A Vision for Change | Review

A Vision for Change | Review Healthcare Policy for Ireland a Critical Review 1. Overview of the document The document â€Å"A Vision for Change† reflects global concerns about mental health, mental illness and impacts on societies[1], and is a key policy document which outlines the projected mode of delivery for mental health services in Ireland. It provides an arguably innovative framework for developing and consolidating positive approaches to mental health and management of mental ill-health across the community context. It also outlines the plan to provide targeted, accessible services to those with mental illness across the whole country. 2. Key points Service users and their careers should be involved in every aspect of the service, at every stage, and should be treated as partners in their care. There should be evidence-based mental health promotion programmes available for every sector of the population at whatever age, as a means of increasing wellbeing and preventing mental illness. The service should be developed and implemented along a model that is focused on recovery, which meets the needs of the individual. The document requires the development and implementation of Community Mental Health teams, fully staffed with appropriately trained staff, and based in the communities which they serve, who can meet any needs of an individual in relation to their mental health across their lifespan. This would involve outreach programmes and liaison and referral to a range of therapies, including pharmaco-medical therapies, and psychological therapies. Services will be organised in designated catchment areas, monitored and managed by transparent processes. Services will be prioritised for those areas which are deemed as of greatest need, with fully inclusive services that can be accessed and are relevant to all user groups. A plan to close acute mental hospitals should be designed and put into place, and their resources re-invested in the new mental health services suggested. Improvements in information systems, mulitprofessional working, training and education are intended. Extra funding is required. The whole plan needs to be accepted and implemented for its principles to work. 3. Provide a critique of the document with reference to its challenges, limitations and strengths The document challenges the current provision of mental health services through particular means. To begin with, much like the NHS Plan[2], it requires the services to reorient themselves to a user-centred focus. To this end, the document itself was developed by a team which had service user input at all stages, which is laudable (Gagliardi et al, 2008). Service user input is a key element of good mental health service design, but also, this document is based on a range of evidence from clinical practice, including all levels of evidence[3]. This is a strength, that it contains the points of view of those who provide the service, those who use it, and some of the research evidence which supports the plan, including the inclusion of psychological therapies[4]. Improving access to such therapies can only benefit service users and providers in the long run[5]. 4. Critically analyse the impact of the document on, and its relevance to, overall healthcare provision The impact of this document on healthcare provision could be significant, particularly as it means closing acute inpatient hospitals and redirecting those resources to the new mental health services. This might affect a significant number of patients who are not prepared to return to the community, and would also affect staff. The drain on services initially might be significant, and only over time would this even out. The financial impact on other healthcare services would have to be evaluated. However, this document clearly sets out to meet the unmet needs of all sectors of the community, and by taking a person centred, recovery oriented approach, seems to be trying to both manage mental illness and prevent deterioration or even development of such illness in the longer term. This is not news, and the urge to move psychiatric and mental health care fully to community contexts has long been argued for[6]. However, there is also the awareness of the impact community-based services would have on primary healthcare providers[7][8]. The document does attempt to address this, but it might not reassure those who will be most impacted by the changes[9]. 