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Health belief model

According to Schnyder et al. (2017), the TPB proposed that the intentions of a person are highly correlated to their behaviour. Still, many individuals in practice would seek professional help for their mental problems. Health promotion should be always based upon conceptual models which do not conform according to the current norms and values of the practice of health promotion. In Dartford, the UK which is a local borough, the incidence of mental health problems among children is increasing and is on the higher end. It has been found depression has become one of the main causes of disability among children in the UK. Over 40 million mental disability occurs among children aged 20-29 years. It is a major contributor to suicide among children. Various mental health problems occurring among children and young adults of age below 24 years are depression, anxiety, bipolar disease, schizophrenia and most commonly stress (Statistics | Mental Health Foundation 2022). Following are some of the theories and models that are aimed at raising awareness of mental health among children as well as young people below the age of 24 years:

Health belief model: This model was developed by Sir Irwin Rosenstock in the year 1966 and it is considered to be one of the profound and influential models in the field of health promotion. There are four constructs of the model: perceived susceptibility, perceived severity, perceived costs of adhering to the intervention that is proposed and perceived barriers. Nowadays, the Health Belief Model is used for predicting general health behaviours as well as positive health behaviours. According to Newton and Asimakopoulou (2015), psychological theories and models provide an important framework for enhancing the understanding of the determinants that adhere to the recommendations that concern endurance of mental health.

However, when the model was proposed generally in the first place, it was designed for predicting actions for clients that are chronically ill. In the HBM, an action that is health-related and it is seen very likely where the actions are can be considered both cost-effective as well as effective in terms of outcomes. The critique of the model has been based upon the fact that all kind of health behaviours does not depend upon rational and conscious choice (Raingrubber 2022). The model has been criticised for being able to focus on various negative factors that ignore all kinds of positive motivations promoting healthy behaviours. The HBM is lacking various concepts which are connected with strategies for change. One of the major complaints where the model focuses upon individual factors rather than environmental as well as socio-economic factors. Thus, this model encourages a “blame the victim” ideological frame of reference. 

Theory of Reasoned Action

Theory of Reasoned Action (TRA): This theory was proposed by Martin Fishbein and Icek Ajzen in the year 1975. As opined by Tuck and Riley (2017), this theory is a psychological theory where the origins lie in the research of measurement and attitude theory. There is an assumption underlying the Theory of Reasoned Action is that individuals take into consideration the after-effects of the behaviours before getting engaged in those behaviours. There are three constructs of this model, behavioural intention, attitude as well as subjective norms. In the TRA, behavioural intention is an ability of the attitude of the person about their subjective and behavioural norms. Subjective norms are expectations of people that are perceived as those for the significant others such as members of the family, experts, co-workers.

Voluntary behaviour is directed by the attitude of the person for the behaviour and things that are important for the people if the behaviour cannot be performed. A critique of this theory states that the behaviour of all individuals is not under their control which includes spontaneous actions along with cravings and habitual behaviours. The second criticism lies in the fact that political, economic and environmental factors are never a part of the theory. The TRA has been diagnosed upon several segments such as dieting, exposure to limited sun rays and this is having a strong predictive utility.

Health promotion as stated by the WHO is “the process of enabling people to have increased control over and improve their health”. Mental health promotion involves any action that is taken to maximise the well-being of the population and the individuals. The operation that improves the scale of values of the alliances for addressing social as well as economic inequalities while validating participatory methods through proper research and development, following various health principles is also explained as health promotion. Various characteristics of strategies for the prevention of mental disorders are primary interventions rendered for helping individuals so that they can have positive effects on society and family (WHO.int 2022). Thereby it sometimes becomes a little difficult to demarcate prevention of primary and secondary level as the fine line of segregation between disability and disorder is not very clear. Measures of prevention often reduce the severity of the disorder and waive off the extent of the problem even if the complete impairment is not possible.

For children and adolescents, improving self-esteem along with life skills via pro-social behaviour, curriculum based on schools and bringing improvement of the climate of school are effective preventive measures for improving mental health. Also, teachers can be trained for improving detection of various problems and facilitating appropriate interventions may render additional advantages (WHO.int 2022). Various psychosocial interventions such as cognitive-behavioural therapy as well as family-based intervention therapy for children have shown appropriate results for preventing the development of anxiety disorders among those children who remain anxious.

