The+Mentally+Ill-+Friend+or+Foe?

**Melissa Driesssen** **n8305811**  **Tutor: Katie Page** **The Mentally Ill- Friend or foe? ** // It’s good to know that if I behave strangely enough, society will take full responsibility for me. // // –Ashleigh Brilliant // ** Topic: ** How far has Australia come in the treatment of the mentally ill? Have they become a friend rather than a foe? **Artefact:** (Davis, 2010) This artefact displays a mentally ill patient restrained to his bed by wrist cuffs and a restricting waist belt. Typically these items were used in lunatic asylums throughout the eighteenth and nineteenth century in order to keep the mentally ill ‘controlled’. The restraints were generally made out of harsh leather to ensure they could not be easily broken or released and were often strapped to a bed or wall within the asylum. The purpose of the restraints was to forbid any movement of the mental patient to ensure they do not harm themselves or anyone else. Generally the patient would wear both wrist and ankle restraints, as well as a tight belt across the waist. (Ibell, 2004).

**Public Health Issue:** The artefact presented is symbolic of the cruel and unjust treatment towards the mentally ill throughout history, as they were seen as dangerous lunatics rather than humans. It is a reminder of how far society has come in terms of how the mentally ill are treated and their inclusion in society today. This essay will explore mental illness awareness within the 21st century to outline what mental illness actually is, as a type of disease rather than lunacy. It will also analyse how far we have come from the inhumane treatment of institutionalised patients throughout history and the movement of deinstitutionalisation within modern society. In addition, it will investigate how this has improved the treatment of the mentally ill throughout civilization and what packages have been put in place to aid this transition. **Literature Review** In modern society the Australian Government considers mental illness to be a group of diseases which dramatically affect how a person thinks, feels and behaves (Australian Government, 2007). The World Health Organization (2000) describes mental Illness as a disorder which can “provoke suffering, cause disability and can even shorten life”. In 2006, mental illness was one of the top ten diseases in Australia, with 13% of the total disease burden (AIHW, 2006). Additionally, a study by the Australian Bureau of Statistics in 2007 specified that 20% of Australians aged 16- 85, experienced a mental illness in the preceding 12 months (ABS, 2008). This is equivalent to 3.2 million people and is one of the many reasons why mental health is placed among Australia’s National Health Priority Areas (AIHW, 2011). This also demonstrates the extreme importance of this issue and why it must continuously be addressed in Australia.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;"> From the information above it can be seen that in the 21st century Australian’s are more aware of what the disease actually involves. Throughout medical settings, mental illness is seen as something that can be treated and most of the resources are provided to support these treatments (Australian Government, 2007). Throughout the community Australian’s are involved in supportive groups, events and fundraisers to support the mentally ill. This is in addition to World Mental Health Day, an event which annually raises public awareness about mental health issues (WHO, 2011). In modern society the Government is also involved in many plans and policies in order to support the mentally ill. To name one, is the National Action Plan on Mental Health which is agreed upon by the Council of Australian Government and has been amended over numerous occasions (Australian Government, 2010). Although Australia still has a long journey to go until meeting the unblemished care standards required for patients- in comparison to the treatment of the mentally ill throughout history, Australia has already come an extremely long way.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Ibell (2004) composed a report on the treatment of the mentally ill throughout history with a focus on social justice and human rights. She demonstrated that throughout the late eighteenth century mental illness was not considered a medical condition, rather a type of lunacy. In addition, those displaying signs of this insanity were kept in a family or supervised home, as an outcast from society. Ibell (2004) also included that towards the nineteenth century the mentally ill were deemed as an exile group in society and were sent to isolated institutions for permanent observation. Throughout institutions patients were kept in secluded rooms, often strapped to their beds with tight restraints or within a straightjacket. The patients had little or no contact to the outside world and were often locked in the one room for long periods of time. This is an illustration of the unjust and inhumane treatment of the mentally ill throughout history. (Ibell, 2004).

<span style="color: black; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Deinstitutionalisation describes the transformation from an institutional exemplary of care in isolated psychiatric hospitals to psychiatric treatment being provided by mental health services. This includes mental health services in the community and psychiatric inpatient units of general hospitals. This process has occurred gradually over the last 30 years (Queensland Government, 2008).

<span style="color: black; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Rosen (2006) conducted a report based on the deinstitutionalisation of the mentally ill over Australian history, emphasizing the source of the greatest changes- the economy. The report illustrates how deinstitutionalisation evolved from a non-systematic to a systematic approach where the largest movements did not occur until they were finally government funded. The non-systematic deinstitutionalisation occurred from the 1950’s, “partly on the basis of renewed clinical optimism, availability of employment and changing social attitudes… Mental health services and resources, however, did not follow their patients into the community” (Rosen, 2008). This demonstrates that the clinical workers and society were gaining a sense of morality and desired to move the mental patients into a more just environment. However, it wasn’t until 1983 when David Richmond was commissioned to report on the lack of services and support for people with severe mental illness and their families in the community, that the systematic approach occurred. Richmond recommended (as quoted by Rosen, 2008) “a gradual shifting of resources from psychiatric hospitals to where most of these people now lived”. In addition to the first National Mental Health Policy released in 1993, Rosen claims these acts were the prominent cause of deinstitutionalisation with government funding. Following this, he then states the only limitation of moving the mentally ill into community care, is that the private clinics are funded by taxpayers through the Health Insurance Commission, which has increased by 64.9% since 1992-3 (Rosen, 2008).

