Please read reading 2.1 (link under reading & resources tab) Althaus, C. M., Bridgman, P., & Davis, G. (2013). Policy analysis. In The Australian policy handbook (5th ed., pp. 59-89). Crows Nest, Australia: Allen & Unwin. This will describe each of the steps involved in the policy analysis section below. Please support your argument & recommendations with evidence (local or international or even from another discipline).
A policy analysis is a little different to usual academic writing. Whilst formal or academic writing is required the traditional introduction, body and conclusion is different. Please use the following as a guide on what should be addressed in each section.
The word limit at each section is only a guide based on the marks allocated; you can of course manipulate this depending on the strengths of you critical discussion.
Introduction (15 marks) 750 words
Policy Analysis (25 marks)
The better defined your problem here the more defined your solutions. Having clarity in this section will pave the way for your objectives & solutions that can ameliorate your policy issues. Whilst an evidence base here is an advantage; for some there will be experience that identifies that the policy may not be achieving its goals. This identifies the importance of including key stakeholders in the policy making process.
Consider your frameworks (see Althaus- legal/economic/social/political); you do not have to consider all the frameworks. Pick some (perhaps 3-4) that will give you enough discussion and critical depth
• Set out objectives and goals.
• Identify decision parameters.
• Search for alternatives.
Conclusion (10 marks) 500 words
Conclusions are completely based on policy and related superior literature and demonstrate their potential significance for the health services. Change suggestions are critically explained.
• Propose a solution or options.
Mental health policy analysis
According to the definition of World Health Organization, mental health is a state of wellbeing in which people are efficient in realising their potential, manage stress in life, is efficient to contribute to the community and work effectively and efficiently. When an individual has conditions that influence his or her mental status that may lead to psychological health disorder or mental health illness such as anxiety, depression and bipolar disorder(World Health Organization, 2016). 54 percent of Australians with mental health problems do not avail care facilities any care or treatment. The proportion of individual with mental health problems avail care facilities is half the number of individuals with physical health problems.
Like all other developed nations, in Australia too mental health problem is extensive. Mental health illness has an adverse impact on the economic, social and personal levels of people. The Australian Bureau of Statistics (ABS) carried out a report from the 2007 National Survey of Mental Health and Wellbeing included about 8800 people aged between 16 and 85 in Australia. Three major mental health disorders that have been identified in the report are Substance abuse disorders, Affective disorders, Anxiety disorders and Substance Use Disorders. Anxiety disorder affects 14% while 6% of adults are affected by Affective disorders each year(McKenna, Furness, Dhital, Park, & Connally, 2014).
At varying levels of severity, mental health problems affect people’s lives. Based on statistics, about 3 percent of Australian adults have severe mental health disorders, identified on the duration of illness, symptoms intensity and degree of disability resulted. About half a million of the Australian population have mental health illness, 50 percent of them have primarily schizophrenia psychotic illness or bipolar affective disorder. Majority of the people who have a mental health problem in their adulthood has its onset in their early years of childhood or adolescence(Parliament of Australia, 2019). People who are with mental health problem also are more prone to experience adverse economic, social and health consequences. People who are living with severe psychotic disorder have shorter average life expectancy. Individuals who is in prison or homeless are found to have mental health issues.
Data from the Australian study demonstrates about 75% of homeless adults have mental health problems, one-third of them are affected severely. Further, the studies have shown that around 40 percent of people living in prison have been suffering from mental health problems whereas 10-20 percent have the serious disorder(Australian Government: Department of Health, 2009). According to the survey estimation, conducted The Australian Bureau of Statistics (ABS) National Survey of Mental Health and Wellbeing (NSMHWB). The statistics demonstrate that about forty-five percent Australian adults have suffered from mental health issues any time of their life.
The economic cost of mental illness is considerably high as suggested by National Mental Health Report 2013 that mental health services in 2020-2011 cost A$6.9 billion which is about 7.7% spending of all spending made by Australian Government. The impact of mental health illness is intangible in nature that encompasses side-effects of medications, psychological distress, social exclusion, social isolation and stigma and discrimination.
