation of where Australia used to stand thirty to fifty years ago, as we used to also incarcerate our SUFFERERS, and it contrasts to now in such a short amount of time, that people with a mental illness are all throughout our society, living relatively normal lives to people without an mental health problem. Personally I have a connection to this situation, having friends and family with mental health issues and also my own. Researching this topic allowed me to relise my own misconceptions and prejudices on mental illness and allowed me to relate and sympathise rather than potentally chastise people with a mental health issue. I know understand that these people don't overly have a choice over the cause of their illness, and it's only when people reach for support that i'll have the understanding and reasoning to properly support them in their times of need. Outside personal development this series of assignments allowed me to further my critical analysis skills and be able to pull out critical details of an issue, understand them and adapt actual theory to discover why this stigmatisation occurs and how through community development we can fairly easily remove the stigma associated with mental illness.

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">References

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Australian Institute of Health and Welfare, (2011) Mental Health, accessed 1/11/11 at [|www.aihw.gov.au/mental-health/]

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Australian Bureau of Statistics, (2007) National Survey of Mental Health and Wellbeing: Summary of Results, pp 4-10, accessed 1/11/11 at @http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/6AE6DA447F985FC2CA2574EA00122BD6/$File/43260_2007.pdf

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Chiu, SN. (2000) Historical, Religious, and Medical Perspectives of Possession Phenomenon, Hong Kong Journal of Psychiatry, 10(1): 14-18

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Department of Health and Ageing (2007) What is Mental Illness?, Department of Health and Aging, Canberra, Australia.

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Dublin, WR; Fink PJ, (2005) Effects of Stigma on Psychiatric Treatment. In Fink PJ, Tasman A (Eds.), Stigma and Mental Illness (pp. 1-4) American Psychiatric Press, Inc. Washingtion, DC.

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Durkheim, E, (1997) Suicide: A Study in Sociology (ed. Simpson, G Spaulding JA, Trans.). USA. (Original work published in 1897).

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Hocking, B, (2003) Schizophrenia: reducing mental illness stigma and discrimination – everybody's business, The Medical Journal of Australia, 178(9 Suppl): S47-S48

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Jorm, AF. (2000) Mental Health Literacy: Public knowledge and beliefs about mental disorders, The British Journal of Psychiatry, 177: 396-401

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Piddock, S, (2001) Convicts and the Free: Nineteeth-Century lunatic asylums in South Australia and Tasmania (1830-1883), Australian Historical Archaeology, 19: 84-97

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Turrell G, Oldenburg B, McGuffog I, Dent R (1999) Socioeconomic determinants of health: towards a national research program and a policy and intervention agenda. Queensland University of Technology, School of Public Health and Ausinfo, Canberra; Found in Fleming ML, Parker E (2009) Introduction to Public Health, Elsevier Australia. p128.

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">WHO Media Centre (2010) Mental Health: Strengthening our Response. World Health Organisation. Accessed 1/11/11 at www.who.int/mediacentre/factsheets/fs220/en/

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">Wynaden, D. (2005) Book Review: Closing Asylums for the Mentally Ill, Accessed 2/11/11 at @http://hsr.e-contentmanagement.com/archives/vol/14/issue/3/review/19/closing-asylums-for-the-mentally-ill-social

<span style="color: #000000; font-family: Calibri,Calibri,sans-serif; font-size: 14.6667px;">**Comments on other wiki's**

http://healthculturesociety.wikispaces.com/message/view/+Cultural+Sensitivity%2C+can+health+services+%27feel%27%3F/45591148

**An issue that will only increase in the years to come**
Now thats some food for thought. I agree that since Australia is becoming an increasingly larger multicultural society due to immigration of expatriates. Personally I have seen this on-road with the QAS, with having to use a translator to talk to a victim potentially hurt by a crash. This skill of cross cultural communication is only going to be increaseingly needed in the years to come, and it is a shame that there isn't much interest from the health profession to pick this skill up nd run with it as obviously there needs to be better trainging programs across the board. Once this language barrier is broken then we as a health profession can stop comprimising our patients and deliver a more culturally sensitive and appropriate healthcare and end up with better outcomes.
 * || [|Scruffy012] Nov 4, 2011 9:25 am ||

http://healthculturesociety.wikispaces.com/message/view/+Genuine+or+Genuine+Photo+Opportunity+%E2%80%93+The+truth+about+closing+the+gap/45533266

[|Scruffy012] Nov 4, 2011 10:05 am I whole heartedly agree with your analysis of the shameful gap between the living conditions, mortality and access to services that the aboriginals are exposed to comparison to the rest of Australia.
 * re: Agreeing with your assessment of your artefact.**

Sure since the mid 1990's the liberal and labour governments have been throwing millions if not billions on money and resources, but as isam90 above me has stated, we need to step back and look at the problem and situation and actually research and setup a framework into where and how we can actually improve this situation to finally close this gap.

very thought provoking and every Australian should have a stance on this subject to some degree.