Welfare State Replacements: Deinstitutionalization, Privatization and the Outsourcing to Immigrant Women Enterprise

2018 ◽  
Vol 48 (2) ◽  
pp. 247-266 ◽  
Author(s):  
Jennifer Nazareno
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Welfare State ◽  
Mental Health Care ◽  
Immigrant Women ◽  
Health Care Facilities ◽  
Direct Care ◽  
Term Care ◽  
Severely Mentally Ill ◽  
The U.S

The U.S. government has a long tradition of providing direct care services to many of its most vulnerable citizens through market-based solutions and subsidized private entities. The privatized welfare state has led to the continued displacement of some of our most disenfranchised groups in need of long-term care. Situated after the U.S. deinstitutionalization era, this is the first study to examine how immigrant Filipino women emerged as owners of de facto mental health care facilities that cater to the displaced, impoverished, severely mentally ill population. These immigrant women–owned businesses serve as welfare state replacements, overseeing the health and illness of these individuals by providing housing, custodial care, and medical services after the massive closure of state mental hospitals that occurred between 1955 and 1980. This study explains the onset of these businesses and the challenges that one immigrant group faces as owners, the meanings of care associated with their de facto mental health care enterprises, and the conditions under which they have operated for more than 40 years.

Mental health policy in Greece: Implications into practice in the era of economic crisis

2011 ◽  
Vol 26 (S2) ◽  
pp. 539-539 ◽  
Author(s):  
I. Grammatikopoulos ◽  
S. Koupidis ◽  
E. Petelos ◽  
P. Theodorakis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Policy ◽  
Mental Health Care ◽  
Economic Crisis ◽  
Rural Areas ◽  
Care Delivery ◽  
Mental Health Policy ◽  
Regional Distribution ◽  
Health Care Facilities

IntroductionBudgets allocated for mental health make up a relatively small proportion of total health expenditures, although there is an increasing burden of mental disorders.ObjectivesTo review the mental health situation in Greece with regards to mental health policy through review of relevant literature.AimsTo explore the basic implications of the economic crisis from a health policy perspective, reporting constraints and opportunities.MethodsA narrative review in PubMed/Medline along with a hand search in selected Greek biomedical journals was undertaken, relevant to mental health policy.ResultsGreece is among the OECD countries with high health expenditure as a percentage of Gross Domestic Product (9.7% of GDP in 2008) but it doesn’t have a specified budget for mental health and is mostly depended in out-of-pocket expenditure (48%). The system is plagued by problems, including geographical inequalities, overcentralization, bureaucratic management and poor incentives in the public sector. The lack of cost-effectiveness and the informal payments comprise a major source of inequity and inefficiency. Uneven regional distribution of psychiatrists exists and rural areas are mostly uncovered by mental health care facilities, as well as extramural mental health units and rehabilitation places, despite the current reorganization of the whole mental health care delivery system.ConclusionsThe core problem with mental health services in Greece is the shrinking budget with poor financial administration consistent with inadequate implementation of mental health policy. A clear authority with defined responsibility for overall mental health policy and budgetary matters is needed.

scholarly journals The familiar stranger of mental health

2020 ◽  
Vol 15 (4) ◽  
pp. 237-247
Author(s):  
Matthew Sydney Long
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Facility ◽  
Health Care Professionals ◽  
Service User ◽  
Health Care Facilities ◽  
Mental Health Facility ◽  
Content Type ◽  
The Impact

Purpose This paper aims to contribute to the debate about the closure of institutional mental health-care facilities, from an experiential perspective of a former mental health inpatient, ongoing service user and campaigner for retention of such facilities. It argues that auto-ethnographic accounts of mental illness by those with multiple social identities can have a greater role in terms of future training of mental health-care professionals. Design/methodology/approach The paper offers an experiential account of the impact of mental health facility bed closures as a patient admitted to institutional mental health facilities; as a mental health campaigner, fighting for the provision of both places of safety and “safe space” within his own local community; and as an ongoing service user. The research is in the interpretivist tradition of social science in taking an auto-ethnographical methodological stance. Findings This paper is underpinned by two key theoretical notions. Firstly, Stuart Hall’s concept of the Familiar Stranger (2017) is used to explore the tensions of self-identity as the author SHIFTS uncomfortably between his three-fold statuses. Secondly, the notion of “ontological insecurity” offered by Giddens (1991) is used with the paper exploring the paradox that admission to a mental health facility so-called “place of safety” is in fact itself a disorientating experience for both patient and carer(s). Research limitations/implications No positivistic claims to reliability, representativeness or generalisability can be made. It is the authenticity of the account which the reader feels should be afforded primacy in terms of its original contribution to knowledge. Practical implications This paper should have practical use for those tasked with developing educational and training curriculums for professionals across the mental health-care sector. Social implications This paper implicitly assesses the political wisdom of the policy of mental health bed closures within the wider context of the deinstitutionalisation movement. Originality/value This paper is underpinned by original experiential accounts from the author as patient, campaigner for places of safety and onging service-user of mental health care provision.