5. Critically analyse the impact of the document on, and its relevance to, public health nursing practice The role of the public health nurse is very much centred around improving public health for all, but the individual-needs focus here would allow public health nurses to identify ways in which to meet client needs in liaison with the new mental health services. Public health nurses would have to establish good working relationships with the staff of these services, and the parameters of practice would have to be transparent and be agreed upon by all parties. However, there may be implications for inter-professional working and challenges to professional hegemony[10], and the transition period could have some impact on service users. It might be important for public health nurses to be actively involved in the implementation of the plan from the beginning, as a means of ensuring its success (Carr, 2007). 6. Critically consider any recommendations, summaries or conclusions from the document The document requires that the plan it outlines be implemented in full. This would have some significant impact on issues of resourcing and funding. While it would be possible to implement these changes, they are so radical and far reaching that it would be destabilisation of current service delivery over a marked period of time, and it would be financially very costly in the short term, despite the projected financial benefits in the longer term. Finding the resources to implement this could be the biggest challenge, as even single activities that form parts of the plan have significant cost implications[11]. References Bower, P. and Gilbody, S. (2005) Managing common mental health disorders in primary care: conceptual models and evidence base BMJ. 330:839-842 Carr, S.M. (2007) eading change in public health – factors that inhibit and facilitate energizing the process. PrimaryHealth Care Research and Development. 8 207-215. Currie, G. and Suhomlinova, O. (2006) The Impact of Institutional Forces Upon Knowledge Sharing in the UK NHS: The Triumph of Professional Power and the Inconsistency of Policy. Public Administration 84 (1) 1-30. Gask L, Sibbald B, Creed F. (1997) Evaluating models of working at the interface between mental health services and primary care. Br J Psychiatry;170: 6-11 Goldberg D, Huxley P. (1980) Mental illness in the community: the pathway to psychiatric care. London: Tavistock. Goldberg D, Gournay K. (1997) The general practitioner, the psychiatrist and the burden of mental health care. London: Maudsley Hospital, Institute of Psychiatry, Gagliardi, A.R., Lemieux-Charles, L, Brown, A.D. et al (2008) Barriers to patient involvement in health service planning and evaluation: An exploratory study. Patient Education and Counseling 70 (2) 234-241. Department of Health (2000) The NHS Plan London: Department of Health. Department of Health. (2001) Treatment choice in psychological therapies and counselling: evidence based clinical practice guideline. London: Department of Health. Lovell K, Richards D. (2000) Multiple access points and levels of entry (MAPLE): ensuring choice, accessibility and equity for CBT services. Behav Cognit Psychother ;28: 379-91 Shepherd M, Cooper B, Brown A, Kalton G. (1966)Psychiatric illness in general practice. London: Oxford University Press Valenstein M, Vijan S, Zeber J, Boehm K, Buttar A. (2001) The cost-utility of screening for depression in primary care. Ann Intern Med;134: 345-60 World Health Organization. (2001) The world health report 2001—mental health: new understanding, new hope. Geneva: WHO. Woolf, N. (2000) Using Randomized Controlled Trials to Evaluate Socially Complex Services: Problems, Challenges, and Recommendations Journal of Mental Health Policy and Economics 3 (2) 97–109 1 Footnotes [1] WHO, 2001 [2] DoH, 2000, [3] Woolff, 2000 [4] DoH, 2001. [5] Lovell K, Richards D. Multiple access points and levels of entry (MAPLE): ensuring choice, accessibility and equity for CBT services. Behav Cognit Psychother 2000;28: 379-91 [6] Goldberg D, Huxley P. (1980) [7] Shepherd M, Cooper B, Brown A, Kalton G. (1966 [8] Goldberg D, Gournay K. (1997) [9] Gask L, Sibbald B, Creed F. (1997) [10] Currie and Suhomlinova, 2006 [11] Valenstein M, Vijan S, Zeber J, Boehm K, Buttar A. (2001)

