Welfare is the support of citizens by the government whereby it tries to ensure that the poor can also meet the minimum standards of quality life by offering subsidized services or goods. (Bullock &Stephen 1999) Those included in this support in our country include, the ill, the disabled, the poor, the aged, victims of crime, Aboriginal and Torres Straits Islanders, the mentally ill and many more. The World Health Organization defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO 1948). An individual’s health is determined by the conditions under which one lives and works; and the set of programs outlined to deal with one’s illness. This is directly proportional to the socioeconomic status and the government’s policies on health. Thus, other than economic status, housing standards and many more, Health is also therefore a component of welfare; which is a condition whereby an individual is in a state of faring on well. Mental illness is therefore a deviation from the normal wellbeing.
Mental illness is really broad and includes, but is not limited to mood disorders such as depression, anxiety and maladaptive behaviors such as substance abuse (commonly alcohol abuse) For instance, in Australia, According to Australian Institute of Health and Welfare, Mental illness contributes about 12% of the disease burden in Australia, with a 45% risk (i.e. about half of the population) of developing mental illness among aged 16-85 years (Deutsch, 2013). The risk groups include, former Australian Defense Forces members, females with eating disorders and same sex sexual partners. Members of the family are affected when one of them has mental illness and it also plays also contributes significantly to conditions like homelessness, poverty and unemployment rates (Fairweather, Sanders, Cressler, & Maynard, 2017).. Thus, the welfare service greatly impacts on the lives of the mentally ill in a bid to try raising their living standards.
The mentally ill faces a lot of stigmatization in the society and may lack capabilities to make the right choices with regard to themselves and others. Since most of the time they lack insight on their disorder, it may be difficult for them to accept the treatment choices availed to them. It is with this in mind that mental health legislation, a structure that stands for their rights and has their good at heart was established. This ensures that they are well integrated into the society and they receive quality living standards, in terms of employment, housing, studies other the management of their health status. This is all enacted by the legal framework within the country. This legislation is although not present in about 25% of countries and the other significant numbers that have it, it is not a guarantee that the rights of the mentally ill will not be trampled upon. (“Mental Health Legislation and Human Rights”, 2018)
In India, for instance, “The Rights of Persons with Disabilities Act, 2016 and Persons with Mental Illness” Mental illness was only categorized as a disability; but their needs and those of their caregivers (family members) were not addressed when this Act was being instituted. This is regardless of the fact that, family members have been known, in most cases to be the key asset in offering proper support to the mentally ill. In fact, those with a good family support normally have a good prognosis with this condition and their efforts should therefore be encouraged since the absence of family members may leave them to themselves or force them to aimlessly wander in the streets. Failure to involve them in this act is said might criminalize them if they try to be of help to their mentally sick relative who most of the time have poor judgment. At the same time, whereas the People living with disabilities have been offered protection from ill treatment, violation, desecration and being mishandled; it has not been modified to suit the mentally ill. (Narayan & John, 2017) This therefore may mean that these were considered to be sane and able to make appropriate decisions just like any other persons with Disabilities that do not impair mental capacity.