Prevention strategies for mental health disorders among children and adolescents

Some common strategies of communication that can be used for spreading awareness among stakeholders regarding the prevention of mental health disorders among children and adolescents in the UK are publishing policies and program briefs, publishing project findings and journals as well as publications on a state-wide basis. Information can be disseminated on organisational websites, activities of health promotion can be discussed on radio, issuing of the press release, publishing ways of increasing awareness in newspapers and hosting events of mental health promotion are also potential ways in which communication can be done with stakeholders (Methods of Dissemination 2022).

“The Lalonde Report” was a major transformation in the field of healthcare. The report proposed a concept in the field of healthcare stating two objectives: the health care system and preventing problems of health and promoting good health. The significance of this report lies in the fact that services of health care are the only determinants of health. He also indicated aspects of the various determinants in some of the subsequent speeches (Hancock 1986). The Lalonde Report stated that the four major determinants of health care are health care systems, human biology, environment and lifestyle.

The biological aspects influencing health are considered which includes the genetic influences of physical and mental health. This included age, sex, family history of diseases, HIV status, presence or absence of other genetic disorders such as thalassemia, carrying of cancer genes such as BRAC1 or BRAC2, haemophilia, cystic fibrosis or any other inherited conditions. Beyond the familial environment, several genetic factors influence the survival and lifespan of individuals (Passarino, De Rango and Montesanto 2016). “The Lalonde report” significantly transformed the perspective of health promotion all over the world.

Next, the environmental factors where humans have little or no control in terms of the environment as well as the social environment around. Renner and McGill (2016), stated that health-seeking traits and behaviour was the result of the interplay of several individuals as well as environmental factors. Some of the environmental factors influencing health are climate change, the occurrence of disasters, water quality and usage, diseases caused by microbes, various issues associated with infrastructure and other global environmental issues. Among lifestyle factors are included personal decisions that are controlled by human beings and can contribute to illness or death. Another factor or component of health according to the report is health care facilities provided by the respective countries such as availability of hospitals, medical insurance coverages and paramedical services.

Communication strategies for spreading awareness of mental health among stakeholders

Components of healthcare delivery is a very straightforward process while deciding the components of the decision of healthcare is a very complex procedure (Gurupur and Gutierrez 2016). For designing a health campaign and communicating the same to the target population, it is very important to take into consideration the various determinants of health. “The Lalonde Report” was developed by the Canadians but in the UK, the political government dealt with several long-standing problems. There was a lack of access in several non-metropolitan areas of the country. The report was highly accepted by the society of the UK since they were dealing with several fatal non-communicable diseases.

While designing a campaign, availability of proper transportation, safe housing, education level of the society, the income of families, proper access to nutritious foods and skills of language and literacy are considered. Sallis, Owen and Fisher (2015), stated that ecological models specify that various factors like intrapersonal, organizational, community and interpersonal as well as the public can impact health behaviours that call for health promotion campaigns. Before implementing a health campaign, the environmental condition of the place where the campaign is about to be implemented has to be considered. Apart from this, the seriousness of various private and public health institutions in sanctioning health insurance policies must be checked before framing and communicating the campaign. If the same does not happen, then the campaign shall not become a success and common individuals will never implement its usage.  

As an example, the Healthy Relationships campaign in the UK can be considered which was designed and communicated based on the Lalonde Report. This campaign aimed at talking to young people and children about maintaining healthy relationships- to tell them what is important about it, how to recognize the same and build as well as maintain healthy relationships. This campaign also states how various relationships impact mental health. It says that having stable, strong and fulfilling relationships with people all around improves the mental well-being of individuals (Statistics | Mental Health Foundation 2022). This campaign was designed and integrated using the four determinants of health care according to “The Lalonde Report”. All health campaigns in the UK are designed by considering the report.

Another campaign, “Every Mind Matters” is another campaign in the UK that has been formed in partnership with the Local Authorities of the UK along with the NHS. This campaign is intended has to be implemented for supporting the mental health of the public as well as a Covid-19 hub. The campaign renders tips as well as support on the ways of dealing with changes and coping with money and worries and uncertainty of job. There are also practical tips from various mental healthcare experts who deal with anxiety and stress thus boosting the mind and helping the person sleep better. The experts give guidance on ways in which people can help other people thus including various advice for parents on carrying out proper parenting. There are videos for influencing young children as well as the youth (NHS, 2022). This campaign took into consideration, various determinants of mental health, especially the social and environmental determinants and thus can be said that it followed “The Lalonde Report” before its designing and communication.   

