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This assessment requires you to investigate a specific topic using scholarly literature. This literature will be sourced from peer reviewed journal articles. You will need to cite a minimum of four (4) journal articles. You will review these articles in order to synthesise the broad concepts related to the topic in order to assess what is currently known about the topic. This type of essay is sometimes described as a conceptual literature review. Another way to think about this approach is to frame your work as if you are writing an essay with the goal of informing human services workers about the current thinking about the topic you choose, in order for it to inform their practice in the discipline.

  • increase your ability to locate, critique and synthesise literature
  • allow you to comment on the strengths and weaknesses of the articles you examine
  • demonstrate your understanding of a key topic from the course
  • demonstrate your ability to apply your findings to human services practice.

Format As is the case with most essays, your review will have an introduction, a body and a conclusion. The introduction should outline the focus of your essay and why it is important. The discussion should outline the key arguments or findings of the articles you review. You should discuss the overall content, conclusions and implications of the articles and draw attention to where the articles are similar and how they might be different. That is compare and contrast what the authors have to say and how they construct their argument. Your conclusion should bring together what your discussion has shown. It may be that you find that researchers and experts in the field tend to agree or disagree. You should comment on this and what the ramifications for working in the human services might be.

Mental health and many common mental disorders are shaped to a great extent by the social, economic, and physical environments in which people live (WHO & Calouste Gulbenkian Foundation 2014). Discuss how the social determinants of mental health impact on the mental health of a particular population or community group e.g. Indigenous Australians; women and or children; rural and remote communities; older people; LGBTI people or another group as approved by the Course Examiner. Identify which specific social determinants are key factors and how the impact of them manifests for the population being discussed. How might this knowledge enhance practice in the human services?

Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care (Corrigan 2004). Corrigan made this assertion around fourteen years ago. Choose a particular population or community group e.g. Indigenous Australians; women and or children; rural and remote communities; older people; LGBTI people or another group as approved by the Course Examiner. Discuss the impact of stigma on mental health service utilisation today. Comment on other barriers to service utilisation that are specific to the population you choose. How might this knowledge enhance practice in the human services?

Impact of Stigma on Mental Health Service Utilization of Indigenous Australians

Stigma is the primary barrier to mental health utilization among the Indigenous Australians. Psychological health patients fear the discriminative opinion of the society and the caregivers about their conditions (Brown, Rice, Rickwood, & Parker, 2016). A majority of the Aboriginals lack relevant knowledge on mental illness; hence tend to ridicule and sideline the patients. The stigma makes patients reluctant in seeking a solution to their problems. The reluctance to visit a mental health facility delays diagnosis and care towards the disorders. Apart from Stigma, other factors such as communication barriers, socio-economic status, and rural location of the aboriginals also act as barriers to treatment (McIntyre et al., 2017). This essay will discuss the impact of stigma on mental health service utilization among the Aboriginals. The paper will also explore other barriers to the use of health services such as socio-economic status. Finally, the write-up will explain how the knowledge may enhance practice in human services.

A stigmatizing attitude applies to both the physical and mental health patients; however, the vice is rampant towards and within the psychological patients. A majority of people believe that the causes of mental disorders include criminality, prostitution, and drug addiction. Therefore, the public feels that the psychological patients are responsible for their predicaments. People tend to treat the patients with prejudice and shy away from helping the victims. The impacts of public stigma include coercive treatment and withholding help towards the patients (Gulliver, Farrer, Bennett, & Griffiths, 2017). Individuals tend to avoid the patients of mental illnesses due to stigma. The social avoidance makes the patients stay away from the public and health facilities.  

Employers also shy away from recruiting individuals with mental disorders. Therefore, the patients lack money to seek for adequate and appropriate health services. Apart from the impacts of public stigma, self-stigma also leads to underutilization of mental health facilities. Patients with psychological disorders feel less important in the society due to how people interact with them (Knox et al., 2014). Public stigmatization makes the confidence and the self-esteem of the patients to suffer. Therefore, a person with low confidence and depleted low esteem is reluctant to seek medical attention towards the condition. The victims fear that the caregivers can laugh at them when they visit the health facilities. Therefore, such individuals prefer to remain indoors; thus underutilizing the mental health services.

