Abstract
Modern science and medicine in mental health welcome a variety of methods of helping those in need. The selection of the way may depend on the actual problem for the patient, which he encounters most often. It can be social stigma, financial failure, lack of awareness, bad experiences in the past, and many other problems. The stories of patients who have mental illnesses are unique. After experiencing negative experiences, many people tend to reject the idea of ​​treatment. Modern psychiatry and medicine, in general, try to be flexible, especially under the pressure of external circumstances. A flexible system of assistance will expand the opportunities to receive support from more people; therefore, it will improve the health of society. However, the community must also meet the health system halfway and develop along with it, eliminating stigmatization, prejudice, and stereotypes. It is only with a comfortable public perception of mental disorders and inclusiveness that complex work on diseases is possible.
Introduction and Thesis
Mental health care currently faces several challenges: high fees for services and medicines, stigmatization in society, stereotypes and prejudices, and some legal difficulties. These problems make it difficult for patients and potential patients to receive quality care. This complex issue increases the number of suicides, unemployed people, and even criminals. In addition, in this area, like in no other, the issue of integrating patients into society is acute. Researchers highlight several severe problems with examples in mental health; information technology and teamwork can solve these problems.
Literature Review
The research was conducted by searching, comparing, and analyzing current medical sources. These sources dealt mainly with psychiatry (including child psychiatry), public health, psychology, and social work. The main parameter for finding sources was their relevance for the present time. Some sources relate directly to the problems of the COVID-19 pandemic and its consequences, which suggests that the selected studies meet modern challenges and take into account the context of contemporary medicine in crisis. Articles were drawn from verified journals, and selected websites were about medicine or public health. The private Tulane University recommended one of the articles chosen for the study for public health and psychiatry issues. Selected journal articles address both the narrow United States issue and the international dimension of the problem; selected journals include international, American, and European. Springer, ScienceDirect, Pubmed were chosen as the central databases for information retrieval.
Most people face problems when they want to receive psychological support at different levels. It applies to healthy people who have experienced stress: divorce, loss of a relative or loved one, dismissal, malicious bullying. It also applies to people suffering from severe mental illnesses such as schizophrenia. People who use alcohol or drugs are also susceptible to such diseases. People can see that every person living in society has the potential to become a patient of a psychologist or psychiatrist. However, this sad fact does not contribute to improving the mental health system. On the contrary, people see a lot of obstacles when trying to get psychological help.
Research at the private university Tulane shows that neglect of counseling is often culturally embedded. Often gender stereotypes prevent people, in particular men, from receiving qualified psychological assistance promptly (Understanding mental health as a public health issue, 2021). The authors postulate a real connection between society and mental problems since mental instability is strongly associated with the level of crime, alcohol, and drug use. Against this background, the number of divorces, unwanted pregnancies, abortions depends on the stability of the psyche and the quality of life. The most crucial problem of violence permeating society also has a strong connection with mental trauma. Unfortunately, peers or parents often abuse violent people during childhood. Some investigators highlight, in general, essential details of family relationships and culture that are not usually covered in medical sources. By realizing this problem, people and readers will understand how close mental health issues are to them. Every person has experienced trauma or stress, so indifference to mental health problems is unacceptable.
Other studies point to structural difficulties and the inaccessibility of mental health care in the face of high citizen demand. Research shows that 56% of Americans have ever sought help for themselves or a loved one (National Council for Mental Wellbeing, 2018). On the other hand, this particular study, perhaps due to its state orientation and some interest, considers the problem under discussion from veterans’ point of view. People with PTSD (Post Traumatic Stress Disorder) are also often unable to seek help, as they live in rural areas rather than in large cities with developed infrastructure. Often such patients have to travel far in a car to receive qualified assistance. Patients note the high cost of care and that insurance does not always cover it. Some point out that the price tag of the treatment forces them to choose between that treatment and the essentials. Other patients report waiting a week or more for help. The study again draws attention to social stigma because patients in society often have to hide and lie about their problems.