According to Sayal et al. (2018), the shift of mental health services from child to adult makes a health worker face several challenges. This happens due to differences in thresholds, training and lack of focus for the health services. Poor transition often leads to disengagement of ongoing needs which consequently gives rise to worse outcomes. For this, the implementation of a proper mental health care campaign is necessary and it is also important to increase awareness among the beneficiaries. There has been an immense increase in mental health problems among children in the UK recently. It has been found that 50% of the mental problems begin by age of 15 while 75% begin by 24 years of age (Mental health statistics: children and young people, 2022). This assignment aims to create a campaign for increasing mental health awareness among school children of Dartford. The name of the plan will be “Smile with Peace”.

Approach for the planning of health promotion: The six stepped approach for the implementation of the campaign is as follows:

Step 1: Planning Process: The purpose of this step is to manage the participation of the stakeholders, decide the timeline, resources for the campaign and determine the methods that are necessary for gathering data. This step also includes interpreting the results and making the final decision for the implementation of the campaign “Smile with Peace”.

Step 2: Conduction of situational assessment: The purpose of this step is to gain more knowledge about the target population, their interests and dislikes, the trends in the population and their issues that might hinder proper implementation. The needs want and assets of the community might also be assessed (Barry et al. 2019). In this assessment, various health statistics and data will be gathered from different websites and journals regarding the mental health conditions of young adults and children in the UK. Based on this assessment, the need for framing a potential campaign can be figured out which will address the issue of mental health problems among this age.

Step 3: Identification of goals and objectives and expected outcome of the campaign: After conducting the situational assessment, the results will be used for determining the goals and interests of the population. After framing of objectives, the outcomes that are being expected will also be chalked out roughly. The goal of this campaign is to reduce or prevent the onset of mental health problems among young adults and children through effective measures so that they can result in their betterment.

Step 4: Identification of strategies, activities and explanation of the process: With the help of situational assessment, the various strategies taken as a part of the campaign will be framed along with feasible activities and resources that are available. The resources should be such that they help in fulfilling the objectives and achieving the outcomes (The Health Communication Unit 2022). This campaign will involve mental health workers such as psychologists and psychiatrists to visit schools and colleges and take sessions on awareness of improving mental health. They will conduct one-to-one counselling sessions with students which can help them speak up about their problems and eventually lead a life that is devoid of stress and filled with mental peace.

Step 5: Development of indicators: The purpose of this step is to develop a list of variables that can be analysed and tracked to measure the success of the campaign. It is important that for each of the outcomes as well as process objectives, the intended results are considered. Defining every indicator is also important followed by performing a quality check so that they can ensure that all the indicators are valid and reliable as well as accessible. Record of individual experiences and social experiences will help in developing indicators that will help the management of the campaign to understand whether the program is being successfully implemented.

Step 6: Reviewing the plan of the campaign: In this step, the contribution of each component of the campaign shall be ensured for the fulfilment of each objective, identification of gaps and presence of every resource. This also helps in maintaining consistency of plan throughout the ongoing campaign (The Health Communication Unit 2022). If the entire plan of the campaign “Smile with Peace” is reviewed before implementation, then any loopholes may be spotted that can be rectified before launching the campaign on a full-fledged basis.

Resources required for carrying out the campaign: A range of toolkits and resources can be used for carrying out public involvement in campaigns. Newsletters and pamphlets can help in the promotion of the campaign. Online resources of learning are used for giving prospectus to the beneficiaries, primary care networks and social media platforms are some of the resources that can be used for the dissemination of the campaign. Apart from this, resources like electronic resources such as laptops, tablets, smartphones shall be needed for communication and data-keeping. Human resources shall be required for teaching the beneficiaries and raising awareness about the campaign. Financial resources shall be needed for funding the campaign.

Stakeholders: The various stakeholders of the mental health awareness campaign are the management, the staff and employees carrying out the program, the investors, the partners who are funding the program and the beneficiaries who are participating in the program for help. The coalition members or competitors are also stakeholders of the campaign.

Design and evaluation frameworks: Two types of design and evaluation frameworks are as follows:

Impact evaluation: This framework assesses the effect of the program on the participants as well as the stakeholders. This framework helps in the evaluation of various programs or several evaluations of a single program (Evaluation Framework 2022). It also includes the changes that have resulted from the outcomes. In this campaign, the impact evaluation framework will assess the improvements and changes that will be seen in the mental health of children and youth of Dartford.

Performance monitoring: This framework assesses the metrics of the baseline compared to other points of data continuously through the implementation of the program (Crowfoot and Prasad 2017). The “Plan-Do-Study-Act” framework is used in this case. With the help of this framework, the new knowledge about the mental health campaign is integrated and corrections needed midway can be done. This framework also will help in bringing about continuous improvement of the framework.