The particular policy on mental health has been chosen as it defines a vision for individuals’ future mental health conditions. It further aids in identifying an effective framework that can be implemented to tackle and prevent mental and neurological illnesses that are a priority as stated by WHO. With accurate conceptualization, mental health policy can support in undertaking and coordinating relevant activities and services so that effective care and treatments are delivered to people who are in need as well as closing the gaps of the health care system. A plan on mental health is developed on the policy that defines its objectives and vision. Different activities and strategies to meet those objectives underlying in the mental health policy also are recognised through a policy as well as identifying the purpose and goals to be achieved through the policy implementation.
Mental health policy also includes different roles and responsibilities of different key stakeholders who are engaged in the program and activity such as government agencies, care users and their families, care providers, professional associations, academic institutions and nonprofit organizations. Therefore it can be analysed from the above section that mental health policy facilitates in setting policy, goals, objectives, purpose, activities and strategies that are required to be adapted to meet the area for which policy has been made, mental health care in this context. It has been already been discussed in the policy paper that mental health illness has been one of the priority areas to focus on as Australian population has been experiencing increasing rate of different mental health issues(McGorry, Bates, & Birchwood, 2013). Tackling the mental health issues or related outcomes and preventing the population from acquiring the illness need to have an effective policy on mental health. Witnessing the significance of mental health issue in Australia context, health policy in these specific areas has been undertaken.
The policy aims to provide quality and affordable mental health care access so that prevent mental health issues, tackle mental illness, promote de-stigmatization and ensure social inclusion of the people who experience mental illness. Therefore the particular mental health policy aims at promoting accessible and high quality affordable treatment in managing mental health illness as well as preventing this particular health issue. Moreover, the mental health policy further aims at addressing stigma against the people who experience mental health issues while promoting their socio economic inclusion.
There is a growing recognition that mental health is one of the most essential development aspects in meeting the Millennium Development Goals as considered by the international community(Sunderland, Newby, & d Andrews, 2013). Contributing Lives, Thriving Communities is a final report published by the Australian Government that undertook the National Mental Health Commission. The aim of carrying out a mental health illness based national review and service programme is to evaluateefficiency and effectiveness of programmes and services that are developed and integrated to support people who suffer from mental health problems(The Department of Health:Mental health policy, 2016).
Further, the Fifth National Mental Health and Suicide Prevention Plan was designed to achieve effective suicide prevention, multiagency a multi professional treatment through coordination for people with critical mental health diseases, suicide prevention and promotion of mental health conditions of Aboriginal and Torres Strait Islander. The plan further works in improving the physical health of people who are affected by mental health illness and thus aims to diminish mortality. The particular plan also aims at eliminating differentiation and stigma of the people who are with mental health issues where the quality of care and safety are the key aspects of the treatment and services. The plan ensures high quality system performance and system improvement that it is adhered to(Department of health: The Fifth National Mental Health and Suicide Prevention Plan, 2017).
A wide number of Australians experience a mental health issue,anytime in their lives or anyone from their own family, friends and colleagues. Accessing effective care when it is needed is difficult for mental health care seekers. Well-designed metal health ‘architecture’ is lacking in Australia. A clear vision of funding mental health system is not in place. No agreed national framework or design is in place that will help in prevention and accurate care for individuals who face mental health issues. When compared to physical health, mental health and psychiatric care are immensely underfunded. Mental illness cannot be considered separately from wider social influences such as childhood experiences, unemployment, marginalization and social disadvantage(Mental Health Services in Australia, 2019). The underfunding mental health initiatives and programs result in the least access to care facilities and prevent vulnerable people from tackling the negative social determinants and childhood aspects. Lack of ability in tackling the growing issue of mental health has been identified in all levels of the healthcare system in Australia. Inadequate access to beds for major illnesses result in delays in discharge. Community care delays or poor access due to poor funding and community care result in ineffective access to support services, lack of early intervention and uncoordinated treatment. Government initiatives have fallen short in meeting the need for transformation and resources (Australian Medical Association, 2018).
An agenda has been established by The Fourth National Mental Health Plan for promoting collaborative government action in improving mental health care and prevention between 2009 and 2014. It has designed an effective care system to implement early and provide integrated care on the health and social care sectors. Further, it provides guidance on funding for mental health. In 2011, the mental health system was included in the wider National Health Reform and committed $2.2 billion Budget to National Mental Health Reform to support Australian people who are affected by mental health illness in providing them with accurate and need-based care. With the inclusion of annual report on Mental Health and Suicide Prevention, the performance of mental health is assessed and it promotes best practice in National Mental Health Commission (Australian Government: Department of Social Services, 2014).