Most of the articles have focused on disputing social stigma, such as the study by Knaak, Mantler, & Szeto (2017), where the authors postulate the idea of ​​self-stigma. Patients often develop feelings of guilt and shame towards themselves and their bodies. The article by Knaak, Mantler, & Szeto (2017) deserves special attention as it talks about a somewhat taboo issue. It is a problem of stigmatizing their patients by doctors. According to the authors, patients reported that doctors often use stigmatizing language (or possibly hate speech) against them. The authors conclude that many doctors or nurses are not aware of the specifics of the perception of their patients. Some doctors are pessimistic about patients and tirelessly talk about the fact that a cure is impossible. It makes the patients feel severe pressure; stigma leads to poor quality care.
Social stigma, however, is only one obstacle to getting adequate care. The authors of 7 challenges to providing behavioral and mental health services (2017) challenges identify seven structurally and capaciously. The challenges include lack of knowledge, stigma, lack of specialists with education, access to assistance, the inability to use the latest developments in help, and financial problems. Legal difficulties are often added to economic issues since it is complicated in the legal field to resolve the patient’s adequacy and ability to make decisions and own and dispose of the property.
The mental health of doctors is also under threat and stigma. It was especially clearly shown by the situation with COVID-19 in the Greenberg et al. (2020) studies. Under the pressure of circumstances and constant work, doctors can feel guilt, exacerbated by many victims. This guilt becomes the foundation of the desire to commit suicide. The authors recorded the inability to speak out about their problems and the high fear of doctors being removed from their work in the medical community.
When working with such patients, doctors need to think about the prospects because such people will have to integrate into society in the future. The problem of stigmatization in society can be solved by showing respect for the patient and not considering him as the object of action, that is, treatment. Jørgensen and Rendtorff (2017) point out that it would be good to work with doctors as a team to achieve equality and care for patients. It should be immediately noted here that the participation of complex patients (for example, schizophrenia and paranoia) in treatment is very controversial. Further research should better define the position of critically ill patients.
Besides, to solve other problems, experts suggest reducing the effect of pharmacotherapy. It is necessary to try to rid the medical prescribing system and patients from drug addiction. Pharmacotherapy should be correctly combined with psychotherapy, work with a doctor. These aspects are also aimed at successfully integrating the patient into society and reducing the number of suicides. Complex therapy with increased attention from doctors will improve the quality of life. Kilbourne et al. (2018), like the previous authors, among other things, noticed the involvement of patients in their treatment. It is especially suitable for dealing with depressed or anxious patients.
In addition to depressed and anxious patients, such methods can help people under stress. Veterans’ associations and people with PTSD are trying to help themselves. Usually, such people are interested in finding a therapy, clinic, or individual doctor for themselves. Wilson et al. (2017) note this and add that it is not possible to give up a lot of drugs when it comes to addictions. Unfortunately, drug and alcohol addictions currently require serious medications support. This study also reveals the most important fact: people eager to help themselves are happy to use telemedicine services. A lot of sociological studies and others based on surveys deal with the convenience of this type of assistance. Telemedicine services can help reduce costs, and some states provide coverage for telemedicine services.
Specialists offer to master information technologies to provide psychotherapeutic assistance. People with disabilities, people living in rural areas are happy to take advantage of this opportunity, as Hoefl et al. (2017) research shows. Moreover, telemedicine helps to hide the lack of specialists and facilitate the distribution of tasks for doctors. Sometimes telemedicine services can be afforded by people with low incomes who cannot meet with psychotherapists one or more times a week. Telemedicine is associated with the possible study of the literature on their disease problems, allowing some patients to understand better what is happening with their bodies. Unfortunately, telemedicine has its limitations, which many specialists notice. The COVID-19 pandemic has opened up many opportunities for telemedicine and, for example, depressed patients. It is constructive for depressive episodes in healthy people stressed by moving, hard work, difficult marital status, or problems in their personal life. Telemedicine is not suitable for people with dementia, drug or alcohol addiction.
The sources reviewed vividly describe the accessibility of mental health care and barriers to services. Among the problems, a special place is occupied by social stigma, which puts pressure on both sick people and healthy people who have experienced stress. They are forced to lie and hide but not talk about their problems at work or personal life. Some people are physically unable to reach the mental health centers or do not have the right specialists where they live. Teamwork with people and attempts to involve them in treatment is recommended for improving patients’ social status and position. People can solve other income and location problems by using services remotely.