Thus, with the help of the “Smile with Peace” campaign, the rising number of mental health problems can be reduced to a great extent and children and adolescents can lead a stress-free life.

Comparison of the current campaign with an existing campaign: On successful implementation of the campaign “Smile with Peace”, children and young adults of the UK shall be able to open up about their problems associated with psychology such as stress, anxiety and behavioural disorders. This will enable the caregivers of the campaign to give them proper advice which will eventually help students focus on their studies. As a result, their academic performance will see an enhancement. Since this campaign is mainly focused on bringing about improvement in the mental health of children, it will certainly be more effective than the “Healthy Relationships” campaign which is targeting the entire population of the UK.

Reference List

Barry, M.M., Clarke, A.M., Petersen, I. and Jenkins, R. eds., 2019. Implementing mental health promotion. Springer Nature.

BetterEvaluation. 2022. Evaluation Framework. [online] Available at: <https://www.betterevaluation.org/en/evaluation-options/evaluation_framework_templates> [Accessed 31 January 2022].

Crowfoot, D. and Prasad, V., 2017. Using the plan–do–study–act (PDSA) cycle to make change in general practice. InnovAiT, 10(7), pp.425-430.

Gurupur, V.P. and Gutierrez, R., 2016. Designing the Right Framework for Healthcare Decision Support. J. Integr. Des. Process. Sci., 20(1), pp.7-32.

Hancock, T., 1986. Lalonde and beyond: Looking back at “a new perspective on the health of Canadians”. Health Promotion International, 1(1), pp.93-100.

Mental Health Foundation. 2022. Mental health statistics: children and young people. [online] Available at: <https://www.mentalhealth.org.uk/statistics/mental-health-statistics-children-and-young-people> [Accessed 31 January 2022].

Mental Health Foundation. 2022. Statistics | Mental Health Foundation. [online] Available at: <https://www.mentalhealth.org.uk/statistics> [Accessed 30 January 2022].

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Newton, J.T. and Asimakopoulou, K., 2015. Managing oral hygiene as a risk factor for periodontal disease: a systematic review of psychological approaches to behaviour change for improved plaque control in periodontal management. Journal of clinical periodontology, 42, pp.S36-S46.

NHS, 2022. Every Mind Matters. [online] nhs.uk. Available at: <https://www.nhs.uk/every-mind-matters/> [Accessed 31 January 2022].

Passarino, G., De Rango, F. and Montesanto, A., 2016. Human longevity: Genetics or Lifestyle? It takes two to tango. Immunity & Ageing, 13(1), pp.1-6.

Raingrubber, B., 2022. Health Promotion Theories. [ebook] Jones & Barnett Learning, pp.53-94. Available at: <https://samples.jbpub.com/9781449697211/28123_CH03_Pass2.pdf> [Accessed 30 January 2022].

Renner, L.A. and McGill, D., 2016. Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana. Ghana medical journal, 50(3), pp.149-156.

Ruralhealthinfo.org. 2022. Methods of Dissemination. [online] Available at: <https://www.ruralhealthinfo.org/toolkits/rural-toolkit/6/dissemination-methods> [Accessed 30 January 2022].

Sallis, J.F., Owen, N. and Fisher, E., 2015. Ecological models of health behavior. Health behavior: Theory, research, and practice, 5(43-64).

Sayal, K., Prasad, V., Daley, D., Ford, T. and Coghill, D., 2018. ADHD in children and young people: prevalence, care pathways, and service provision. The Lancet Psychiatry, 5(2), pp.175-186.

Schnyder, N., Panczak, R., Groth, N. and Schultze-Lutter, F., 2017. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. The British Journal of Psychiatry, 210(4), pp.261-268.

The Health Communication Unit, 2022. Introduction to Health Promotion Program Planning. [online] Mentalhealthpromotion.net. Available at: <https://www.mentalhealthpromotion.net/resources/introduction-to-health-promotion-program-planning.pdf> [Accessed 31 January 2022].

Tuck, M. and Riley, D., 2017. The theory of reasoned action: A decision theory of crime. In The reasoning criminal (pp. 156-169). Routledge.

Who.int. 2022. PREVENTION AND PROMOTION IN MENTAL HEALTH. [online] Available at: <https://www.who.int/mental_health/media/en/545.pdf> [Accessed 30 January 2022].

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