Importance of including key stakeholders in the policy making process is wide such as they facilitate planning, help in managing key as well as sensitive stakeholders and thus conflicts can be avoided. When all the key stakeholders are included in the decision making process, they have adequate understanding of the different processes and elements included in the policy. With their active engagement, they also suggest different elements that can be implemented to have an effective policy formulation as well as address different issues in the problem solving method that increases the overall chance of plan success.
Different aspects will be considered in order to develop mental health policy, such as economic, social, legal and political.
Economic: Interest rates, inflation, unemployment are the key elements that affect health care services and access to the treatment by care users in addressing their ill health condition. Care users capacity to spend in accessing healthcare facilities depends on the mentioned elements.
Social: Healthcare policy must consider changes in demographics, values, and beliefs of Australian people. The mental health sector must remain aware of the population that they are going to serve as well as the stakeholders of the policy also must have adequate knowledge on populations demography so that violating values or norms can be prevented.
Political: Changing procedures and policies of care users protection, tax legislation and insurance aspect are the key aspects of the political environment that could influence upon mental health care system. For instance, a change in tax policy may have a change in treatment cost. Additionally, changes in employment law may also result in major alterations in staffing or overtime requirements.
Legal: International human rights treaties play a significant role in protecting and promoting people’s rights who experience ill mental health status through better care and treatment. International instruments that are incorporated in federal law are considered to ensure equal human rights and non-discrimination towards people with ill mental health status. Disabled people possess rights to have dignity and experience normal life as others, in compliance with The Declaration on the Rights of Disabled Persons. Complied with the Human Rights and Equal Opportunity Commission Act 1986rights who experience ill mental health status and psychiatry are protected while equality before the law is protected by The International Covenant on Civil and Political Rights(Schmied, et al., 2013). All the legal elements will be followed while establishing and incorporating the mental health policy so that equal rights are promoted and people who experience ill mental health status are protected from inequity and differentiation(Gooding, 2013). Further discrimination in the employment of the people with mental illness is protected ILO Convention 111 and ensure that they experience equal treatment in their workplace and do not face any discrimination based on their mental illness and psychiatric issues (Australian Human Rights Commission, 2010).
Objectives and goals of the particular mental health policy are:
The particular mental health policy aims at promoting easily accessible and affordable treatment in managing mental health illness and preventing this particular health issue. The mental health policy further aims at eliminating stigma against the people who are affected by mental health illness while promoting their socio economic inclusion.
Following WHO benchmarks are required to be achieved through policy planning and implementation:
Benchmark 1: Intersectoral action
As per this benchmark, it is required to be assessed how people are benefitted from minimising exposure to different risks as an outcome of the reform. Information structure is needed to be developed to monitor and measure health inequalities and to conduct studies to minimise those health inequalities(World Health Organization, 2016).
Benchmark 2: Financial fairness
Both financial and non-financial barriers must be reduced to achieve equitable health care accesses. This benchmark encourages in including as many as population into insurance scheme and the formal sector as possible. Benchmark two focus on two objectives of formal sector change alongside increasing sector size. Those two aims at effective benefits to all groups of workers and adopt different schemes that include the workers.
Benchmark 3: Address non-financial barriers
This benchmark aims at eliminating non-financial treatment and care barriers such as inadequate supplied of drugs, facilities and supplies. The particular benchmark addresses gender barriers which are essential among the Aboriginal population of Australia to primary care. These barriers as recommended by the particular benchmark can be addressed by engaging community political groups as those barriers cannot be addressed just by delivering services(World Health Organization, 2016).
Benchmark 4: Comprehensive benefits
All people regardless of their gender, class or ethnicity have different health needs and there occur some social limitations in meeting those health needs. Healthcare system concentrate on differential treatment of people based on their social economic class bot between the private and public but with the public sector. In public sector health settings people have to wait four to five hours to consult physicians for five minutes whereas in private health care settings they can access care facilities right away.