Workforce Planning for Embedded Mental Health Care in the U.S. Navy

2020 ◽  
Vol 185 (11-12) ◽  
pp. e1961-e1967
Author(s):  
Jeffrey Millegan ◽  
Robert Lippy ◽  
Gabriel De La Rosa ◽  
Michael Swayze ◽  
Thomas Murray ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Linear Programming ◽  
Mental Health Care ◽  
Workforce Planning ◽  
Care Staff ◽  
Programming Algorithm ◽  
Care Providers ◽  
Staffing Levels ◽  
The U.S

Abstract Introduction Embedding mental health providers directly into operational units provides opportunities for holistic individual and population focused mental health support. To effectively provide clinical mental health care to a large number of Sailors and Marines while supporting the larger command, it is crucial to arrive at an optimal number of mental health (MH) care staff. In response to an increasing demand for MH care by operational units distributed globally, the U.S. Navy (USN) critically analyzed the current MH staffing levels, estimated future demand for MH care providers, and evaluated several staffing options. The following article illustrates a case study of workforce planning for the USN’s embedded MH delivery model. Materials and methods Several existing data sources were used to calculate current number of MH care staff across all USN platforms and to estimate demand for MH care. An open source Linear Programming application was used to estimate staffing solutions that meet business requirements in the most efficient manner possible. Results Results suggested different conclusions for embedded mental health staffing across USN communities. Depending on existing staffing levels and the number of Sailors or Marines anticipated to require care, the Linear Programming algorithm estimated needed staffing levels to address demand. Conclusion The current project represents the first systematic workforce planning initiative designed to help staff the USN’s global demand for community focused MH care. The results of this project have identified areas where additional embedded mental health resources should be made available. By systematically documenting all services and capabilities and carefully examining the operational demands of each community, the current solution was able to identify precisely what type of MH resources should be allocated to a given community.

The helps toolkit - a tool to promote the physical health of residents in psychiatric facilities across Europe

2011 ◽  
Vol 26 (S2) ◽  
pp. 587-587
Author(s):  
P. Weiser ◽  
T. Becker ◽  
R. Kilian
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Physical Health ◽  
Health Care Facilities ◽  
Medical Care System ◽  
Increased Risk ◽  
Co Morbidity ◽  
Wide Range ◽  
Care Facilities

IntroductionPeople with a mental disorder are at increased risk for physical illness and therefore their risk of premature death is raised. An unhealthy lifestyle, living conditions, medication side-effects and a lack of physical health monitoring are regarded as the main causes of high somatic morbidity. But up to now only little research has addressed the physical co-morbidity in mentally ill. At present, there are no specific policies to improve the health status of residents in mental health care facilities.Objectives / methodsAgainst this background a multi-disciplinary network of experts from 15 European countries was set up. Working together with researchers, stakeholders, professionals, networks, practitioners, and relevant organizations, the HELPS network developed a “physical health promotion toolkit” for routine application in a wide range of mental health care facilities across Europe. The HELPS toolkit intends to empower patients and staff to identify the most relevant risk factors in their specific context and subsequently select the most appropriate action out of a range of defined health promoting interventions. In doing so, the toolkit takes into account the heterogeneity of mental disorders, the high number of somatic problems, aspects of lifestyle, environment, medical care system, personal goals of patients and their motivation for health behavior.Results / conclusionsThe poster presents the HELPS toolkit. It illustrates the individual components of the tool and the processes of its implementation and evaluation. First results of the pilot study concerning the feasibility of the toolkit will be presented and discussed.

Are Mental Disorders Brain Disorders?

2015 ◽  
Vol 17 (3) ◽  
pp. 185-201
Author(s):  
Callie Joubert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Conceptual Analysis ◽  
Mental Illnesses ◽  
Brain Disorders ◽  
Category Mistake ◽  
Ethical Implications ◽  
The U.S

The mission of the U.S. National Institute of Mental Health is to transform understanding and treatment of mental disorders. According to its former director, Dr. Thomas Insel, fundamental to its mission is the proposition that “mental illnesses are brain disorders.” The aim of this article is to examine this proposition and to argue that it does not make sense. As a scientific proposition, it is based on contentious empirical claims, and as a metaphysical proposition, it is consistent with those who claim that a person is a brain. A conceptual analysis is employed as a tool to show that it is a category mistake to ascribe psychological properties of a person to a brain. The article concludes with a brief indication of the ethical implications of Insel’s proposition for mental health care.

scholarly journals The challenges faced by service providers on satellite mental health-care facilities in Yangon, Myanmar: a qualitative study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kyaw Lin ◽  
Sun Lin ◽  
Than Tun Sein
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Service Providers ◽  
Health Workers ◽  
Health Care Facilities ◽  
Significant Treatment ◽  
Content Type

PurposeMyanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services are integrated into primary health care (PHC), the challenges are unknown. This study aimed to assess the challenges perceived by providers in the service delivery of satellite mental health care (SMHC) in two sample townships in Yangon.Design/methodology/approachThe research was based on a case study design by applying a qualitative approach using in-depth interviews (IDIs). In the three types of service providers, a total of six staff participated as interviewees. These consisted of two team leaders, two clinical specialists providing consultations to clients and two mental health nurses.FindingsProviders perceived the following as major challenges in the provision of services: unstable financial resources and management, insufficient human resources and capacity of service providers, restricted outpatient services, the lack of a functional referral system, overcrowding, inadequate individual consultation time, long-waiting hours, finite opening days and hours and poor setting of infrastructure, resulting in lack of privacy.Research limitations/implicationsIn the absence of similar studies in Myanmar, findings could not be placed in the context of the national literature for comparison. Further, the study involved a limited number of respondents, which may have affected the findings.Originality/valueAlthough the challenges revealed were not uncommon in mental health services in developing countries, this study focused on a specific model of mental health care integrated into general healthcare settings in Myanmar. The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies.

scholarly journals Patterns of Service Provision in Older People’s Mental Health Care in Australia

2020 ◽  
Vol 17 (22) ◽  
pp. 8516
Author(s):  
Hossein Tabatabaei-Jafari ◽  
Jose A. Salinas-Perez ◽  
Mary Anne Furst ◽  
Nasser Bagheri ◽  
John Mendoza ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Rural Health ◽  
Service Provision ◽  
Outpatient Care ◽  
Hospital Care ◽  
Term Care ◽  
Health Service Provision ◽  
Health Districts

Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and diversity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy.

Sign in / Sign up

Export Citation Format

Share Document