A Case Study Of Mental Health

A Case Study Of Mental Health Mental health has become a major global problem. It affects 450 million people and one in four of us will suffer from mental ill- health at some time in our lives (WHO, 2001). Mental Health is used positively to indicate a state of psychological well- being, negatively to indicate its opposite ( as in mental health problems) or euphemistically to indicate facilities used by, or imposed upon , people with mental health problems ( as in mental health services). During the nineteenth century, all patients were certified under lunacy laws. That is, the State only made provisions for the control of madness. The fledgling profession of psychiatry ( this term was first used in Britain in 1858) was singularly preoccupied with segregating and managing lunatics . With the emergence of the First World War, soldiers began to break down with shellshock now called post traumatic stress disorder . From this point on, psychiatry extended its jurisdiction from madness to versions of nervousness provoked by stress or trauma. In the twentieth century, more abnormal mental states came within its jurisdiction, such as those due to alcohol and drug abuse and personality problems. Today, mental health services may be offered to, or be imposed upon, people with this wide range of problems, although madness or severe mental illness still captures most of the attention of professionals .Another aspects of the term mental health problems is that some people, criti cal of psychiatric terminology, object of scientific or logical grounds to notions like mental illness or mental disorder. In the 1983 Act and equivalent Scottish legislation mental illness is not defined. However, Article 3(1) of the Northern Ireland Order does define it as a state of mind which affects a persons thinking, perceiving, emotion or judgement to the extent that he requires care or medical treatment in his own interests of other persons. Neither the Scottish nor Northern Ireland definitions include psychopathic disorder and there has recently been some discussion in the context of review of the Mental Health Act about removing it in England and Wales. Issues concerning mental health have been raised substantially in the consciousness of politicians, the media, and the public. Moreover, the burden of mental disorder is regarded not just as a if not the- principal cause of human misery, but as a significant impediment to social and economic growth. Measurement of the years of potential life lost and the years of productive life lost through mental ill- health could reach 15% of all diseases and deaths globally by 2020 (WHO, 1999). A further dimension of inequalities in the apparent scale of mental health problems is race. Race is controversial to define. Genetic distinctions between groups of humans ( other based on sex) have little empirical basis. Racial distinctions arose from anthropological investigations carried out by colonized indigenous people. However, because of colonization, the social identity of these people became real for them and others. In the United States black patients are overrepresented in mental institutions, and have become increasingly so over the postwar period. This has particularly been the case within state mental hospitals, where minority groups constitute 35 per cent of the hospital population, and are subject to higher rates of admission and readmission. In a review of eight epidemiological studies conducted in the United States between the late 1950s and mid- 1970s, Kessler and Neighbors (1986) found that among persons with low incomes black people exhibited significantly more distress than white people. They claimed, therefore, that race is an important independent variable in determining the likelihood of an individual becoming mentally ill. There is some dispute over what to make of this evidence. Cockerham (1990) maintains that the majority of studies on the incidence and distribution of mental health problems suggest that race is not an independent variable: race alone does not appear to produce higher rates of mental disorder for particular groups. Rather, it is because more black people are in the lower social cases that they tend to demonstrate more signs of mental distress. Others, however, disagree. Halpern (1993) argues that minority status can be demonstrated to result in a tendency towards psychiatric problems. As with gender, a number of studies have been conducted indicating that racial bias exists in the assessment, diagnosis and treatment of mental health problems. It has been found, for example, that white therapists generally rated their black clients as being more psychologically impaired than did black therapists. Patients who are uncooperative, threatening or abusive are more likely to be diagnosed as being mentally ill if they have minority status. In particular, it has been found that being black tends to increase the chances of a person being diagnosed as being schizophrenic (Wade, 1993). Certain groups such as people of Afro- Caribbean origin tend to be more likely than whites to receive psychotherapy. Minority groups have proved less able to make use of community- based services. This is partly because they have lacked the resources to participate in the development of community care, and partly because of the lack of interest in or understanding of the specific cultural needs of minority groups when establishing services ( Wade, 1993). The term Afro- Caribbean refers to black people who either still live in Caribbean or who moved to Britain. Britain is an ex-colonial power, which enslaved and forcibly transported African people. Afro-Caribbean people have higher rates of diagnosis for schizophrenia but lower rates for depression and suicide than indigenous whites. An unresolved debate about over- representation is whether it is actual ( black and Irish people are mad more often) or whether it is a function of misdiagnosis . The data of Irish people highlight why the stresses of racism, based purely on skin colour, are not an adequate explanation of differences in mental health status. Although Afro- Caribbean people are vulnerable to