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Discuss About The Theory and practice of counseling and psychotherapy.

Analysis and critical evaluation of the mental health system in the nation

Statistical studies show that a huge number of people in Australia experience mental illness at some point in their lives. It is also seen that almost every Australians will experience the consequence of psychological ailments in a family member, work colleague as well as friends. However many of the members had reported that operating the mental healthcare system and thereby recognizing the right care at the proper time has been not only difficult but frustrating for them (Binyaruka et al., 2018). Australian medical association is of the opinion that overarching mental health “architecture” is totally absent in the nation. They have stated that there is a lack of clarification of what the mental healthcare system would look like in the near future. Moreover, there has been also a failure on the part of the government to introduce an agreed national design as well as the structure that will help in the facilitation of prevention as well as proper care for the people along with mental illness (Farrer et al., 2018). This assignment would be based on different aspects of mental health system in present generation in nation and the status of the psychotherapist and the counselors in them.

Mental health issues and psychiatric care is seen to be grossly underinvested when comparison to physical health is done in the arena of the years of life lost and the burden of disorders. Researchers are of the opinion that mental health  should not be seen as different part of as in isolation with wider societal influences like that of the social disadvantages, early childhood, unemployment as well as marginalization. The under-resourcing of the mental health initiatives as well as programs often help in the prevention of the least able as well as the most vulnerable individuals from tackling and overcoming the adverse determinants of health and their early childhood experiences (Meurk et al., 2016).

Researchers are also of the opinion that there is a significant lack of ability at the different levels of the mental healthcare policies. It is seen that policies, which are trying for stripping the resources from the areas of the mental health to provide for others, are baneful. Healthcare are seen to have poor access for acute beds and these can be well proven by the extended delays that are in the emergency departments as well as lack of access to the community care delays discharges or even lead to the failure of the discharges.  Poor funding of the community services are also reported meaning that the prevention as well as support services as well as lack of access and coordination in the early interventions(Griffiths et al., 2015).

Changes required for sustainable and equitable mental health system in the nation

The Australian Institute for the Health and Welfare helps in estimating that around $8.5 billion per annum is spent on different types of service related to mental-health in the nation of Australia. Services mainly seen to include different types of residential as well as community services and many services provided by the hospital. These include both inpatients as well as outpatient services. It is generally acknowledged in the recent scenario of the nation that there had been significant deficits in the mental health funding. In the year 2014-2015, mental health is seen to receive for about 5.25 percent of the overall health budget at the same time of representing 12 percent of the total burden of the disorder (Rosenbaum et al., 2018). Reports also suggest that non-government organizations are also seen to struggle for supporting people with mental illness as well as their carers. They are also seen to experience chronic under-resourcing as well as unavailability of sustainable funding.

A very interesting information had been uncovered in many studies is that state there is a serious as well as continuing problem in the inability for linking as well as integrating the mental healthcare that is provided to the patients in the initial care. A recent survey had also given valuable information (Slade et al., 2014). Reforms such as the National Disability Insurance Scheme (NDIS) and Primary Health Networks (PHN) are mainly designed in the reduction of the deficits as well as the fragmentation in the mental health care as well as the reduction of the pressures on the hospitals. It has been found that while some of the PHNs are working in an effective manner, others are lacking opaque funding, transparency, and the procedures of robust governance. All these need to be addressed if every of the PHNs are desired to achieve the expected reforms in the mental well-being.

The Australian people with the mental health issue are mainly seen to deserve access to the quality mental health service those are based on the particular requirements. This is mainly seen to require significant expansion of the services as well as interventions and supports for the people with psychotic disorders across the total continuum of the care. This also requires better collaboration of the clinical service for the patients with complex, severe as well as acute needs. Researchers are therefore of the opinion that in order to address the gaps in the per capita expenditure of the mental well-being, significant investments are to be made for the reduction of the gaps in care as well as fragmentation, disastrous coordination and accessing for effective and adequate care (Semrau et al., 2016). It can be stated that when the well-coordinated as well as properly funded community can be developed, it would help in the management of the mental health care for the people with mental disability. This would be done by the reduction of the needs for the hospital admissions as well as re-admissions and has the potential ability for diminishing the severe condition of the ailments and its various consequences.

