A Vision for Change | Review

A resourcefulness for Change Re deliberatewellnessc are polity for Ireland a Critical Review1. Overview of the rollThe document A Vision for Change reflects global concerns about intellectual wellness, psychological illness and impacts on societies1, and is a key policy document which outlines the communicate mode of li rattling for psychological health benefits in Ireland. It provides an arguably innovative example for developing and consolidating positive approaches to psychical health and supervisement of mental ill-health across the fellowship context. It besides outlines the plan to provide targeted, penetrationible goods to those with mental illness across the undivided country.2. Key pointsService exploiters and their copeers should be tortuous in every aspect of the service, at every stage, and should be toughened as partners in their care.There should be severalise-based mental health forward motion programmes available for every sector of the po pulation at whatever age, as a nitty-gritty of increasing wellbeing and preventing mental illness.The service should be developed and implemented a enormous a model that is instructioned on recovery, which repletes the needs of the individual.The document requires the learning 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. go will be organised in designated catchment areas, monitored and managed by transparent processes. operate 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 subtile mental hospitals s hould be designed and put into place, and their resources re-invested in the new mental health services suggested.Improvements in information systems, mulit sea captain functional, 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 strengthsThe document challenges the on-going provision of mental health services through particular means. To begin with, much homogeneous the NHS Plan2, 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 worthy (Gagliardi et al, 2008). Service user input is a key element of nifty mental health service design, but also, this document is based on a range of evidence from clinical practice, including all levels of evidence3. This is a strength, th at 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 therapies4. Improving access to such therapies can only benefit service users and providers in the long run5.4. Critically analyse the impact of the document on, and its relevancy to, overall healthcare provisionThe impact of this document on healthcare provision could be evidentiary, particularly as it means closing acute inpatient hospitals and redirecting those resources to the new mental health services. This office affect a of import 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 all the way sets out to meet the unmet needs of all sectors of the commu nity, 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 feign psychiatric and mental health care fully to community contexts has long been argued for6. However, there is also the awareness of the impact community-based services would have on primary healthcare providers78. The document does attempt to address this, but it might not reassure those who will be most impacted by the changes9.5. Critically analyse the impact of the document on, and its relevance to, public health nursing practiceThe 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 relati onships with the staff of these services, and the parameters of practice would have to be transparent and be concord upon by all parties. However, there may be implications for inter-professional working and challenges to professional hegemony10, 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 documentThe 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 implications11.ReferencesBower, P. and Gilbody, S. (2005) Managing common mental health disorders in primary care conceptual models and evidence base BMJ. 330839-842Carr, 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 rival of Institutional Forces Upon Knowledge Sharing in the UK NHS The Triumph of Professional causality 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 Psychiatry170 6-11Goldberg 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, brownish, A.D. et al (2008) Barriers to patient involvement in health service planning and evaluation An exploratory study. Patient command and Counseling 70 (2) 234-241. subdivision 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) octuple access points and levels of entry (MAPLE) ensuring choice, accessibility and equity for CBT services. Behav Cognit Psychother 28 379-91Shepherd M, make B, Brown A, Kalton G. (1966)Psychiatric illness in general practice. London Oxford University PressValenstein M, Vijan S, Zeber J, Boehm K, Buttar A. (2001) The cost-utility of screening for notion in primary care . Ann Intern Med134 345-60World Health Organization. (2001) The world health report 2001mental health new understanding, new hope. Geneva WHO.Woolf, N. (2000) apply Randomized Controlled Trials to Evaluate Socially Complex Services Problems, Challenges, and Recommendations Journal of Mental Health Policy and Economics 3 (2) 971091Footnotes1 WHO, 20012 DoH, 2000,3 Woolff, 20004 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 200028 379-916 Goldberg D, Huxley P. (1980)7 Shepherd M, Cooper B, Brown A, Kalton G. (19668 Goldberg D, Gournay K. (1997)9 Gask L, Sibbald B, Creed F. (1997)10 Currie and Suhomlinova, 200611 Valenstein M, Vijan S, Zeber J, Boehm K, Buttar A. (2001)