The Scotland Act (2000) was passed on by the Scottish government to ensure proper direction concerning the welfare and financial management of the mentally ill who are unable to do so. This also guides the process whereby someone can be able to make decisions who someone who is incapable of due to the illness. This is done for adults with severe mental illness, those with dementia or those with mental retardation. So, for the ones with dementia for instance, they have the ability to decide what they require in their daily life, but lack the financial management ability (Arrigo, 2012). This act also ensures that only plausible decisions can be made for the mentally ill, e.g. decisions concerning certain treatments cannot be imposed on them against their will. The mental welfare commission in this case also monitors if the interests of the mentally ill are being kept by the guardian, monitors any complaints that may arise and offers various guides concerning the patient. (“Adults with Incapacity (Scotland) Act 2000: A short guide to the Act”, 2008)
Australian Treaty National Interest Analysis (2008) Article 1 agrees with the UN convention of people with disabilities to ensure adequate protection of the rights and meeting of the needs of those with mental illness. Safeguard against abuse is also well outlined in the Mental Health Acts. (“United Nations Convention on the Rights of Persons with Disabilities”, 2006)
The mental Health and Welfare System and its related Laws in Japan adopted a plan of rehabilitating the disabled, including the mentally ill and counselling to their families in a bid to strengthening the welfare service. To ensure their adoption into the society they are offered a better place of living and working, through health and welfare services. The aim was also to demolish stigmatization to the ill by aiming to improve the society’s understanding through volunteer activities. For those who lack a proper welfare support Social Admission was done to cater for both the social and mental disabilities (Horden & Smith, 2013). People are now being discharged from hospitals into the social welfare units as a form of support for independence, by enhancing welfare workshops and homes, community living support centers. Their rehabilitation will be achieved through training of adequate numbers of Psychiatric Social Workers by enactment of Psychiatric Social Worker law. (Masafumi, Masaaki & Rizzoli, 2018)
Those who have recovered after treatment normally have the ability to work in the community and offer relevant service, however, those with severe mental illness have decreased working capacity due to increased functional limitation and may therefore earn relatively lower income. The Social Security Disability Insurance Program and the Supplemental Security Income program, therefore tries to improve income support to the low-income earners and their family (Saxena, Thornicroft, Knapp, & Whiteford, 2007). Though there have risen increased criticism as Public income support programs are being used to enhance employment insurance. However, if better policies are in place it will ensure the right people (the mentally ill) are placed in these programs and might also find ways of enabling them to work if possible (Dazinger, Frank & Meara, 2010)
References
Adults with Incapacity (Scotland) Act 2000: A short guide to the Act. (2008). Retrieved from https://www2.gov.scot/Publications/2008/03/25120154/1
Arrigo, B. A. (2012). Punishing the mentally ill: A critical analysis of law and psychiatry. SUNY Press.
Australia’s health 2018: in brief, How healthy are we? – Australian Institute of Health and Welfare. (2018). Retrieved from https://www.aihw.gov.au/reports/australias-health/australias-health-2018-in-brief/contents/how-healthy-are-we
Dazinger, S., Frank, R., & Meara, E. (2010). Mental Illness, Work, and Income Support Programs. American Journal of Psychiatry, 166(4), 398-404. Doi: [10.1176/appi.ajp.2008.08020297]
Deutsch, A. (2013). The mentally ill in America-A History of their care and treatment from colonial times. Read Books Ltd.
Fairweather, G. W., Sanders, D. H., Cressler, D. L., & Maynard, H. (2017). Community life for the mentally ill: An alternative to institutional care. Routledge.
Horden, P., & Smith, R. (2013). The locus of care: Families, communities, institutions, and the provision of welfare since antiquity. Routledge.
Masafumi, M., Masaaki, M., & Rizzoli, A. (2018). The mental health and welfare system and its related laws in Japan [inglese] | www.psychiatryonline.it. Retrieved from https://www.psychiatryonline.it/node/4200
Mental Health Legislation and Human Rights. (2018). Retrieved from https://www.who.int/mental_health/policy/services/7_legislation%20HR_WEB_07.pdf pg. 18
Narayan, C., & John, T. (2017). The rights of persons with disabilities act, 2016: Does it address the needs of the persons with mental illness and their families. Indian Journal of Psychiatry, 59(1), 17. Doi: 10.4103/psychiatry.indianjpsychiatry_75_17
Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007). Resources for mental health: scarcity, inequity, and inefficiency. The lancet, 370(9590), 878-889.
The New Fontana Dictionary of Modern Thought Third Edition (1999), Allan Bullock and Stephen Trombley Eds., p. 919. Retrieved from https://www.harpercollins.co.uk/9780006863830/the-new-fontana-dictionary-of-modern-thought/
United Nations Convention on the Rights of Persons with Disabilities. (2006). Retrieved from https://www.un.org/disabilities/documents/convention/convoptprot-e.pdf
WHO (World Health Organization) (1948). Preamble to the Constitution of the World Health Organization. Geneva: Retrieved from https://whqlibdoc.who.int/hist/official_records/constitution.pdf
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