The Management of US Homeland Security

The US employs a federal state of governance to manage and secure the totality of the individual states as mandated by the Constitution. The federal government’s headquarters is centered in the White House in Washington, D.C. The government is divided into three separate sectors, each with a well-defined role: (1) executive branch, defines the role of the president and his body and the limit to their powers; (2) legislative branch, is a bicameral form consisting of the House of Representatives/Congress and the House of the Senate and is generally concerned with passing of laws and amendments; (3) legislative branch, acts as the forecourt in judging state matters and decision-making on any matters, whether executive or legislative regarding US Constitution.The US Constitution dictum includes freer reign in each individual states meaning that in the federal government, the powers are limited because they are heavily limited and separated in each individual state. Each branch is separated into agencies and smaller branches with a definitive role.US being an industrial and a political giant would be an important target for those who aim to undermine its power. External conflicts, counterterrorism attacks, and mitigation of related disasters are major fora for homeland security. The Executive Office of the President houses 17 councils and since the power vested in the president, aside from being the â€Å"head of the state†, is the military chief –command, then it is concluded that the â€Å"decision-making† regarding national security befalls upon him.There are three offices of import to his role as the military chief-in-command: (1) Homeland Security Council (2) National Security Council and (3) Whitehouse Military Office. Understand that in the insidious role of protecting the homeland security, the council enacted for this task is the Homeland Security Council but this does not mean it is responsible for the safety alone since it harm oniously relates with the National Security Council and the Intelligence and the military to produce and ensure maximum homeland security.The HSC was established by the Homeland Security Act of 2002 under Executive Order 13228 last October 8, 2001 as a protective and legal response to the attack on the twin towers. The main quota of the act is to guarantee synchronization among executive departments and federal agencies regarding combating terrorism and ensuring homeland security.   Ã‚  Ã‚  It is spearheaded by the President with attendees like the Secretary of Defense, Chairman of the Joint Chiefs of Staff, Secretary of State, the Secretary of the Treasury, Director of National Intelligence, and other â€Å"heads† of agencies are invited to attend the meetings.Currently the homeland security and counterterrorism advisor is Miss Frances Townsend; she facilitates the HSC meetings and the thirty-five member-staff and accepts the and organizes the reports from staff pertaining to (1) peripheral security,   (2) biochemical defense,   (3) continuity of operations between agencies, (4) emergency preparedness (5) anticipation of ‘events’, and (6) nuclear defense. She works hand in hand with the Assistant for the National Security Affairs in combating terrorism.Naturally, homeland security would involve that of the United States Intelligence Community (production and dissemination of intelligence) and the Military of the US (civilian protection). The Intelligence is subdivided into three, namely, Central Intelligence Agency (CIA), Defense Intelligence Agency (DIA), and National Security Agency (NSA); and the Military Unit, into four, Army, Marines, Navy, and Coast Guard. Their executive heads work hand in hand with HSC and the transfer of information and job relation of the various agencies all assist in the rendering of the task of bringing about homeland security.Bush’s National Strategy for Homeland Security, which was amended in Oc tober 2007, aims to target security at two levels: (1) terrorist and non-terrorist attacks which may have implications for the security and (2) offense and defense on the face of terrorism.   The conceptual framework on the Strategy is based on the following goals: (1) avert terrorist attacks; (2) protect state members, assets, properties, resources; (3) counteract incidents; and (4) strengthening the foundation to for long-term success.With so many levels or branches of government, would it still be possible for an effective management and delivery of homeland security system? Bush’s strategy and to achieve that of the fourth goal, proposed for a comprehensive Homeland Security Management System at the national, state and tribal level using the scheme guide-plan-assess-execute-evaluate. All complementary processes and practices must be implicated at all levels, employ multidisciplinary education opportunities, use s & t and governmental influences, and working hand-in hand with the Congress.There are problems regarding this area although this is highly resolvable by an ingenius shift of high-performance information technology between sectors. The e-government, as we may call it can facilitate, a more clear connection between the hundreds of agencies whose roles are rather overlapping and who must maintain thousands of information across the different bureaus. This may also facilitate not only more efficient communication between government agency channels but as well as mediated response between the members of the state and the government.The E-government strategy as an agenda for improving efficiency across homeland security channels may facilitate for a good protective homeland security measures in addition to the branching, structure of the Homeland Security.ReferencesForman, M.(2002). E-Government Strategy. Retrieved Dec 17, 2008 from http://www.whitehouse.gov/omb/inforeg/egovstrategy.pdf.Homeland Security Council. (2007). Retrieved Dec 17, 2008 from http://www.whitehouse.gov/government/

