Mental+Illness+Medication+-+Is+it+as+straight+forward+as+it+seems?

Cultural Artefact
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Presentation of Cultural Artefact
The cultural artefact I have chosen is a song by popular English rock band the Verve called “The drugs don’t work”. The lead singer of the band, Richard Ashcroft wrote this song in 1995 in verbally portraying his drug usage in attempt to grieve over his father’s passing. Richard stated in an interview that even though the drugs made him feel worse, he still took them. Out of frustration and pure anger you turn to something else to try to escape. The video in itself is predominately black and white depicting sadness and sorrow whilst the performers have emotionless faces as if a part of them is missing. The beginning of the video I believe illustrates the feelings of the song/performers as they insert 50 cent pieces into a machine that vends “feelings”.

Public Health Issue
//__Mental Health/Illness -__ Mental health problems and mental illness refer to the range of cognitive, emotional and behavioural disorders that interfere with the lives and productivity of people// (Mental Health Council of Australia 2007).

“The drugs don’t work, they just make you worse” is a significant part of this song. Not only can this song be used in context to illicit substance abuse, but also in terms of the consumption of mental health medication. Mental illness in Australia is frequently increasing, throughout the years 2004 and 2005 11% (approximately 2,236,146) of all persons accounted for currently had a long-term mental illness (Australia Bureau of Statistics, 2006). In 2007 this figure rose significantly, with 20% of the population aged between 16 and 85 (approximately 3.2 million) having a mental disorder (Australian Institute of Health and Welfare, 2007). Mental health illnesses have been named among the greatest causes of disability, lessened quality of life and reduced productivity. In 2003 mental illnesses were among the ten leading causes of disease burden in Australia, being responsible for 13% of the total burden on disease (Australian Bureau of Statistics, 2006). With the prevalence of mental illness being so recurrent, the treatment set in place clearly isn’t sufficient enough to aid such diseases as depression, schizophrenia, anxiety and others alike. The Australian Government have funded various new action plans designed to make access to services and medication a lot easier for patients e.g. //The Council of Australian Governments National Action Plan on Mental Health// (Council of Australian Governments, 2006). Although they have failed to realise that perhaps the main problem in regards to this illness **IS** the professionally prescribed medication they are making more readily available to sufferers. With regards to either the lack of effectiveness and or the physical/mental side effects which usually results in non adherence.

//“For patients, an informed decision to take a particular medication can be a highly personal choice that involves balancing perceived benefits with potential drawbacks and risks. To make this choice, patients must be offered opportunities to clearly communicate their preferences, and prescribers must acknowledge and respect patients' stated choices”.(Wilder, Elbogen, Moser, Swandon, Swartz, 2010).//



Literature Review
In 2007 alone, 45% of Australians between the ages of 16-85 years old had experienced at least one form of mental illness at some point in their life. The Mental Health Council of Australia states that mental disorders and suicide are accountable for 14.2% of Australia’s total health burden (Mental Health Council of Australia, 2007). With the overwhelming percentage of Australians affected at some point in their life, mental illnesses were identified as the leading cause of the loss of quality of life due to the disability. Due to the loss in productivity and labor force contribution this type of illness alone has been estimated to annually cost $20 billion (Australian Bureau of Statistics, 2009). With the daunting amount of Australian’s affected by mental illness and also the effect this illness has on the Australian economy, surely the means for new forms of treatment and or medication is crucial in overcoming the burden this disease has on Australia.

The main methodology of treatment remains as antidepressants, whilst with diagnoses most patients are diagnosed by primary care physicians (Akpaffiong, Wilson-Lawson, Kunik, 2008). Health professionals are relying on sets of criteria that organize a patients self-reported symptoms and their history of illness which then will fall into a specific disorder with a specific line of treatment (Norquist & Hyman 1999). The limitations associated with these methodologies include: patients non adherence to antidepressant medication due to the potential side effects and or lack of effect and also patients non adherence to treatment as their opinion and personal preferences have not been properly heard or understood. Understanding and including patients voiced opinions and views towards treatment prevent non adherence and negligence towards treatment (Wilder et al., 2010).

