The development of mental health policy has undergone consistent changes in the course of the 20th century, while, today, mental health policy is totally different from the policy conducted a hundred years ago. In this respect, it is important to lay emphasis on the fact that mental health policy shifted from indifference and isolation of people with mental health problems to the provision of health and social services and, what is more, integration of this people into their community and normal social life. In other words, mental health policy has undergone a metamorphosis which has changed the attitude of policy makers, health care professionals and ordinary people to people with mental health problems. Today, people with mental health problems are not outcasts, as they used to be in the past, instead, they are viewed as people, who have special needs and social and health services aim at their integration into social life with the help of the community.
In the past, people with mental health problems were doomed to isolation and contempt of other, “normal” people (Cameron, D. and Fraser, 2001, p.24). Often, people with mental health problems were subjects to discrimination and humiliation from the part of other people, who did not have such problems. In this regard, the state did not pay much attention to problems of people with mental health illnesses and mental health policy was poorly developed. Often, it was family members who took care of people with mental health problems, while health care professionals did not have possibility or desire to treat such people because mental health problems were viewed as problems that could not be treated.
Nevertheless, policy makers could not ignore the problem of people with mental health problems since many people with mental illnesses were believed to be dangerous. Moreover, policy makers and society at large did not want to focus on the problem of people with mental health illnesses. Instead, health care system and policy makers simply preferred to move people with mental health problems to asylums, where they could not “disturb the public” (Tremain, 2001, p.74). The latter means that they were isolated to asylums where they could be treated, but the psychiatric treatment with the use of new methods, including both medication and psychological help, were developed and these methods opened new opportunities for the treatment of people with mental health problems. Eventually, it became obvious that they can be treated and lead a normal life, at least the majority of those who were traditionally kept in asylums. As a result, by the late 20th century, people with mental health problems had started to get a different treatment as their isolation was viewed as a problem rather than a treatment and new approaches and policies were developed.
Basically, social problems that people with mental health problems face fall into three main categories: social exclusion, inconsistency in service provision; and the problem of management of services.
At first glance people with mental health problems seem to be needed more urgent help but in fact there should be no differences or preferences of those who suffer either from some mental health problems or learning disabilities that are also a big problem for people.
As for people having mental health problems, it should be said that today, specialists and policy makers recognize that their problems affect not only them but also their care providers, families, communities and society as a whole (Pfeiffer, 1995). It is not only the absolute numbers of people with mental health problems or who are suicidal or self-harming that present a challenge but also the disproportionately higher rates of mental ill-health experienced by people living in the most deprived communities, where GP consultations for anxiety and depression are twice as high as in the more affluent communities. First admission rates to specialist psychiatric care for people with schizophrenia are higher twice as many suicides occur. Children of families in social class are approximately three times more likely to have a mental health problem that those in Social Class People with mental health problems have the highest rate of unemployment among people with disabilities. This relationship between deprivation and mental illness means that actions directed at improving mental health have to be integral to broader policy goals of social justice and social inclusion.
The real problem of people who have mental health problems is their isolation from the rest of the society. Unfortunately, people having learning disabilities are not in a better position. The situation is very difficult for them and in the future it may aggravate because in the contemporary society, when the transition to post-industrial and information societies is observed in many countries of the world and the US is one of the leaders of this process, people need to be able to acquire a lot of knowledge in possibly short terms in order to be competitive in the labor market and simply remain in the current of recent technological, scientific and other achievements.
Today specialists (Enns, 1999) agree that people with mental health problems have difficulties with integration and inclusion in the society they live in. Unfortunately, nowadays in the US many people with learning disabilities do not find work and so must live on welfare benefits. Consequently, one of the primary tasks the society has to fulfill is to provide such people with employment and normal income and, thus, normal level of life.
It should be also said that health and social services play a particularly significant role in the lives of many people with learning disabilities and their families. For many people, it is no exaggeration to say that the quality of their daily lives is dependent on the quality of the services they receive. Consequently, the level of such services should be as high as possible.
Furthermore, in last decades the policy of integration of people with learning disabilities and mental health problems became more active and concentrated on resettlement of such people from hospitals into communities.
In order to achieve easier and faster integration of people with learning disabilities and mental health problems there were worked out a number of different programs that would be discussed in details a bit later.
Nowadays, the situation has obviously been improved but it is still not perfect. As it has been already mentioned, there were created a number of different programs and public organizations that aimed at improvement of the position of people with learning disabilities and mental health problems, as well as different legislative act were implemented in the UK having the same goal.
The authorities is to drive up quality, tackle variations in access to care, increase the effectiveness of care and enhance user and care provider experience by ensuring changes are systematic and sustainable. They came about because standards of care for people with mental health problems varied greatly depending on the geographical area in which they lived. A person with a mental illness should therefore expect to be able to access services and be treated in the same ways as anyone else.
However, even nowadays people with mental health problems still have a lot of problems. For instance, sometimes, people with learning disabilities are excluded from services if they are found to be difficult to handle or present with challenging behavior.
Moreover, people with mental health problems from minority ethnic communities are at particular risk of discrimination in gaining access to appropriate health care or proper treatment. Problems arise if professionals are not aware of cultural or language issues or only use English language based assessment tools.
Thus, mental health policy has evolved from the policy of indifference to and isolation of people with mental health problems to policy of integration of people with mental health problems.
References:
Cameron, D. and Fraser, V. (eds.) (2001). Disability and Federalism: Comparing Different Approaches to Full Participation. Kingston: McGill-Queen’s University Press.
Enns, A.. (1999). A Voice Unheard: The Latimer Case and People with Disabilities. Halifax: Fernwood Publishing.
Pfeiffer, D.(1995). “Major Problems with the ICIDH”. Proceedings of the Society for Disability Studies.
Szasz, T. (1984). The Myth of Mental Illness. New York: Random House.
Tremain, S. (2001). “On the Government of Disability.” Social Theory and Practice. 27(4).