Apart from stigma, communication barriers also lead to underutilization of the mental health facilities. The aboriginals speak a different language from the caregivers from the other Australian tribes. The disparity in the language interferes with communication between the nurses and the patients (Armstrong et al., 2017). Therefore, mental health patients receive substandard attention due to the misunderstanding between them and the care providers. The differences in cultural values also have an impact on communication between the caregivers and the mental health clients. The aboriginal patient may understand English, but the cultural beliefs can limit the amount of openness towards the caregiver. An example is when a male patient attends to a female indigenous patient. The client can be uncomfortable with the gender difference and fear to provide all the necessary information regarding the mental disorder.

Other Barriers to Service Utilization for Indigenous Australians

Experiences of patients in their interaction with caregivers can also hamper communication; thus minimizing health service utilization. A patient that received harsh feedback from a caregiver can shy away from disclosing information on the health status (McCann, Bamberg, & McCann, 2015). The reception of negative input from the caregiver troubles the patient and minimizes access to healthcare. The health perception of the Aboriginals also differs from that of the nurses from the majority tribes. The majority of mental health patients from the indigenous groups feel uncomfortable with the caregivers. Therefore, the disparity in perceptions is a communication barrier and minimizes service utilization.

The rates of poverty and economic disadvantages among the Aboriginals are higher than those of the other tribes. Therefore, the SEC affects the ability of the people with a mental health condition to access the mental health services. A majority of the psychological patients are unemployed; hence cannot afford the high costs of medical treatment (Bastos, Harnois, & Paradies, 2018). Australian government funds its health care system from its budget and payments from the patients. The poverty facing the aboriginals prevents them from helping the government to support for mental services. Therefore, the lack of payments leads to the establishment of a few psychiatric facilities. Economic disparity lowers the life expectancy and increases the mortality rates of the Aboriginal mental health patients. A majority of aboriginals also earn low incomes from their jobs; thus failing to pay for proper medication.

The aboriginals who stay in urban centers tend to visit the rural health centers due to the expensive costs of treatments in the municipal facilities. The patients have cited high traveling costs as a barrier to receiving the medical services (Wakerman et al., 2017). Recent research also indicates that aboriginal patients receive late treatment in comparison to other patients. The patients with mental disorders from the indigenous community shy away from the health facilities due to their low income. There is a lack of mental health services in the rural set-ups where most aboriginals live. Additionally, rural isolation prevents the aboriginals from accessing quality care.

Inhabiting rural centers have a significant impact on mental health utilization among the Aboriginals. Hospitals in rural Australia are understaffed and find difficulties in recruiting caregivers to stay and work at the rural facilities (Bonevski et al., 2014). Therefore, the mental health patients face isolation and economic disadvantage. The aboriginals staying in the rural areas have poor access to medical services leading to increased mortality rates. The separation from the urban areas and rural location rise the healthcare disparity between the indigenous population and the majority of Australians. Recent studies have indicated that the quality of care provision is higher in the urban facilities than in the rural places. However, the cost of traveling to the urban centers to access quality medication is expensive due to the interior location of the Aboriginals.

The poor infrastructure network and insecurity prevent the caregivers from visiting the mental health patients in the remote areas. The people with a mental health condition from the rural areas also have difficulties in accessing the urban hospitals due to the lousy state of the roads (Hoeft, Fortney, Patel, & Unützer, 2018). Additionally, the means of transport are limited in the interior places. The Australian government spends a lot of capital in constructing quality health centers in the urban places compared to the interior areas. Therefore, the aboriginals with mental problems have to travel to the downtown places to receive quality care. The government is also reluctant in conducting conclusive research on the needs of the Aboriginals. Therefore, rural location minimizes the utilization of mental health facilities by the mental health patients.