psychosis, prevalence rates of all diagnostic categories are higher than for the indigenous ( non- Irish)whites in Britain. What are the implications of comparing and contrasting these two ex-colonized groups for our understanding of the relationship between race and mental health? The first point to emphasise is that given the white skin of the Irish, racism based on skin colour may be a stressor but is not one that accounts for racial differences in mental health. A second point is that while both groups are post-colonial remnants of forced migration, the circumstances for each were different. Third, the circumstances of migration to Great Britain were similar in some ways but not others. Employment opportunities governed population movement in each. Fourth, as ex-colonized, Afro- Caribbeans and the Irish have been recurrently stigmatized and rejected. A confirmation of this point is that these groups are also over-represented in the prison population, not just in involuntary specialist mental health services. Fifth, and following the previous point, whatever the causal explanations for over- representa tion, the racial bias means that these groups are disproportionately dealt with by specialist mental health services. As the latter are dominated by coercion, this outcome can be thought of as a form of structural disadvantage for these groups. The needs, issues and concerns of black and minority ethnic people (BME) with mental health problems have been pushed to the fore of the national health policy agenda (Department of Health, 1999; Department of Health, 2005). Britain is a multi- cultural society where the percentage of the population that is from minority groups is steadily increasing. In 2001 minority groups comprised seven per cent of the population, with a concentration in London and other inner city areas. BME communities occupy particular positions of disadvantage in the United Kingdom. Inequalities are reflected across all indices of economic and social well- being.They generally have higher rates of unemployment, live in poorer housing, report poorer health, have lower levels of academic achievement and higher rates of exclusion from schools. The tragic but significant marker for BME communities was the death of David Bennett while being restrained by nursing staff on a medium secure ward. After a long campaign by his family, an independent inquiry report concluded that the NHS mental health services are institutionally racist'( Norfolk, Suffolk and Cambridgeshire SHA, 2003). The government subsequently published an action plan for Delivering Race Equality (Department of Health,2005). This plan has three building blocks: to develop more appropriate and responsive services, to provide better quality information on the mental health needs of BME, to encourage greater community engagement in the planning and delivery of mental health services. DRE focuses on organisational change, but fails to appreciate the heterogeneity within the BME population, and the complex range of identities and practices it contains.It also fails to appreciate that the inequalities in mental health for black people exist within a broader historical and contemporary context of social and economic inequalities and prejudice. Moreover, the problem seems to have been framed in the context of culture- thus, the focus in the DRE strategy on developing a culturally competent workforce. Fernando (2003) argues that a focus on culture can itself be racist and therefore has to be examined in this context. Another issue to consider is the impact of racial disadvantage and discrimination on individuals , their families and communities. Petel and Fatimilehin (1999) suggested that the impact of racism is psychological, social and material. The effects of these are likely to be detrimental to mental health, but it has to be borne in mind that for some it may be minimal, while for others it may be of great significance to their emotional well-being. The effects of racism on the individual may have wider impacts on families and communities . The impact of racism therefore has to be analysed in the context of histories of migration, histories of alienation, the subordination that resonates for these groups, and the way in which these groups have been stigmatised and continue to be stigmatised in society today. There are many competing discourses and perspectives on what constitutes mental illness. Bracken and Thomas (2005)argue that our knowledge of mental illness and distress is indeterminate and new ways of thinking about mental illness are constantly emerging. Coppock and Hopton (2000)suggest that there is ample evidence to show that mental illness is affected by social and political circumstances. Mental illness can be deeply dehumanising and alienating. It is generally regarded with anxiety and fear and loads to rejection and exclusion. A report by the Social Exclusion Unit (2004) found that people with mental health problems are among the most disadvantaged and socially excluded groups in society. The stereotype of big and dangerous has been fixed in the popular case of Christopher Clunis- a back man who had a diagnosis of schizophrenia, who randomly killed a stranger to him, Jonathan Zito, in a London underground in 1992. Keating et .al (2002) have demonstrated that such stereotypical views of black people, racism, cultural ignorance, stigma and anxiety associated with mental illness often combine to influence the way in which mental health services assess and respond to the needs of BME communities. There are at least three factors that underpin black peoples experiences of the mental health system: one, how black people are treated in society; two, how people with mental health problems are treated in society and three, the power of institutions to control and coerce people with mental health problems. Black peoples experiences in society have an impact on their mental and emotional well- being; these experiences in turn influence how they experience and perceive mental he alth services, and their position in society affects how they are treated in mental health services. Eradicating the disparities in mental health treatment and