Paper
Friday, July 15, 2005
Utilization of a Critical Social Thinking Perspective in an Analysis of Mental Health Service Access
Anne L. Bateman, EdD, PMHAPRN, BC, Graduate School of Nursing, University of Massachusetts Worcester, Worcester, MA, USA
| Learning Objective #1: Identify two barriers to service access following a mental health crisis |
| Learning Objective #2: Describe the primary system-related variables that negatively impact mental health service access |
For mental heath services, reform has been 'a work in progress' since the 60's and the early days of deinstitutionalization that legislated a shift in locus of care from institution to community. This movement also precipitated organizational restructuring and a process of never ending budgetary reallocation that has been continued with managed care. Out patient providers have been forced to serve a population with higher acuity levels that require greater amounts of non-reimbursable collateral time. In addition, a greater number of individuals are seeking mental health services for a variety of psychosocial concerns, including the stresses associated with changing family life, employer downsizing and broad brushed reduction in social services and welfare benefits. The reduction in social supports has contributed to deterioration in the individual's coping ability, resulting in an overall increase in service demand in an environment of diminishing resources. When considering the factors that impact access to any segment of the health care delivery system, a critical social thinking perspective was instrumental to accurate assessment of the associated variables. A critical social reconceptualization of the environment involves uncovering and critiquing the oppressive social structures that constrain individual health, limit life possibilities, and restrict equal and fully conscious participation in society (Stevens, 1989). Research and analysis within the realm of critical social theory (CST) helps promote conscientization among persons who are impeded by oppressive constraints. This process brings about conditions in which oppressive elements are illuminated and a dialogue about action for change can occur. This presentation provides information about service access for individuals following a mental health crisis.