Since the movement towards deinstitutionalization, in the year 1970 to 1980 which showed the shifting of much of the caring style as well as treatment of the patient with a mental illness out from institutions to that of the communities, community–based mental health services have not been properly structured or funded (Silove & Mares, 2018). Therefore, the community based mental health services and care should be improved, properly funded, supported and better correlated. This would help in ensuring the improvement of the access to the different essential services. These should be including psychologists, pediatricians, mental health nurses, counselors, drugs, alcohol as well as gambling support staffs. Governments must be addressing specific arenas of different underfunding as well as lack of sustainable investment. These should include Aboriginal and Torres Strait Islander mental health, adolescent mental health, migrant mental health, refugee and mental health services in regional and remote areas.

While investing for the number of psychological problems are transitioning to the PHNS, the target for the healthier society along with the reduction of the pressure on the hospitals, reduction in the cost as well as blame shifting needs to be achieved. This is only possible when states and the commonwealth are overcoming jurisdictional and funding barriers (Mossialos et al., 2016). Moreover, the carers of the people with mental illness should be receiving recognitions as well as support from the government. This should include both financial support as well as additional services.

The Australian government is seen to provide appropriately sized as well as skilled and resource workforce, which are able to provide high quality as well as recovery oriented mental health facilities in the safe as well as secure environment. It is also seen that newer theories for example the description of the recovery mediated healthcare had also been published. Australia must have a properly sized, skilledas well as workforce with proper resourcesthat helps in delivering high quality as well as recovery based mental health services in a safe as well as secure atmosphere (Harris et al., 2015). The aspiration of the mental health reform should be mainly based on the workforce of mental health, helping to increase access to care and helping to meet all the reasonable requirements. 

Increase in the number of invested psychiatrist trainee are also important along with an increased funding in the workforce training as well as assistance for the other mental health workers, specifically the mental healthcare nursing professionals. This would help in ensuring that the mental healthcare service continuum is achieved. Another important issue that needs to be focused is the mal-distribution of the psychiatrists as well as psychologist and different mental health care facility providers. This only leads to deficiency in the workforce in the different regional areas that need to be addressed. The authorities should be rewarding and acknowledging the work of the healthcare professionals (Maybery  et al., 2014). The different actions for the work of the healthcare professionals in the mental healthcare like that of the frontline staff of Emergency Department, psychiatrists, GPs, , pediatricians, as well as psychologists and the nurses for mental health care must be recognized, championed as well as supported.

Researchers are of the opinion that prevention is better than cure and accordingly prevention should be given more importance than treatment just as in case of physical health. Therefore, they state that prevention based on evidence can be socially as well as economically beneficial for treatment. Significant investment should be allocated for carrying on researching and assessing of programs that would help in delivering prolong benefits.Government should realize the advantages of ensuring that all the children are having free as well as equitable access to that of education (Wong et al., 2017). Nutrition, healthcare as well as meaningful activities can bring in resilience. Researchers are of the opinion that vulnerable families as well as children in particular gets benefitted from the measures which help in overcoming disadvantage as well as inequities. Handling of social problems and dysfunctions also help in reduction of the mental health problems and would help in managing the mental health cases successfully by reducing the number of cases (Mendelson & Lin, 2016).

The governmental as well as non-governmental departments should also develop Sustained national community evidence-based awareness campaigns. These would help in the increasing of the mental health literacy as well as reduction of the stigma. It would also help in reducing the misunderstandings that people have regarding mental health issues along with their prejudices including the identification of the requirements and options for the treatment. Early recognition as well as intervention is been found to be important not only for preventing or delaying of the improvement of the future mental health issues but also promoting the best conditions for the mental health problems. Researching both basis as well as translational is essential for providing effective mental healthcare as well as innovative delivery (Reppermund et al., 2017). Therefore, research in healthcare should be handled as the highest priority arena for the public funding because of the higher rates of disability as well as huge loss of productivity related with mental illness and substance abuse. The new programs need to introduce research as well as evaluation funding as an important and significant part of the set-up-costs.