Health Beliefs in the Latino Culture Essay

Vomiting, fever, crying, restlessness (Evil eyeness), brought on by an admiring or covetous look from a person with an evil eye. All children are susceptible. Prevented if the person with the strong eye touches the child when admiring her/him; also by wearing particular earrings, necklaces, or other jewelry. Treated with a barrida (Puerto Rican) or limpia (Mexican) which is a spiritualistic sweeping of the body with eggs, lemons, and bay leaves, accompanied by prayer. Barrida/limpia are believed to have treatment value. Susto Anorexia, insomnia, weakness, fright disease hallucinations, and various painful sensations, brought on by traumatic situations such as witnessing a death. Treatment may include a barrida (see mal de ojo), herb tea and prayer. Caide de mollera A condition thought to cause fallen, sunken anterior fontanella, crying, failure to suckle, sunken eyes, vomiting. Popular home remedies include holding the child upside down over a pan of water, applying a poultice to the depressed area of the head, and/or inserting a finger in the child’s mouth and pushing up on the palate. Empacho Lack of appetite, stomach ache, diarrhea, and vomiting caused by poorly digested food, or uncooked food sticking to the walls of the stomach and/or digestive tract. Treated by massaging the stomach; drinking a purgative tea (estafiate); or by azarcon or greta,   medicine that has been implicated in some cases of lead poisoning. Ataque Severe expression of shock, anxiety or sadness, characterized by mutism, hyperventilation, bizarre behavior, hyperkinesis, violence, and uncommunicative behavior. A culturally appropriate and sometimes expected emotional response to shocking or unexpected news. Bilis Vomiting, diarrhea, headaches, dizziness, migraine headaches, nightmares, loss of appetite, and the inability to urinate brought on by livid rage and revenge fantasies. Believed to stem from bile pouring into the bloodstream in response to strong emotion, resulting in an imbalance of â€Å"yellow bile† and the person â€Å"boiling over.† Bilongo (hex) Any illness may be caused by a bilongo or hex; proper diagnosis and treatment requires   consulting a Santero/Santera (priest or priestess). Hot and cold theory Health is the product of balance of the four body humors–blood and yellow bile being â€Å"hot† and phlegm and black bile being â€Å"cold.† Diseases are caused by humoral imbalance. Foods and medications will cure disease by restoring the balance. Thus a â€Å"hot† illness is cured with â€Å"cold† medication and food; â€Å"cold† illnesses are treated with â€Å"hot.† Those that believe the common cold is caused by a cold draft entering the body will not drink cold fruit juices because it will add more â€Å"coldness† to the body. However, the provider can recommend more hot teas, broths, and soups for liquids. The family would accept this. Note. From Delivering Preventive Health Care to Hispanics: A Manual for Providers (pp. 57-58, 66-68), by COSSMHO, 1988 , Washington, DC: The National Coalition of Hispanic Health and Human Services Organization. Copyright 1988 by The National Coalition of Hispanic Health and Human Services Organization. Reprinted with permission.

Religion is Detrimental to Society and the Individual

For science can only ascertain what is, but not what should be, and outside of its domain value judgments of all kinds remain necessary. Religion, on the other hand, deals only with evaluations of human thought and action; it cannot justifiably speak of facts and relationships between facts†¦Now, even though the realms of religion and science in themselves are clearly marked off from each other, nevertheless they exist between the two strong reciprocal relationships and dependencies. Though religion may be that which determine the goals, it has, nevertheless, learned from science, in the broadest sense, what means will contribute to the attainment of the goals it has set up.† - Albert Einstein (1940) A religion is an organized†¦show more content†¦Egypt had a hierarchy of gods that stated that the after life was thought to be reserved for elites. Only those who passed Osiris â€Å"weighing of the heart’ on judgement day, tested how well the individual behaved in their life time. Greco- Roman gods were held above everyone else with human personalities and supernatural powers. These people had the belief that you could do everything right and still lose since forces beyond out control shape our lives, and that respect for the gods was the most important above all. Norse religion was associated with Vikings, who were known for stealing and fighting were punished for stealing only if it was not done in a courageous fashion (O’brien, 2014). Hinduism requires a devotion to a particular god and consequences of actions follow the individual though the next life, with the hierarchy of social classes determining the affects of the afterlife. Buddhism says that each life is a combination of a particular impermanent circumstance that is the doctrine of dependent origination (Open University, 2014). It is clear that regardless of religion, all require different recommendations in order to be deemed ‘good’ to achieve the afterlife. Religions are all conflicting which provides no stability to their claims of a higher power and decency, especially regarding hierarchies and social class structure. Marx believes that religion develops out of the longings of the oppressed and it is aShow MoreRelatedReligion and its Effect on Society and Individuals Essay1603 Words   |  7 PagesOver the years, society has come to evolve and progressively become more efficient as society’s viewpoints and perspectives on various aspects of life have also changed. However, the one aspect of life that has stayed constant has been religion. The impact of a constant religious opinion on a changing society has detrimental and benign effects on the populace of such a society. 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