outcomes for a black people requires change in individual practices, but this can only be successful if supported by changes at the organisational level. Efforts to improve mental and emotional well- being for BME communities should be anchored in an understanding of history, broader societal conditions and contexts, and black peoples lived experiences: not just their experiences of racism, but also how they have survived in the face of multiple adversities. McKenzie (2002) has argued that the lack of definition of mental health from a British African Caribbean perspective and the use of diagnostic criteria based on white European norms rather than on the values and experience of the African- Caribbean population is problematic. Further evidence Hunt (2003), Keating, Robertson and Kotecha (2003) and McKenzie (2002) suggests that people from BME communities experience a number of social and environmental risk factors which adversely affect their mental health. These include high unemployment rates: poor housing, racism, low educational expectations, particularly for African and Caribbean boys (Grater London Authority/ London Health Observatory 2002); isolation; and a lack of access to opportunities for personal development. A report by the black mental health charity Footprints (UK) (2003), which works primarily with African Caribbean service users, has identified continuing issues of concern about care and treatmet as: the need for better assessment to promote more culturally acceptable interventions, concerns about medication, including high dosages and polypharmacy, resulting in numerous adverse side- effects and negative staff attitudes. Keating et al. (2003) have highlighted the point that black people see using mental health services as a degrading and alienating experience and that their perception is that service respond to them in ways that mirror some of the controlling and oppressive dimensions of other institutions in their lives, for example exclusion from schools and contact with police and the criminal justice system. The National Service Framework for Mental Health ( NSFMH) is an important driver and ways a key step in actively signalling that health services must ensure that the needs of people from BME communities are incorporated in the planning processes from mental health care. The framework emphasised the need for diverse communities to be consulted about the ongoing effectiveness and suitability of services. The NHS Plan is underpinned by ten core principles that are aimed at ensuring that people who use mental health services are at the centre of determining how services are delivered. The NHS Plan contains an explicit recognition of the diversity that exists within Britain. The recently published strategy on black mental health again underscores the governments commitment to race equality and outlines the underpinning roles of the NSFMH and the NHS Plan in ensuring that its modernisation programme within mental health is delivered. In conclusion the impetus and improvement for mental health service delivery to BME communities can be seen. Many people who use mental health services, however, would argue that what is less tangible is change in hospital wards, day centres, residential homes and engagements with community mental health teams; in essence, at the coal face. There is scope for substantial and sustainable change. It will require a recognition by mental health professionals of the strengths that service users and their families can bring in reshaping service delivery, partner- professionals and, most importantly, agreement by service providers and service users on clear and mutually agreed goals and outcomes about what constitutes improved care and treatment. Efforts to improve mental and emotional well- being for BME communities should be anchored in an understanding of history, broader societal conditions and contexts, and black peoples lived experiences: not just their experiences of racism, but also how they have survived in the face of multiple adversities. Beata Kulinska Student no: 09284805 Word count: 2999 References Pilgrim, D.(2005) Key Concepts in Mental Health. London: Sage Publications Ltd. Scull, A.(1979) Museums of Madness .Harmondsworth: Penguin. Stone, M,( 1985) Shellshock and the psychologists. London: Tavistock. Rogers, A. and Pilgrim, D.(2005) A Sociology of Mental Health and Illness.3rd ed. Maidenhead: Open University Press. Wade, J. (1993) Institutional racism: an analysis of the mental health system. American Journal of Orthopsychiatry.63(11): 536-544. Littlewood, M. (1980) Ethnic minorities and psychiatric services. Sociology of Health and Illness.2: 194-201. Sashidharan, S.(1993) Afro- Caribbeans and schizophrenia: the ethnic vulnerability hypothesis re- examined. International Review of Psychiatry. 5: 129- 144. Bracken,P.J., Greenslade, L., Griffen, B., Smyth, M. (1998) Mental health and ethnicity: an Irish dimension. British Journal of Psychiatry. 172: 103-105. Greenslade, L.(1992) White skin, white masks: psychological distress among the Irish in Britain. Leicester: Leicester University Press. White, A. (2002) Social focus in brie: ethnicity. London: Office for National Statistics. Healthcare Commission (2005) Count me in: results of a national census if inpatients in mental health hospitals and facilities in England and Wales. London: Healthcare Commission. Bhui, K., McKenzie, K., Gill, P. (2004) Delivering mental health services for a diverse society. British Medical Journal. 329: 363-364. McKenzie, K.(2002) Understanding racism in mental health. London: Jessica Kingsley Publishers. Trivedi, P. (2002) Racism, social exclusion and mental health: a black service users perspective. London: Jessica Kingsley Publishers. Department of Health (1999) National Service Framework for Mental Health: Modern Standards and Service Models. London: Department of Health. Department of Health (2000) The NHS Plan: A Plan for Investment, a Plan for Reform. London: The Stationery Office. National Institute for Mental Health England (2003) Inside/ Outside: Improving Mental Health Services for Black and Minority Ethnic Communities in England. London: Department of Health.