Discussion
Study literature structures the knowledge gained on a chosen topic. Some of the sources, such as 7 challenges to providing behavioral and mental health services (2017), have a spacious and straightforward structure that is easy to navigate. However, identifying structures in such a problem is fraught with narrowing the topic since many of the obstacles are related to each other. For example, people with low incomes and living in rural areas are often the same patients (Understanding Mental Health as a Public Health Issue, 2021). Based on the literature studied, the ideal option for such people would be to use remote capabilities (Wilson et al., 2017). Conversations with a psychotherapist via a smartphone or laptop, with a good and fast Internet connection, would help patients with PTSD, anxiety, or depression (Hoeft et al., 2017). But such conversations would be of little help to people with addiction, paranoia, mania, or schizophrenia. A significant proportion of patients can indeed be satisfied by offering telemedicine services. The question remains open when doctors talk about very different patients.
Unfortunately, patients receiving distance treatment have no guarantees that they will not acquire stigma. From this, investigators can conclude that it is impossible to finally structure the aspects of obstacles for patients, but specialists can separate them. Social, cultural, economic, physical (territorial) – these are aspects into which the number of possible obstacles can be divided. Social aspects are usually addressed through teamwork; there are weaknesses in many studies here, as researchers postulate difficulties in fulfilling this mission and creating a team atmosphere (Kilbourne et al., 2018). Specialists and doctors can eliminate cultural aspects through total awareness and the educational work of psychologists (Knaak et al., 2017). Society needs training to eliminate prejudices against people with mental disorders (Jørgensen & Rendtorff, 2017). The economic part is primarily tied to health insurance, which usually does not cover the costs of psychotherapy, antidepressants, antipsychotics, and other drugs; psychotherapists are also generally very expensive (Hoeft et al., 2017). The territorial aspect and the economic one are usually solved with the help of remote assistance.
A special place in this topic is occupied by stigmatization in the health care system, and not only in society as a whole; this stigma affects doctors and patients alike. This stigma undermines trust in the health care system and instills in people’s minds the idea of ​​helplessness, defenselessness (Greenberg et al., 2020). The COVID-19 pandemic has become a severe test for the health care system; a lot of doctors faced condemnation and mistrust. They said in studies that they felt ashamed and guilty about not being able to help a large number of people during the pandemic (Greenberg et al., 2020). It is a specific problem for which universal knowledge and sources will not be suitable. Perhaps, it is necessary to highlight unique literature and consider exceptional cases for its consideration in the future (Greenberg et al., 2020). Healthcare professionals’ clinical environment and community is a unique environment in which stigma is also successfully perpetuated. The managers are too busy to help their charges, the younger doctors. An indifferent environment aggravates the position of specialists; in some of them, it encourages suicidal thoughts.
Social stigma and health care inaccessibility is a public health issue. Studies have shown that social stigma ultimately affects everyone: doctors, patients, friends, and relatives (Understanding Mental Health as a Public Health Issue, 2021). Even people who have not experienced mental illness (perhaps these diseases have not been diagnosed by one of their friends or relatives) suffer from stigma (National Council for Mental Wellbeing, 2018). A massive social construct of prejudice and condemnation towards mentally ill people is born in their heads. Subsequently, such people do not dare go to a psychologist or doctor themselves but begin to use alcohol or psychoactive substances.
Conclusion
The mental health of a modern person affects all aspects of society. On the outside, a healthy and civilized society can be sick on the inside, which is very evident in mental health. Until a community develops a good attitude towards mental disorders, people will suffer from prejudice and stigmatization. Lies and withholdings, censorship, and self-censorship increase alcoholism and drug addiction, and many people develop suicidal thoughts. Experts recognize lack of awareness and social stigmatization as one of the most critical obstacles to obtaining psychological assistance.