As stated previously, the Australian Government have funded various action plans designed to make mental health services and medication more readily available. The Department of Health and ageing Australia have released several new action plans to allow uncomplicated access to certain services (e.g. General Practitioners) and treatments. An example of this type of action plan is the //Better Access Initiative//, where its main goals and outcomes include Medicare benefits and rebates for diagnosed patients, access up to 12 individual or group services with rebates and also in extreme situations, access to a further six individual or group services (Australian Department of Health and Ageing, 2011). Only recently however (within two years), the Australian Government in conjunction with the Department of Health and Ageing have also released action plans relating to the mental health skills training of General Practitioners (GPs). The //implementation of mental health skills training for general practitioners// plan aims to encourage GPs to undertake this form of training by raising the payment they are entitled to when developing a mental health treatment plan. Further educated GPs means the likelihood of patient’s opinions and plans being heard and understood will increase significantly (Fox, 2009). Numerous studies have shown that when patients voice their input about their own treatment, they are considerably more prone to adhere to that treatment (Wilder et al., 2010). Although patients are more likely to adhere to forms of treatment they have had a say in, this by no means guarantees the treatment will be a success. The undesirable side effects and or lack of positive outcomes with mental illness medication may combine to worsen the stigma linked with the treatment of mental illness (Sajatovic & Jenkins 2007). Whilst attempting to research new breakthroughs in medication for mental illness, very few articles were found on the sole basis of conducting research for new medication. The most common articles found were related to different ways of treatment for patients still using the same medication and resources and their success rates [e.g. //Public Conceptions of Serious Mental Illness and Substance Abuse, Their Causes and Treatment](//Kuppin & Carpiano 1996).

In 2004-2005, a mere 19% of adults reported using some form of medication to treat their mental illness. Of that 19%, 27% were using anti depressants, 23% sleeping tablets and 10% were using other types/forms of medication for anxiety or nerves (Australian Bureau of Statistics, 2006). This shows the declining rate of Australians using mental health medication. A suggested reason behind this is the drug having physical side effects, leads to addiction and or simply ineffective (Fleck, 2005). In the 1980’s drugs such as Tricyclic antidepressants and Serotonin Reuptake Inhibitors were brought into market. These drugs were invented to assist illness such as depression and bipolar disorder and were professionally classified as a ‘//safe drug’//. However, these forms of drugs did not assist diagnosed sufferers which called for a more drastic drug to be created (Kuruvilla, 2006). Monoamine Oxidase Inhibitors (MAOI’s) were then invented as the preferred choice of treatment, if the above mentioned medication (Tricyclic and Serotonin) was deemed ineffective. This medication proved to have some positive effects although the physical and mental side effects when using this drug (e.g. hypertensive crisis) were far too drastic for sufferers (Lovatt, 2011). Therefore this form of medication was neglected by many which further resulted in non adherence. With the somewhat ineffectiveness of Tricyclic and Serotonin medication, together with the daunting side effects of MAOI’s, the decline in adherence to medication prescribed as treatment for suffers of this illness poses as the cause to the incline in mental illness.

Touched on previously, the side effects of the popular mental illness medications are extensive, which in turn results in non adherence to prescribed treatments of mental illness. Whilst boasting the safe appeal, Serotonin Reuptake Inhibitors were not without their side effects. Serotonin Reuptake Inhibitors have been found to upset GI, assist in sexual dysfunction, possible hypotension and sleep impairment. Tricyclic Antidepressants and MAOI’s were no better as they boasted hypertensive effects on the patient (high blood pressure) which could result in possible organ damage and other potentially fatal repercussions (e.g. shortened life span) (Akpaffiong et al., 2008). When researching the side effects of the popular mental illness medications, it is evident as to why there has been a declining figure of sufferers taking medication. These drugs contain far too many potentially fatal side effects for a person who already has a potentially fatal mental disorder. Whilst researching the success rates and potential side effects of mental illness medication, the lyrics contained in the culture artefact aid in supporting the argument. . “The drugs don’t work, they just make you worse” tells the story of how mental illness medication has effected numerous sufferers in an extremely negative sense. The only way to improve adherence to mental illness medication and improve success rates is for further funding to be invested towards research in creating medication(s) that are deemed professionally safe with minimal side effects and the potential to assist and eventually cure different types of mental health illnesses.

Cultural and Social Analysis
By reading the literature review above, the Government and health professionals play a major role in the treatment of mentally ill sufferers. The Australian Government are the main source of revenue for further research in mental illness treatment, and can affect this issue in a proactive and positive manner. The Australian Government can invest further funds towards research in improved/enhanced mental illness medication and change the treatment process for many sufferers. Changing the treatment process can also mean changing the cornerstone of diagnosis and promoting early intervention further. Allowing patients to voice their opinions and views on the treatment process can promote adherence as they have a say in what they are taking and or undertaking in. If the Government were to promote early intervention programs together with new enhanced medication and treatment processes the daunting prevalence of mental illness would be significantly lessened.

