Problems of Illness and Health Care F. Inadequate Mental Health Care 1. Since the 1960s, U.S. mental health policy has focused on reducing costly and often neglectful institutional care and on providing more humane services in the community. a. This movement, known as deinstitutionalization, has largely failed to live up to its promises. (1) Only 1 in 5 U.S. children with mental illness is identified and receives treatment. (2) Fewer than half of adults with a serious mental illness received treatment or counseling for a mental health problem in the last year. b. Reasons for not seeking treatment include the stigma associated with mental illness, fear and mistrust of treatment, cost of care, and lack of access to services. 2. Mental health services are often inaccessible, particularly in rural areas. 3. In most states, services are available from “9 to 5” and are closed on weekends when many people with mental illness experience the greatest need. 4. Across the nation, people with severe mental illness end up in jails and prisons, homeless shelters, and hospital emergency rooms. 5. Many children with untreated mental disorders drop out of school or end up in foster care or the juvenile justice system. a. As many as 70 percent of youths incarcerated in juvenile justice facilities have mental disorders. b. In a survey of 367 colleges and universities in the U.S. and Canada, 92 percent of counseling center directors believe that the number of college with severe psychological problems has increased in recent years, yet only 58 percent of colleges and universities offer psychiatric services on campus. 6. Given the increasing growth of minority populations, another deficit in the mental health system is the inadequate number of mental health clinicians who speak the client’s language and who are aware of cultural norms and values of minority populations. 7. The mental health system is also plagued by inadequate federal and state funding of public mental health centers, which results in rationing care to those most in need; thus, people must “hit bottom” before they can receive services.
VIII. STRATEGIES FOR ACTION: IMPROVING HEALTH AND HEALTH CARE A. There are two broad approaches to improving health care: selective primary health care and comprehensive primary health care. 1. Selective primary health care: using technocratic solutions to target a specific health problem, such as immunization and oral rehydration therapy to promote child survival 2. Comprehensive primary health care: focuses on broader social determinants of health, such as poverty and economic inequality, gender inequality, environment, and community development 3. Targeting specific health problems may be necessary, but not sufficient for achieving long-term health gains; only where health interventions are embedded within a comprehensive health care approach, including attention to social equity, health systems, and human capacity development, can real and sustainable improvements in health status be seen. B. Improving Maternal and Infant Health 1. Access to family planning services, skilled birth attendants, affordable methods of contraception, and safe abortion services are important determinants of the well-being of mothers and their children. a. Family planning reduces maternal mortality simply by reducing the number of unintended pregnancies. b. Spacing births two to three years apart decreases infant mortality significantly. c. Since 1960 contraception use among married couples in developing countries has increased from 10-15% to 60%, but there are still millions of women who do not have access to contraception. d. Although most reproductive health programs focus exclusively on women, some reach out
Published on Jan 13, 2017
solution manual understanding social problems 6th edition mooney. Full file at http://testbank360.eu/solution-manual-understanding-soci...