Psychotherapist as defined by the Australian institute of Health and welfare are professionals who would mainly carry out consultations with individuals as well as other groups. They are mainly seen to assess the psychological disorders of different citizens and thereby administer the different programs of the treatment. They do not provide any advice on medications and are mainly seen to carry on the non-pharmacological treatment of individuals as explained by the Australian psychological society (Logan et al., 2017). However, there had been massive arguments regarding the role that the psychotherapists and counselors are forced to play in the mental healthcare system in Australia. Researchers have noted that the public health sector is the bigger employer of the psychotherapist mainly in the community mental health teams. Recent evidences say that psychologists in the team are seen to be employed in the generic positions like in the positions as “case managers” as well as “allied health workers”. They do not get the scope of providing psychological assessment as well as treatment for which they are trained. It is seen that most of them are busy with the dealing of the clients with severe mental illness. Therefore, they do not get the scope of providing early effective intervention for any form of upstream treatment or treatment to people with high prevalence disorders like that of depression (Lal & Adair, 2014).

Therefore, it is seen that mental health services are now only available to those who are currently suffering from severe mental health disorders. Those individuals who are suffering from complex and high prevalence psychological problems are not able to access the psychological treatments in the public health sectors although there is evidence of their effectiveness (Davidson et al., 2016). Moreover, there had been also evidence of the long waitlists as well as increasing caseloads present in the continuation of the care mental health teams. This means that there is no or little opportunity for the clinical psychologist for providing early interventions and as well as relapse preventions.

One of the renowned Psychologist Dr Jillian Horton had put forward his opinion that public mental health facilities should maintain the responsibility to have a capacity for providing psychological treatments to the clients by increasing availability of positions for the for the clinical psychologists. Therefore, it can be stated that more positions should be made for 6 year trained psychotherapists in Community Health Centers and public mental health facilities. These would be helpful for the consumers to access mental health services. It is also argued by the researchers that the positions of psychotherapy should notbe downgraded in the generic mental health workers positions or that to other professions with limited training in a limited number of skills for psychotherapy(Corey et al., 2015).

Counseling mainly refers to the short-term consultation, on the other hand, psychotherapy mainly refers to the longer more of treatment. The former mainly deals with current issues that can be easily addressed on the conscious levels. Psychotherapy is seen to intensively and extensively examine the psychological; history of the person.  Counseling is mainly seen to help the client to process powerful feelings like that of grief, anger, as well as deal with the different immediate causes of stress and anxiety. They help in clarifying different values as well as identity options when making important decisions both personal as well as professional (Harris et al., 2015). They help in managing conflicts within relationships, develop better interpersonal as well as communication attributes or intentionally change productive thoughts as well as behaviors. Psychotherapy is the evolutionary procedures helping a person to look at the long-outstanding attitudes, behaviors as well as thoughts that have contributed to the current quality of the life and relationships of the person.

Better access to psychologists as well as the counselors should not only be supported for increasing the opportunity of mental health services. They should be also increased to maintain balance between the talk-therapy as well as the “drug therapy”. Many of the researches have concluded that medication treatment was sometimes overused for both the psychiatrists as well as the general practitioners (Capuzzi & Stauffer, 2016). The non-pharmacological intervention was often considered effective as a supplement or in combination with the medication. It has been seen that most clients with less severe mental health conditions do not receive necessary care for their issues from the GPs.  This leads to deterioration their mental health conditions. GPs tend to provide them with medication for these mental health issues that adds to the high costs of the medical care. The psychotherapists and the counselors can treat such clients effectively and hence effective measurements are to be taken.

Conclusion:

From the above discussion, it becomes clear that the mental health system in Australia is not in its best state in the present generation. Lack of effective funding in the different arenas of mental healthcare had been seen from the different evidences. Lesser number of skilled workforces, improper funding for development of architecture, absence of proper polices and many others had made the system worse. In fact, the counselors and psychotherapists are not also able to practice their skills up to their full potential and effective mental health delivery is disrupted. Therefore, healthcare departments and the government should take necessary reforms to bring in more stability in the system.

References:

Binyaruka, P., Robberstad, B., Torsvik, G., & Borghi, J. (2018). Objectives To gain an understanding of current trajectories of Aboriginal young people through the mental health care system in Australia.. International Journal for Equity in Health17(1), 1-16.