Communication Barriers

Both public and self-stigma are the major hindrances to mental health service utilization. The knowledge about the impact of stigma should swing the health stakeholders into action to ensure that the patients access quality care. The government and the caregivers should team up and enlighten the public on mental diseases (Lowe, 2018). The stakeholders should encourage the public to interact with and support the psychological health patients. The caregivers should also help the patients to visit the health facilities for specialized treatment. Therefore, eliminating stigma boosts the utilization of mental health services by the patients.

Communication barriers, socio-economic status, and rural location also limit the full utilization of psychological services by clients. The Australian government should recruit the aboriginal specialists to eliminate the language barrier. Additionally, the ministry of health should incorporate the cultural beliefs of the indigenous population into the methods of treatment (Leske et al., 2016). The government should ensure that mental health treatment is cheap and affordable for all Australians. The national administration should also construct quality health facilities in the rural areas to meet the health needs of the Aboriginals. Furthermore, the government should facilitate the recruitment of caregivers to serve in the rural health facilities. Therefore, the knowledge of the inhibitors of health service utilization can improve care for the psychological patients.

Conclusion:

Public stigma has a negative impact on mental health service utilization; since individuals tend to ridicule the victims. Self-stigma makes the patients lose confidence and self-esteem; hence, shying away from the other people and the health facilities. Therefore, the victims of stigma rarely visit the hospital for specialized treatment. Communication barriers limit the level of interaction between the patient and the caregivers. Poverty also limits the ability of the mental health patients from the indigenous groups to pay for quality care. Therefore, finding a solution to the above barriers improves health practice towards the patients.  

References:

Armstrong, G., Ironfield, N., Kelly, C. M., Dart, K., Arabena, K., Bond, K., & Jorm, A. F. (2017). Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait Islanders who are engaging in non-suicidal self-injury. BMC Psychiatry, 17(1), 300.

Bastos, J. L., Harnois, C. E., & Paradies, Y. C. (2018). Health care barriers, racism, and intersectionality in Australia. Social Science & Medicine, 199, 209-218.

Bonevski, B., Randell, M., Paul, C., Chapman, K., Twyman, L., Bryant, J., ... & Hughes, C. (2014). Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC medical research methodology, 14(1), 42.

Brown, A., Rice, S. M., Rickwood, D. J., & Parker, A. G. (2016). The systematic review of barriers and facilitators to accessing and engaging with mental health care among at?risk young people. Asia?Pacific Psychiatry, 8(1), 3-22.

Gulliver, A., Farrer, L., Bennett, K., & Griffiths, K. M. (2017). University staff mental health literacy, stigma and their experience of students with mental health problems. Journal of Further and Higher Education, 1-9.

Hoeft, T. J., Fortney, J. C., Patel, V., & Unützer, J. (2018). Task?sharing approaches to improve mental health care in rural and other low?resource settings: a systematic review. The Journal of rural health, 34(1), 48-62.

Knox, K., Fejzic, J., Mey, A., Fowler, J. L., Kelly, F., McConnell, D., ... & Wheeler, A. J. (2014). Mental health consumer and caregiver perceptions of stigma in Australian community pharmacies. International Journal of Social Psychiatry, 60(6), 533-543.

Leske, S., Harris, M. G., Charlson, F. J., Ferrari, A. J., Baxter, A. J., Logan, J. M., ... & Whiteford, H. (2016). The systematic review of interventions for Indigenous adults with mental and substance use disorders in Australia, Canada, New Zealand, and the United States. Australian & New Zealand Journal of Psychiatry, 50(11), 1040-1054.

Lowe, M. (2018). Ethics and the Care of the Elderly. In Geriatric Medicine (pp. 283-293). Springer, Singapore.

McCann, T. V., Bamberg, J., & McCann, F. (2015). Family carers' experience of caring for an older parent with severe and persistent mental illness. International journal of mental health nursing, 24(3), 203-212.

McIntyre, C., Harris, M. G., Baxter, A. J., Leske, S., Diminic, S., Gone, J. P., ... & Whiteford, H. (2017). Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys. Health research policy and systems, 15(1), 67.

Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P., & Jones, J. (2017). A systematic review of primary health care delivery models in rural and remote Australia 1993-2006.

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