Benchmark 5: Efficiency, efficacy and care quality
As resources are limited, fairness and distributive justice are difficult to achieve. The key element of the particular benchmark is to provide primary health care through community-based initiatives. The policy aims at developing primary care through proper training, community engagement and resource allocation. Further, the benchmark encourages evidence based practice in varied areas of care facilities such as preventative, tackling and curative practices. Improving quality is another major aim through staff training, community engagement, assess care quality and continuous education(McKenna, Furness, Dhital, Park, & Connally, 2014).
Key parameters that are included in the reform policy are resources, timeframes and priorities. Different financial resources, human assets and community members should be taken into consideration. Further, the policy implementation will take 6 months after it is designed and considered by all key stakeholders. Main priorities of the policy implementation are equality and non-discrimination approach, trained qualified staffs, adequate supportive resources to provide mental health treatment and preventative measures and awareness improvisation about accessing mental health treatment.
Alternative ways of improving mental health condition of people are public education for mutual benefit, initiatives to attract and train leaders of mutual help initiative, research studies for mutual initiative, and joint meetings of mental health representatives and professionals of mutual help initiatives(World Health Organization:Mental Health Policy, Plans and Programmes, 2010).
Best practice: Address discrimination and inequity in the health care system so that everyone has equal access to mental health care service facilities. Other alternatives can be adopted if there is no experience of community care including experts in the community from other areas, sending mental health professional to other areas and conducting pilot projects in community care(Brophy, Roper, Hamilton, Tellez, & McSherry, 2016).
Expert opinion: Expert Reference Group (ERG) was established byCOAGto support the Working Group that provides suggestions on new targets and indicators of mental health that are likely to promote change(Wand, Isobel, & Derrick, 2015). Expert groups will be included in the policy implementation and improvement.
Lobby groups: There is seventeen Special interest group for meeting with those who have similar needs or interests for sharing information in developing policy papers and positions.
Mental health is the key contributor in productivity and economic participation and therefore has the potential to influence incomes, living standards and social engagement. Higher mental ability also could result in a minimum cost to the economy because of the lowering mental illness burden and higher contribution to employment. The improved mental health of an individual can contribute to higher economic and social participation, connectedness and contribution to productivity through employment. Improved mental health status of the individual, further leads to the wellbeing of the broader community, higher contribution to society by working in community groups. It further diminishes the burden on informal health care professionals, increased community output from the more efficient and competent workforce as well as improving living standards and national income.
Therefore the particular policy has been planned that aims at providing high quality and affordable mental health care access. Such mental health care facilities are likely to prevent growing mental health issues in population, tackle severe mental illness, promote de-stigmatization and ensure social inclusion of the people who are affected by a mental health problem. Therefore the particular mental health policy ensures accessible and high quality affordable treatment in managing mental health illness as well as preventing this particular health issue.
Recent society has been found to have an increasing prevalence of mental health illness with varying severity. Moreover, the mental health policy further aims at addressing stigma against the people who are affected by mental health illness while promoting their socio-economic inclusion so that they can be protected from discrimination and injustice. With the adoption of the particular health service, equal and non-discriminated high quality care and facilities will be provided to people who have been affected by mental health illness. Therefore treatment and care of the mental health illness and further prevention through adequate initiatives can be achieved. However, the implementation of the proposed policy will need different resources such as human assets, supportive infrastructure for primary care, improved training and continuous education of staffs, and supplies and medications for treatment. Increasing work pressure due to organizational change as well as meeting health care needs will be a burden on the health care providers. Additionally, improper work-life balance, stress, anxiety and other related health problems may affect care providers.
Despite a few challenges of implementing the proposed policy, it will have extensive positive effects on the health outcomes of the care users by addressing and preventing possible mental health issues that are very common in recent time. It can be recommended to the health care system to become well equipped in implementing the policy in effective manner:
Promoting a well-coordinated health care system where multiagency, such as government bodies, research institutions, educational institutes, and non-government organization work together. Through multiagency coordination and better communication, an improved health care outcomes can be achieved. Therefore effective communication channel that promotes transparent communication and initiatives to encourage coordination must be integrated. Further community engagement has a very critical role in policy success. Therefore community people must be engaged in the policy process so that all the mental health illness can be identified in the initial stage, which increases treatment effectiveness.
Effective change management strategies also must be implemented such as staff training, shared vision with staffs, communication and feedback, rewards and recognition of performance so that clinical staffs are encouraged to adopt the change and perform well in line with the changed management system.