Question

Read the case study, then answer the questions that follow. Magdalene is 72 years old and lives with her husband, Spiros. Magdalene and Spiros immigrated to Australia from Cyprus three years ago to be closer to their children and have not yet become citizens. A little more than a year ago several members of her immediate family noticed she seemed to be having some short-term memory problems. Magdalene visited her general practitioner who arranged for her to be assessed. She was diagnosed with dementia. Soon after she began wandering from the house and having difficulty finding her way home. On several occasions, she injured herself while performing routine daily chores. Six months ago, Magdalene’s family decided that it was no longer possible for Magdalene to live at home. To protect Magdalene and make life easier for Spiros, Magdalene was moved to a nursing home specialising in dementia care. Magdalene did not respond well to the move and the situation has been made more difficult because she has lost her ability to communicate in English. Memory problems have caused her to revert to her native Greek. Spiros has needed support from family and friends to deal with the stigma of mental illness affecting his wife and to understand the workings of the mental health sector.

1. Provide an example of a current economic decision that has affected the mental health sector. What were the impacts on people with mental health issues? (Approx. 80 words).

*any current economic decision can be used to answer the question

Answer 1

Greetings of the day!

Answer:

Recently, with the coronavirus supplement maintenance, boosting the payment rate from $550 a fortnight, or $40 a day, to $1200 a fortnight for six months, people have been flooded with pleas from despondent Australians struggling to understand bureaucratic language and systems or trying to contact Centrelink to get clear information.

We’ve heard how people have become emotionally drained, how they’ve grown fearful and unsure how they’ll manage when coronavirus supplements stop, or angry and confused about why their payments weren’t raised along with others. There is financial and psychological impact of debt, of the grinding daily endurance contest of living in poverty, and the stress of feeling worthless and alone.

Organisations and groups such as the Anti-Poverty Network, the Unemployed Workers Union, Centrelink and Other Info and the Australian Council of Social Services provide assistance to those struggling to navigate what is often termed a “broken system”.

The current economic crisis is increasing poverty  The economic crisis will hit people with low income – and those made poor through loss of income or housing – the hardest . The economic crisis has increased the number of households in high debt, repossession of houses and evictions. The current economic crisis is probably increasing the social exclusion of vulnerable groups, low-income people and people living near the poverty line in the European Region . Such vulnerable groups include children, young people, single-parent families, unemployed people, ethnic minorities, migrants and older people. Economic pressure, through its influence on parental mental health, marital interaction and parenting, affects the mental health of children and adolescents. The effects of extreme poverty on children include deficits in cognitive, emotional and physical development, and the consequences on health and well-being are lifelong .

Social gradients of health exist in Europe, and moving down the socioeconomic ladder due to loss of jobs and income affects people’s health. During recessions, social inequality in health can widen . The least well-educated people are at greatest risk of ill health after job loss . Unsurprisingly, substantial research has revealed that people who experience unemployment, impoverishment and family disruptions have a significantly greater risk of mental health problems, such as depression, alcohol use disorders and suicide, than their unaffected counterparts. Especially men are at increased risk of mental health problems and death due to suicide or alcohol use during times of economic adversity.

Unemployment contributes to depression and suicide , and young unemployed people have a higher risk of getting mental health problems than young people who remain employed. Evidence indicates that debt, financial difficulties and housing payment problems lead to mental health problems . The more debt people have, the more likely they are to have mental disorders overall . The crisis will increase mortality linked to mental health problems. In the EU, increases in national unemployment rates are associated with increases in suicide rates . In the Russian Federation, the societal change after the dissolution of USSR in 1991 and the collapse of the rouble in 1998 have been followed by increases in alcoholrelated deaths . Likewise, great increases in unemployment have been linked to a 28% rise in deaths from alcohol use in the EU . It can be concluded that the economic crisis is likely to negatively affect health, especially mental health. The next sections outline possible measures to mitigate the mental health effects of the current crisis.

Impacts on people with mental health issues:

Maintain mental health systems in the economic crisis Mental health problems, binge drinking , suicide and (in many countries) alcohol-related deaths tend to increase during economic downturns, creating a need for governments to upgrade mental health action. Many countries in the European Region are facing pressure from the international financial community to reduce health and welfare budgets. Despite increased need, mental health is a vulnerable target of these cuts, as it usually lacks a strong advocacy base to oppose them, unlike physical illnesses.

Evidence from past economic crises predicts what is likely to happen in the current economic downturn. Despite increased pressure on mental health services, government expenditure on health will be squeezed and will probably fall in real terms, contributing to worse health outcomes. Household income to pay for health services will drop. Insurance protection will decline. People will switch from the services that require out-of-pocket spending to less costly services: in some countries this means switching from the private to the public health care sector.

In countries without comprehensive services funded by taxes or health insurance, the people who need mental health services the most may have less access to them because of the costs involved. Overall, the health effects of the economic downturn will be less pronounced in countries with better social safety nets .

Tackle the stigma of mental illness

One reason for the apparent low funding priority given to and neglect of mental illness is the high level of stigma associated with mental health problems. Countering this stigma and discrimination remains one of the most critical challenges for improving mental health in Europe because this stigma may influence the willingness of public policy-makers to invest in mental health. Past public surveys in some countries have indicated that mental health can be given low priority in terms of safeguarding services in the face of budget cuts . Although general population anti-stigma campaigns have shown only modest effects, targeted approaches seem more effective.

Build the case for investing in mental health

Demonstrating that investing in mental health has economic benefits may help in persuading governments to invest in mental health. Investing in mental health action, both inside and outside the health care sector, provides resources and opportunities to reduce the risk of social exclusion and promote social integration. It is crucial to take a broader economic perspective than that of the health system alone and to communicate that investment in mental health generates savings in other sectors . Despite the availability of cost-effective interventions that can mitigate or prevent much of the effects of poor mental health, the priority it receives in most health care systems has been remarkably low so far .

Continue mental health reforms

Due to financial constraints, governments will inevitably have to review their welfare services. It is important that any changes imposed support the mental health agenda for the European Region of deinstitutionalization and strengthening primary health care. Increasing the efficiency of services can go hand in hand with developing modern mental health services. Sound financial incentives are needed to support the provision of high-quality community care and to use existing resources optimally. Linking funding to accreditation systems and assessment of provider performance will support the development of services.

Ensure universalism in mental health services

In times of economic hardship, access to basic social safety networks is increasingly important. Universal coverage of mental health services is a cornerstone in reducing the effects of the crisis and is likely to restrain social inequality in health .

Conclusion:

The effects of the present economic crisis on mental health present an opportunity to strengthen policies that would not only mitigate the impact of the recession on deaths and injuries arising from suicidal acts and alcohol use disorders but also reduce the health and economic burden presented by impaired mental health and alcohol use disorders in any economic cycle. There are powerful public health arguments for social protection, active labour market programmes, family support, debt relief and effective alcohol policy, and the present economic downturn strengthens these arguments. Governments could consider reorienting budgets to protect populations now and in the future by budgeting for measures that keep people employed, helping those who lose their jobs and their families to overcome the negative effects of unemployment and enabling unemployed people to regain work quickly. Governments could consider strengthening their alcohol policies, in particular by raising the price of alcohol or introducing a minimum price. Such a policy would have a particular effect on reducing the harm of risky and heavy episodic patterns of drinking. Mental health service provision needs to be strengthened by continued efforts to develop universal mental health care, supported by sound financial incentives for good quality community care.