50 Shades- Feminist Theory

Erica Freedman 1-24-2013 Feminist Theories in Intercultural Perspective- Hoffman The explosively popular 50 Shades of Grey series depicts Ana Steele, an aspiring young writer who quickly falls into the clutches of an extremely seductive and successful Christian Grey in a dominant/ submissive love story. Easily sweeping the young and restless girl off her feet, Grey’s confident and demanding presence starkly contrasts Ana’s who is known to self deprecate and hide behind plain clothing or a pile of books.From the onset it is clear that stereotyping Ana as frail and naive are what allow Christian to appear as the ultimate prince charming. Ana is initially depicted as independent: hyper-focused on a successful career in the literary world, the perfect daughter and the perfect student who has never had time for a boyfriend. Her best friend and roommate Kate is even more self-sufficient as the requisite foil with the outspoken personality and journalistic go-getter attitude. When Kate and Ana lose site of their goals due to the handsome pair of successful brothers, two gender aspects are highlighted.Kate’s strength is suddenly depicted as a mask that was disguising her truly feminine and love seeking qualities. Her priorities become completely disheveled and all she begins to desire is spending more time with her new infatuation. Ana grapples with a watered down battle of morality where she claims to feel immense discomfort in having an overpowering lover who can get her to do anything he wants, while still wanting to make her own way. This idea is consistently undermined by her actions throughout the story.For instance, after saving herself for the perfect person for twenty-two years, Ana is convinced to giver herself away in a one-night stand with Grey. Immediately past this point, Christian places Ana in a highly-controlled, powerless relationship where he stalks her, takes all of her time and insists on buying her things she supposedly does n ot desire–including a new wardrobe and a higher position in a publishing company that he decides to acquire a few weeks after she begins interning there.Anastasia is suddenly incapable of talking to one of her closest friends, Jose, because of Christian’s overwhelming jealousy. Ultimately, Anastasia caves to his wishes on that front as well. As sexually liberated and filled with love as Christian makes Ana feel, he also easily and quickly strips her of as much of her independence as he can. It is these traits that make the existence of their relationship possible. Without Ana’s willingness to adhere to Christian’s expectations and demands, she cannot have him, and so she does what is expected of her instead.

Racism in “Snow Falling on Cedars” by David Guterson Essay

In Snow Falling on Cedars, the theme of racism stands out most strongly. Events, characters’ attitudes, and emotions are all directly related with the surrounding environment of racial tension, caused by war hysteria. This prejudice retains a strong hold over the people of San Piedro Island, as well as all over America at this time. Events in the novel take place as a direct result of bigotry, such as the search for a â€Å"right handed Jap.† This comment made by Horace Whaley to Sheriff Moran, caused a search warrant to be issued, with special attention to persons of physically apparent Japanese descent. Even while in court, a supposed place of justice, racial barriers still existed. Nels Gudmundsson attempted to overcome this obstacle by his statement of â€Å"†¦the shape of Kabuo Miyamoto’s eyes, the country of his parents’ birth — these things must not influence your decision. You must sentence him simply as an American, equal in the eyes of our legal system to every other American.† to the jury. Most characters in the novel are racist against the Japanese, except Arthur Chambers, who is accused of siding with the â€Å"enemy† for contributing Japanese points-of-view into his newspaper editorials, and his son, Ishmael, who later views Japanese in a negative light. Ishmael’s change in attitude occurs because of his frustration in the failure of his pursuit of Hatsue. Etta Heine’s attitude towards the Japanese is among the worst of any character in Snow Falling on Cedars. She does not see the Japanese as an equal race, but as an evil, vengeful race with ulterior motives. Etta’s skepticism becomes obvious in the meeting between Carl, Zenhichi, and herself, through her thoughts; â€Å"he was always nodding†¦It was how they got the better of you–they acted small thought big†. David Guterson developed the theme by the general condescending attitude and actions by the whites towards the Japanese. There is constant tension between characters of different races (Etta and Zenhichi), problems with interracial relationships (Ishmael and Hatsue), and a fearful, bigoted dialogue; â€Å"They’re Japs†¦We’re in a war with them. We can’t have spies  around.† The majority of elements in the novel revolve around racial issues, as Guterson creates an important and poignant theme of a difficult era in American history.