Capuzzi, D., & Stauffer, M. D. (2016). Counseling and psychotherapy: Theories and interventions. John Wiley & Sons.

Corey, G. (2015). Theory and practice of counseling and psychotherapy. Nelson Education.

Davidson, F., Heffernan, E., Greenberg, D., Butler, T., & Burgess, P. (2016). A critical review of mental health court liaison services in Australia: a first national survey. Psychiatry, Psychology and Law23(6), 908-921.

Farrer, L. M., Walker, J., Harrison, C., & Banfield, M. (2018). Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016. PloS one13(6), e0198400.

Griffiths, K. M., Mendoza, J., & Carron-Arthur, B. (2015). Whereto mental health reform in Australia: is anyone listening to our independent auditors. Med J Aust202(4), 172-174.

Harris, M. G., Hobbs, M. J., Burgess, P. M., Pirkis, J. E., Diminic, S., Siskind, D. J., ... & Whiteford, H. A. (2015). Frequency and quality of mental health treatment for affective and anxiety disorders among Australian adults. The Medical Journal of Australia202(4), 185-189.

Harris, M. G., Hobbs, M. J., Burgess, P. M., Pirkis, J. E., Diminic, S., Siskind, D. J., ... & Whiteford, H. A. (2015). Frequency and quality of mental health treatment for affective and anxiety disorders among Australian adults. The Medical Journal of Australia202(4), 185-189.

Lal, S., & Adair, C. E. (2014). E-mental health: a rapid review of the literature. Psychiatric Services65(1), 24-32.

Logan, S., Rouen, D., Wagner, R., Steel, Z., & Hunt, C. (2017). Mental health service use and ethnicity: An analysis of service use and time to access treatment by South East Asian?, Middle Eastern?, and Australian?born patients within Sydney, Australia. Australian Journal of Psychology69(1), 12-19.

Maybery, D., Goodyear, M., O'Hanlon, B., Cuff, R., & Reupert, A. (2014). Profession differences in family focused practice in the adult mental health system. Family process53(4), 608-617.

Mendelson, D., & Lin, N. (2016). Mental Health Legislation (Civil) in Australia and China: A Comparative Perspective.

Meurk, C., Leung, J., Hall, W., Head, B. W., & Whiteford, H. (2016). Establishing and governing e-mental health care in Australia: a systematic review of challenges and a call for policy-focussed research. Journal of medical Internet research18(1).

Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of health care systems. Canadian Agency for Drugs and Technologies in Health.

Reppermund, S., Srasuebkul, P., Heintze, T., Reeve, R., Dean, K., Emerson, E., ... & Szanto, T. (2017). Cohort profile: a data linkage cohort to examine health service profiles of people with intellectual disability in New South Wales, Australia. BMJ open7(4), e015627.

Rosenbaum, S., Hobson-Powell, A., Davison, K., Stanton, R., Craft, L. L., Duncan, M., ... & Ward, P. B. (2018). The Role of Sport, Exercise, and Physical Activity in Closing the Life Expectancy Gap for People with Mental Illness: An International Consensus Statement by Exercise and Sports Science Australia, American College of Sports Medicine, British Association of Sport and Exercise Science, and Sport and Exercise Science New Zealand. Translational Journal of the American College of Sports Medicine3(10), 72-73.

Semrau, M., Lempp, H., Keynejad, R., Evans-Lacko, S., Mugisha, J., Raja, S., ... & Hanlon, C. (2016). Service user and caregiver involvement in mental health system strengthening in low-and middle-income countries: systematic review. BMC health services research16(1), 79.

Silove, D., & Mares, S. (2018). The mental health of asylum seekers in Australia and the role of psychiatrists. BJPsych International15(3), 65-68.

Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., ... & Whitley, R. (2014). Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry13(1), 12-20.

Wong, D. F. K., Cheng, C. W., Zhuang, X. Y., Ng, T. K., Pan, S. M., He, X., & Poon, A. (2017). Comparing the mental health literacy of Chinese people in Australia, China, Hong Kong and Taiwan: Implications for mental health promotion. Psychiatry research256, 258-266.

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