<span style="color: black; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">The perspectives of deinstitutionalisation are also shared within a report by Lamb and Bachrach (2001), as the authors highlight the obvious positives of community care, but also the objective negatives. The article outlines the three components of deinstitutionalisation being, “the release of these individuals from hospitals into the community, their diversion from hospital admission, and the development of alternative community services” (Lamb & Bachrach, 2001). Through these components the mentally ill are welcomed into society to develop a sense of independence, community involvement and care. However the controversial article included some limitations which provided an unexpected yet legitimate limitation of deinstitutionalisation. This includes the issue of removing some mental patients from institutions which they have for many years called ‘home’. This then sanctions the concern for those severely ill patients who have been discharged into the community and are now seen as homeless on the community streets. However Lamb and Bachrach (2001) conclude their report by stating that if all three areas of deinstitutionalisation (as stated above) are applied, the result has most often benefited persons who suffer from mental illness. <span style="font-family: Arial,Helvetica,sans-serif;">** Cultural and Social Analyses: ** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Although deinstitutionalisation is considered one of the crucial movements towards superior health care of the mentally ill, the social and cultural implications must be considered. While Australia has come a long way in mental illness equality and impartiality, mental illness stigma and discrimination still disturbs the lives of those suffering. A report by Overton and Sondra (2008), outlined the prejudice attitudes which still arises within the 21st century as “People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services.”. This stigma is not only offensive but limits the chances of mental patients achieving opportunities which are well within their reach. The report concludes by making the bold statement that “Negative connotations and false assumptions connected with mental illness may be as harmful as the disease itself” (Overton & Sondra, 2008).

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Yoon and Bruckner (2009) focused a report on the influence of deinstitutionalisation and reducing psychiatric beds, on suicide within mental patients. The experiment tested the increase of suicide rates from the years 1982-1998. As a result the decrease of psychiatric beds within institutions did increase suicide rates within the mentally ill. The report stated that although suicide rates may rise, “an increase in community mental health funding may be promising” (Yoon & Bruckner, 2008). This as a result would have a large effect on society and the government, as the deinstitutionalisation is jeopardizing the care for indigent, severely mentally ill patients that require treatment but lack sufficient economic resources. The increase of suicide rates would also have a large effect on the friends, families and proactive groups within the community who care for the wellbeing of the patients.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Tabatabainia (2003) conducted a report which was dedicated to the opinions of family members regarding deinstitutionalisation. The report found that although the government, policy makers and service providers could see the positives in deinstitutionalisation (creating independence within the patients and promoting community involvement), the family members resisted. The major challenge and concern of families was being able to “find and sustain a safe, sound, respectful, caring, and permanent residential place for their relatives” (Tabatabainia, 2008). This interrelates with the report discussed earlier by Lamb and Bachrach (2001), as the movement of the mentally ill into the public may result in an increase of patients living on community streets. A notion which the government, families, proactive groups and society would agree is not ideal.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">As a society it is important that we focus on all areas of deinstitutionalisation, including the effects on society and culture. Although the argument above mostly emphasizes the negative results of deinstitutionalisation towards society, the areas for improvement can be outlined. It can be seen that health experts should focus on the economic crisis for many mental patients who have been moved into the community. Further support may be implemented into government funded housing for mental patients or allowances to the family members for the extra care which is required. Additionally it can be seen why awareness of this issue is important, as Australian’s must learn to welcome the mentally ill into their communities- rather than creating a prejudice environment. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Analysis of the Artefact and your own Learning Reflections** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">My artefact is a representation of the positively developed treatment and awareness of the mentally ill throughout history. It allows an insight into the inhumane and unjust treatment of the mentally ill from earlier eras and demonstrates how far we have come in the understanding of this complex disease. Through further analysis, the artefact also allows us to recognize the positive and negative effects deinstitutionalisation has and continues to have on mental patients, their families and also the community. Personally, it is hard for me to understand how people throughout history and even in the present can treat another human being in such a negative and cruel way. Additionally through exploring this topic, I have gained respect for those who have suffered this journey of inhumane treatment to finally being acknowledged as part of society.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">From this assessment I have learnt that although the government and society may portray the positive effects of deinstitutionalisation, there are many hidden truths. Especially as the opinions of those actually suffering with the disease and their family members are taken into consideration. Therefore, this will affect my future learning as I will not only understand the information provided by the government or policy makers, but will read deeper into the views of the people who are actually involved. This will allow me to gain a better understanding of the issue and become more actively involved. My thinking process will also be developed as I will no longer make quick judgments of an issue based on what others have said; but will advance my learning to form my own attitudes and beliefs.