The most affected persons in regard to this public health issue are the pre-diagnosed and diagnosed. With the lack of effective and safe medication combined with the cornerstone beliefs of health professionals in regards to diagnosis and treatment options, the effects of this can leave a sufferer sceptical and or non adherent to treatment. Piat, Sabetti and Bloom (2009) critiqued long-standing treatment models that focus on adherence to medication; they found that these approaches undermined patient’s opinions and choices, their empowerment and their self determination. The study undertaken by Piat et al. (2009) was based on the recent treatment options and new improved ways of treating patients. They discovered that recent treatment options were very one sighted, as they believed doctors diagnosed and treated patients without considering the numerous options and without complying with the patient. This has been a problem with treating mental health illness in present times as doctors prescribed similar treatments to all sufferers, without considering that each individual is different and the array of types/ways treatment will work for different people. Rates of non-adherence or discontinuation of treatment are high, which means the need for increased treatment options, medication and greater consumer participation in treatment are crucial. (Piat et al., 2009).

Awareness of this issue is crucial, as it affects numerous Australians and others alike around the globe (2007 statistic – 45% of Australians) (Mental Health Council of Australia, 2007). The treatment of mental illness has yet to be mastered by health professionals whether it is the diagnosis or the prescribed medication/treatment options. Researchers have also failed to produce minimal side effect medications that will not deter patients away from treatment, which would be a major breakthrough and an extremely popular treatment option. Adding to the argument, the fact that anyone can be affected by this illness at any point in their lifetime increases the need for awareness of this issue. The public health experts should express the need for further funding towards research in all areas, such as: the diagnoses phase and criteria, early prevention programs, different forms of medication/treatment and listening and implementation skills/training when dealing with mentally ill persons.

Analysis of Artefact and Learning Reflections
The issues that have been presented in this analysis can directly reflect upon the cultural artefact. The title of the artefact “The drugs don’t work” couldn’t be more specific to the issues described and depicted in this analysis. The public health issue chosen was that mental illness medication was the problem in regard to the high prevalence of mental illness in Australia, as it was either ineffective and or contained side effects (physical, mental) that deterred patients away from this form of treatment. “Never coming down” was also a main lyrical part in this song, this was portrayed in the song as Richard believed he was never going to come down from the high the drugs he had ingested gave him. This can be related to mental illness medication also, the addiction phase that some forms of medication can have on sufferers is detrimental and their chances of returning to sanity during this addiction phase is a difficult task.

Personally, I have never been diagnosed with a mental illness or been acquainted with a person with mental illness. However, undertaking this research report has opened my eyes to the somewhat neglect mentally ill sufferers are faced with on a daily basis. I did not realise the extent of the problem that mentally ill patients have been faced with, including the side effects or lack of effects of medication and the criteria and straight forward approach to treatment mental health professionals undertake. I was surprised to uncover the mistreatment some sufferers are receiving and would encourage more media coverage to be undertaken on the basis of this so that the Government and other organizations involved can understand the seriousness and act accordingly.

This negligence in the diagnostic process can be compared to the treating illnesses such as the flu. Health professionals believe the illness is the just the simple flu after running standard test; they understand no further testing is needed, merely prescribing the standard medication for it. This process is too often used to diagnose mentally ill cases, patient complaints are not alike, diagnosing through the standard procedure results in too many patients being misdiagnosed. The medication and or treatment prescribed does not assist in rectifying the illness, instead potentially infecting the patient with greater side effects and promotes further scepticism towards it.

In writing this analysis the personal affects it has had on me are numerous. Whilst researching several journal articles and Government documents I discovered the amount of distress mentally ill sufferers go through. Writing this analysis was based on the need for sufferers to receive treatment that will actually benefit them and not cause further pain when they are clearly already in so much. Mentally ill diagnosed patients are already dealing with their mental disorders that cause them distress and pain, therefore why undertake in forms of treatment that will cause further pain and distress in the form of side effects and unwanted unfamiliar treatment?

<span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: justify;">Throughout this assessment I have learnt various new skills of researching and analysing different journal articles and Government documents. This assessment will definitely affect my future learning and thinking process as I have somewhat gone against the grain in terms of public health issues and I believe have successfully analysed the subject. This has challenged my skills in analysing and persuasive speaking although which has resulted in what I believe to be a credible analysis. I will definitely personally consider and sympathize with the mentally ill suffers as a result of the negligence sufferers of this particular illness have received when I enter the health industry.