Reflections of influences on mental health placements: these were in Community Mental Health Teams (CMHT) and secure inpatient units.
- Politics removal of benefits
- reduction in PIP* for one lady with severe anxiety reduced her support and reduced access to the community as a result, she felt her MH was worsening
- What? middle aged man with EUPD & psychosis felt it was unfair the cuts to disabled benefits, when he was assessed for his PIP he felt because he could ‘function’ in the interview and speak coherently he was marked up in his ability whereas he felt he could not manage day to day. He said this reflected people often dismissing mental health because it cannot be seen and he looks ‘normal’.
- So what? He felt very angry about this and sometimes this was directed at any healthcare staff even those not responsible for benefits, such as when groups were cancelled due to staff shortages.
- Now what? Reflected at the time that it must be difficult to find an outlet for your frustration and anyone working for public sector could be a symbol of the government, remember to not take anger at service constraints personally.
Money from us (from our taxes) is passed to the government, which is passed down to the NHS to fund it. But how does the NHS department should get which money? And which departments should exist and get funded by the NHS at all? How are private companies involved if the NHS is a public organisation? The system set up to decide how the NHS’ money is spent is complicated, and it’s easiest if you just watch this video to understand:
Trends are a something (like a style of therapeutic practice) that is popular at the moment. Example:
- adult colouring books
- active ageing
- life stories
- use of Sensory Integration in settings other than paediatrics
- paternalism being challenged
- holistic approach to health
- in society, being in debt is acceptable whereas in the past it wasn’t
Contexts are the circumstances that influence or affect something (like a trend):
- Politics and the resulting government policies on access to services and funding
- the culture
- the attitudes of individual therapists
Contexts in healthcare are often influenced by political and legislation, because in the UK healthcare is funded by the government because we have the NHS. In other countries where healthcare is paid for by insurance or individuals consumers, it may be be more heavily influenced by these other factors? Anyway, in the UK the Care Act (2014) is a recent policy that supersedes the previous health-related acts such as NHS act (2006). Because of what the Care Act (2014) states, some expected trends to happen in healthcare will be
- integration of services:
- health and social care working more closely
- between hospitals and GPS (primary & secondary care)
- between mental and physical care