**<span style="font-family: 'Arial','sans-serif';">Discussion and Reflection Task! **
 * <span style="font-family: 'Arial','sans-serif';">PAGE: Gen Y- Facing the music **
 * <span style="font-family: 'Arial','sans-serif';">Author- n6382355 **
 * <span style="font-family: 'Arial','sans-serif';">Comment: Interesting and Informative! **

<span style="font-family: 'Arial','sans-serif';">Great work! I like the way your artefact depicts an actual example of how gen Y differs from the other generations (changing social behaviours etc.). Rather than just saying the issue, we can see it in real life. Your title also links in nicely to your theme. Additionally, the way you linked in mental illness to gen y’s pressure to conform was clever and interesting. I also think this may be caused by Gen Y’s persistent need to be “the best”- especially in the work force.

<span style="font-family: 'Arial','sans-serif';">Social and cultural paragraph was good too- Particularly the information on generation unity and conflict. The topic of generation conflict makes me wonder how Generation Y is really perceived by the other generations. I think that despite our determination and optimism- the other generations still see gen Y as irresponsible in terms of how we behave in social situations. Do you agree?

<span style="font-family: 'Arial','sans-serif';">It is great that you pointed out that no matter what, our generations will continue to change throughout society and we must accept this. <span style="font-family: 'Arial','sans-serif';">Over all very good wiki!


 * <span style="font-family: 'Arial','sans-serif';">Page: Depression- In the Pursuit of Happiness **
 * <span style="font-family: 'Arial','sans-serif';">Author: n6874037 **
 * <span style="font-family: 'Arial','sans-serif';">Comment: Excellent Wiki! **

<span style="font-family: 'Arial','sans-serif';">Very informative! I found your facts and statistics on antidepressants and depression very interesting! I did not realise that antidepressants were seen as such an ‘evil’ thing with so many side effects. I would be interested to hear what some of these side effects are, which is good because your wiki has left me wanting to learn more! <span style="font-family: 'Arial','sans-serif';">You had great evidence to back up your points with plenty of experiments and research on the topic. It is interesting to understand that antidepressants work best with interventions and help from health care professionals. <span style="font-family: 'Arial','sans-serif';">I think it would be extremely fascinating to research an experiment with 2 groups, combining use of interventions and antidepressants as well as interventions and a placebo drug. Just to test out exactly how effective the antidepressants actually are.

<span style="font-family: 'Arial','sans-serif';">Thanks and good job!

**<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Reference List ** <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Australian Bureau of Statistics. (2008). National survey of mental health and wellbeing: Summary of results. ABS Catalogue No. 4326.0. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Australian Government. (2007). What is mental illness? //Department of Health and Aging.// <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Australian Government. (2008). A guide to mental health terminology. //Health Services.// <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Australian Government. (2010). National mental health report 2010: Summary of 15 years of reform in Australia’s mental health services under the National Mental Health Strategy 1993-2008. //Department of Health and Aging.// <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Australian Institute of Health and Welfare. (2006). Australia's health 2006. AIHW Cat. No. AUS73.

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Australian Institute of Health and Welfare. (2011). //Mental health//. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Ibell, B. (2004). An analysis of mental health care Australia from a social justice and human rights perspective. //School of Philosophy,// 2- 22. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Lamb, R. & Bachrach, L. (2001). Some perspectives on deinstitutionalisation. //Psychiatric Services, 52// (8), 1039-1045. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Overton, S., Sondra, M. (2008). The stigma of mental illness. //Journal of Counseling and Development//, //86// (2), 143-151. doi: 07.489633/ 317-929.58.x

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Rosen, A. (2008). The Australian experience of deinstitutionalization: interaction of Australian culture with the development and reform of its mental health services. //Acta Psychiatr Scand, 113// (1), 81-89. doi: 10.1111/j.1600-0447.2005.00723.x

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Source of Artefact Picture: Davis, L. (2010). The defiant ones. //Lauren B. Davis Bio//. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Tabatabainia. M. (2003). Listening to families’ views regarding institutionalization & deinstitutionalization. //Journal of Intellectual and Developmental Disability, 28// (3), 241-259. <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: [|www.cinahl.com/cgi-bin/refsvc?jid=1446&accno=2004094645]

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">World Health Organization. (2000). Stop exclusion, dare to care. //Mental Health Around the World.// <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">World Health Organization. (2011). World mental health day. //Mental Health.// <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">URL: []

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Yoon, J., Bruckner, T. (2009). Does deinstitutionalization increase suicide? //Health Services Research, 44// (4), 1385-1405. doi: 10.1111/j.1475-6773.2009.00986.x