Society should change aspects of health insurance, telemedicine should be made available, and the prices of some of the drugs should be slightly lower. Mental health and its importance must be on par with physical health. Much research has focused specifically on the convergence of mental and physical health areas. People should not be ashamed to talk about visiting a therapist if they are not ashamed to say that they attend a massage for low back pain. Then it will be easier in society to prevent collapses and not investigate their consequences. There will be fewer crimes, addictions, suicides, destructive sects, and organizations. It is necessary to develop an educational program that will allow people to avoid ignorance. The medical environment must be the most flexible to provide various services to patients.
Annotated Bibliography
7 challenges to providing behavioral and mental health services. (2017). Children’s Hospital Association. Web.
The article briefly and succinctly, in the form of a list, introduces the main challenges people face in getting psychological help. In almost each of the seven lines of the list, there is a question, how can one or another situation be corrected (high fees, problems with insurance, etc.). Despite the clear pediatric orientation, investigators can apply the list in general to the problems of people of any age trying to get psychiatric help.
Greenberg, N., Docherty, M., Gnanapragasam, S., & Wessely, S. (2020). Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ. Web.
It is a unique article dedicated to the psychological problems of doctors amid the COVID-19 pandemic. The authors conducted a study on doctors’ psychological state and emotions and found that most of them suffer from feelings of guilt and shame, and some even think about suicide. The article raises the vital issue of indifference in the medical environment and lack of compassion, due to which mental disorders develop against the background of stress.
Hoeft, T. J., Fortney, J. C., Patel, V., & Unützer, J. (2017). Task-sharing approaches to improve mental health care in rural and other Low-Resource settings: A systematic review. The Journal of Rural Health, 34(1), 48–62. Web.
Many people need psychological help in rural areas but have no idea where they can get it. The authors of this article aim to find a convenient solution to the problem of receiving psychological help for people who live in rural areas. The paper develops the topic of the benefits of telemedicine and describes in which situations it would be best suited: depression, anxiety disorders.
Jørgensen, K., & Rendtorff, J. D. (2017). Patient participation in mental health care – perspectives of healthcare professionals: An integrative review. Scandinavian Journal of Caring Sciences, 32(2), 490–501. Web.
The article’s authors promote the idea of cooperation with the patient during his rehabilitation. The study has limitations and caveats that the authors hope to address in the future. The limit is that some patients with mental disorders cannot be physically involved in their treatment; some of the most dangerous diseases deprive patients of their identity.
Kilbourne, A. M., Beck, K., Spaeth-Rublee, B., Ramanuj, P., O’Brien, R. W., Tomoyasu, N., & Pincus, H. A. (2018). Measuring and improving the quality of mental health care: A global perspective. World Psychiatry, 17(1), 30–38. Web.
The authors of this article mainly concentrate on the bureaucratic aspects of the work of psychiatrists and doctors in general. They note an essential detail that doctors must align the physical and mental health records. The article contains the idea of convergence of physical and psychological health in recognizing the same importance.
Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare. Healthcare Management Forum, 30(2), 111–116. Web.
Another noteworthy and unique article talks about patients’ negative experiences who have experienced social stigma in clinics. These stories show awareness of mental disorders even among healthcare professionals. Former patients told the authors that the doctors did not take them seriously, did not want to communicate with them, and convinced them that the disease was incurable.
National Council for Mental Wellbeing. (2018). New study reveals lack of access as root cause for mental health crisis in America. National Council. Web.
This article is for public information and is not scientific or medical. The report contains statistics that show how often ordinary citizens seek help from psychiatrists and how often this help is not available to them. The article is easy to read as it is well structured.
Understanding mental health as a public health issue. (2021). Tulane University. Web.
It is a colorful and easy-to-understand article for students and young professionals to read. It is well structured and highlights aspects to look out for when improving your health care system. The authors postulate the importance of mental health as the foundation of a fair, prosperous society.
Wilson, F. A., Rampa, S., Trout, K. E., & Stimpson, J. P. (2017). Telehealth delivery of mental health services: An analysis of private insurance claims data in the United States. Psychiatric Services, 68(12), 1303–1306. Web.
The article’s authors pay attention to insurance and prices for psychological assistance services. They designate the layers most in need of help that could use telemedicine and not waste time and money on visiting doctors in person. Paying for telemedicine services is a complicated issue not resolved in all states; in some states, insurance covers part of the amount billed for the services of a doctor.