Essay on Historical Changes In Program Service Structures and Mental Health Treatment Approaches

For the last 50 years, the mental health industry has faced a lot of changes and challenges as per the rise of mental health needs and social policies aimed at dealing with mental health issues. There has been a notable shift in the understanding of mental health issues from the corners of government, families and the society at large. In the early mid-20th century and the onset of the 1960s, mental health was approached from the biased concept. People with mental health issues were viewed and treated as an unnecessary part of the community. The governments and the society were not keen to spend time and resources in healing something that was regarded as an unwelcome forfeiture (Minas, 37). However, by the early 1970s, special focus was paid towards making mental health a community concern, and there were high levels of mental health integration to social issues.

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The above push was a result of what Barreira and Malorie (22) referred to as intensive lobbying by policy makers under the social work umbrella in the late 1960s. An awakening had been witnessed, and funds were set aside for mental health rehabilitation, change of program structures and research into mental health care. Two policy components of joint policies of community care and deinstitutionalization led to dramatic declines in the length of hospital stay and the discharge of many patients from custodial care in hospitals. By 1980s the mental health treatment in the United States had been integrated as a part of social welfare problem. Changes in the provision of mental health care in the United States over the last 50 years have been as a result of dual policies of community care and deinstitutionalization leading to a more inclusive, acute treatment and prevention based mental health care.

To understand the impacts of acute treatment and prevention based mental health care, it important to revisit the definition and chronicles of dual policies of community care and deinstitutionalization. In the world war era, from a social perspective, Goldman (220) argued that mental health illness were treated with total neglect and at times harm. The above is after considering that traditionally, mental health issues were treated as an abomination. Additionally, there were limited scopes of metal health issues, with the majority being inherent issues. However, Barreira and Malorie (22) found out that a rise of the numerous types of mental health issues, due to changing social lifestyle, led to the acceptance of mental health issues as part health problems. The acceptance by the society that mental health problems were part of social problems was noted by Minas (39) as to have laid the foundation for the community care policies aimed at seeking support from the society in prevention and treatment of mental health issues. To start with, social support was key in the establishment of program service structures that would provide preventive measures in the reduction of mental health issues.

By early 1990, the mental health treatment approaches were mainly based on preventive measures. By this time, care had shifted from the society being responsible for the treatment of mental health issues to the victims or survivors need to address their mental health issues. Notably, mental health treatment approaches and structure had also shifted the mode of treatment from basing treatment and prevention responsibility to the community and families of victims to the victims of mental health issues. The shift led to the enlargement of outpatient services in the community, predominantly in federally financed community mental health centers.

Van Hoof (200) considered massive funding for community health centers as key in the achievements of the deinstitutionalization policies. Without the funding, prevention, treatment, support and research into mental health issues would have stalled. However, there were fears that the deinstitutionalization policies did not effectively create a defining factor between the mentally disabled and the worried well. As such, Minas (39) presented that the deinstitutionalization policies may have led to an increase in the number of people relying on funding as a product of deinstitutionalization policies, taking away its intended goal. Extra challenges witnessed extend the scope of underinsurance for mental disorders, access barriers, discrimination and stigmatization about mental illness.

Despite the challenges, reform movements, financial incentives, and advancement in care stood out as the main changes in the mental health treatment approaches. For example, diagnosis and treatment approaches in the DSM (Diagnostic and Statistical Manual of Mental Disorders) since its inception in 1952 has been revised five times to cater for changing approaches (Van Hoof, 202). Additionally, mental health issues have been integrated into community health care programs.

Dual policies of community care and deinstitutionalization were the foundations of the numerous positive changes in the provision of mental health care in the United States over the last 50 years. Dual policies allowed for a creation of a more inclusive, acute treatment and prevention based mental health care. The shift of change moved from community-based health care and support to personalized mental health care approach. Most importantly, prevention was identified as a key concept in the provision of mental health treatment. Several challenges that were witnessed along the way were in the scope of underinsurance for mental disorders, access barriers, discrimination, and stigmatization.Works Cited

Barreira, Paul, and Malorie Snider. "History of College Counseling and Mental Health Services and Role of the Community Mental Health Model." Mental Health Care in the College Community, 2010, pp. 21-31.

Goldman, Howard H. "Deinstitutionalization and Community Care: Social Welfare Policy as Mental Health Policy." Harvard Review of Psychiatry, vol. 6, no. 4, 1998, pp. 219-222.

Minas, Harry. "The Centre for International Mental Health Approach to Mental Health System Development." Harvard Review of Psychiatry, vol. 20, no. 1, 2012, pp. 37-46.

Van Hoof, Frank, et al. "The role of national policies and mental health care systems in the development of community care and community support: an international analysis." Journal of Mental Health, vol. 24, no. 4, 2015, pp. 202-207.