Gun Control Debate - Free Essay Example

Sample details Pages: 3 Words: 814 Downloads: 5 Date added: 2019/03/19 Category Society Essay Level High school Topics: Gun Control Essay Did you like this example? Recent mass shooting led large number of American citizens to come to the conclusions that we should repeal the second amendment. They claim that not only would this stop mass shootings, but it would make every community safer in the United States. But to what extent would the repealing of the second amendment make the United States safer? Except for a few exceptions, almost every mass shooting has been committed using an illegal firearm. Furthermore, mass shootings have been prevented from a law-abiding citizen that has a conceal carry license that thankfully put an end to the shooting before more victims were added to the shooting such as in September of 2017 when an usher at a church in Tennessee shot and killed a gunman who killed a woman and injured others in the parking lot. Repealing the second amendment would not make America safer but would rather make it more dangerous as citizens would not be able to protect themselves from criminals using illegally owned firearms. Don’t waste time! Our writers will create an original "Gun Control Debate" essay for you Create order Activists from this movement, such as David Hogg, a student at Stoneman Douglas High School where a mass shooting took place in February of this year states that the only way to save more children and people is to get rid of guns. Although this may sound to be a suitable solution there is one major flaw in the argument. More than half of criminals are smart enough not to buy a gun legally. They will get their firearms illegally through the black market. This was exemplified during the prohibition when the American government banned the alcohol and is continued to be shown today with drugs such as Marijuana. Alcohol consumption skyrocketed as people made their own beverages and sold them illegally. This same thing would happen if guns were made illegal seeing as roughly four out of every ten guns are obtained illegally, according to Giffords Law Center. Therefore, if the amendment did get repealed, law-abiding American citizens would be put in more danger. Even if a person carried a knife on them at all times, they dont stand a chance to a person who has a gun. If in fact every person in the United States over the legal limit had a gun in their possession, people would be too scared to use it as they would be neutralized another person carrying a gun. Advocates for the use of firearms say gun-carrying civilians prove that an armed populace can help mitigate the death toll of a mass shooter but could also prevent mass shootings as a whole from happening (2). The only time we hear about gun control is when a mass shooting occurs. Troubled cities such as Chicago and Detroit have murders committed every day, yet we never hear about them in the media. According to the FBI UCR report in 2015, Detroit has some of the strictest guns laws in the nation yet had two hundred and ninety five murders reported whereas Wacko, Texas has less restrictive gun laws and only had twenty two murders reported. The harder a city, county, or nation make it for people to buy a gun, the easier it is for criminals to commit murders and other types of crime. It is human nature for people to want what they cant have. There is a small compromise that both sides of the argument want, tighter background checks. Today, there are many holes in the background check process that allow for a non-qualified person to obtain a gun. For example, mental health records are not looked at thoroughly or even at all by gun shops. This is what allowed Seung-Hui Cho to buy a gun and commit the mass shooting at Virginia Tech in 2007. Cho originally was labeled as Troubled: Further contact within 2 weeks according to the Cook Counseling Center (3). People with high levels of suppression or thoughts of suicide should not be able to own a gun. But this shouldnt take away the rights for everyone to own a gun either. No one knows exactly what a person will do once they buy a firearm, thats why guns should only be sold to people that have no history of mental illness or arrested for a gun related crime. As more criminals and mentally ill people get their hands on guns, we will continue to see murders and mass shootings throughout the country. Their need to be stricter gun laws but that does not mean taking guns away from law-abiding citizens that use them for protection. The more guns there are in the country, the more people will be afraid to use them. Although is it hard to predict how people will use their guns once they buy them, knowing other people have guns will discourage them to commit mass shootings. The second amendment was put in place for a reason and repealing it will only allow more crime to be committed.