Question

Write about the following

1. Because clients have rights, healthcare professionals have responsibilities to tell the truth, respect confidentiality, function as an advocate, and accept accountability for providing proper health care. How do these attributes impact community mental health professionals ?

2. How are the methods to measure accountability in community mental health defined?

3. Is the right to health care a basic human right?

4. Explain how the negative right to be free to enjoy good health led to the positive right to obtain certain services or community mental health safeguards.

5. Explain the differences and similarities in the terms "Right to health" and "Right to healthcare."

6. Does "Society have an ethical obligation to ensure equitable access to health care for all?

Answer 1

Mental health heavily influences our quality of life. So it makes sense that mental health, just like physical health, needs to be taken care of and maintained. And one way that it can be maintained is through finding a sense of community. Community mental health professionals are in a larger aspect are impacted by rights of clients, responsiblities of professionals , respecting confidentiality, functioning as an advocate and accepting accountability.Clinics that offer outreach services may be more integrated in their communities, leading clients to feel more connected to the clinic’s services and resulting in fewer missed appointments. Outreach staff may themselves have close community ties and thus help reduce the stigma often associated with mental health treatment among clients from minority groups by serving as a familiar, more accessible face for the clinic. In addition, outreach staff may conduct reminder calls and reschedule appointments. First, community mental health care encompasses: a) a population approach, b) viewing patients in a socio‐economic context, c) individual as well as population‐based prevention, d) a systemic view of service provision, e) open access to services, f) team‐based services, g) a long‐term, longitudinal, life‐course perspective, and h) cost‐effectiveness in population terms10. It also includes a commitment to social justice by addressing the needs of traditionally underserved populations, such as ethnic minorities, homeless persons, children and adolescents, and immigrants, and to provision of services where those in need are located and in a fashion that is acceptable as well as accessible.Second, community mental health care focuses not only upon people's deficits and disabilities (an illness perspective), but also upon their strengths, capacities and aspirations (a recovery perspective). Services and supports thus aim to enhance a person's ability to develop a positive identity, to frame the illness experience, to self‐manage the illness, and to pursue personally valued social roles.Third, community mental health care includes the community in a broadly defined sense. As a corollary of the second point, it emphasizes not just the reduction or management of environmental adversity, but also the strengths of the families, social networks, communities and organizations that surround people who experience mental illnesses.Fourth, community mental health care melds evidence‐based medicine and practical ethics. A scientific approach to services prioritizes using the best available data on the effectiveness of interventions. At the same time, people who experience mental illnesses have the right to understand their illnesses (to the extent that professionals understand them), to consider the available options for interventions and whatever information is available on their effectiveness and side effects, and to have their preferences included in a process of shared decision making.Thus, we define community mental health care as comprising the principles and practices needed to promote mental health for a local population by: a) addressing population needs in ways that are accessible and acceptable; b) building on the goals and strengths of people who experience mental illnesses; c) promoting a wide network of supports, services and resources of adequate capacity; and d) emphasizing services that are both evidence‐based and recovery‐oriented.

Indicated a range from minimal to substantial progress toward mental health reform across the country; most regions have released a formal implementation plan for system reform; these plans did not always include specific objectives for change, nor did they necessarily identify strategies for monitoring progress toward reform objectives;  many jurisdictions have declared an intent to improve accountability within the mental health sector yet few have a concrete plan to achieve this; the extent of actual performance monitoring activity within the mental health sector varies widely among provinces and territories as does the degree of reporting to stakeholders; no jurisdiction currently releases formal regular reports on mental health sector performance to stakeholders; in some cases, a small number of mental health indicators are reported in the context of ministry or government wide report on health service performance.Èlemets of mental health accountiblity framework are:Performance domains, indicators and measures 2) Agreements between the MOHLTC and transfer payment agencies 3) Operating manual for mental health and addiction agencies 4) Hospital accountability mechanisms (i) “Report Cards” (ii) Business Planning Briefs (iii) Resident Assessment Instrument – Mental Health (iv) Management Information System (v) Legislated Accountability Mechanisms.

Yes. Indeed it is our right.The WHO Constitution (1946) envisages “…the highest attainable standard of health as a fundamental right of every human being.” Understanding health as a human right creates a legal obligation on states to ensure access to timely, acceptable, and affordable health care of appropriate quality as well as to providing for the underlying determinants of health, such as safe and potable water, sanitation, food, housing, health-related information and education, and gender equality. A States’ obligation to support the right to health – including through the allocation of “maximum available resources” to progressively realise this goal - is reviewed through various international human rights mechanisms, such as the Universal Periodic Review, or the Committee on Economic, Social and Cultural Rights. In many cases, the right to health has been adopted into domestic law or Constitutional law .A rights-based approach to health requires that health policy and programmes must prioritize the needs of those furthest behind first towards greater equity, a principle that has been echoed in the recently adopted 2030 Agenda for Sustainable Development and Universal Health Coverage. The right to health must be enjoyed without discrimination on the grounds of race, age, ethnicity or any other status. Non-discrimination and equality requires states to take steps to redress any discriminatory law, practice or policy. Another feature of rights-based approaches is meaningful participation. Participation means ensuring that national stakeholders – including non-state actors such as non-governmental organizations – are meaningfully involved in all phases of programming: assessment, analysis, planning, implementation, monitoring and evaluation.

Mental health is an integral and essential component of health. The WHO constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.Mental health is fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.Universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts 'negative' rights as legitimate rights. Negative rights, the argument goes, place no obligations on you to provide goods to other people and thus respect your right to keep the fruits of your labour. A classic enumeration of negative rights includes life, liberty, and the pursuit of happiness. Positive rights, by contrast, obligate you either to provide goods to others, or pay taxes that are used for redistributive purposes. Health care falls into the category of positive rights since its provision by the government requires taxation and therefore redistribution. Therefore, the libertarian or individualist might argue that health care cannot be a true right. In fact, the protection of both positive and negative rights can place obligations on others. Furthermore, because of its role in helping protect equality of opportunity, health care can be tied to the rights to life, liberty, and the pursuit of happiness. There is, therefore, good reason to believe that health care is a human right and that universal access should be guaranteed.

Health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity. The realization of the right to health may be pursued through numerous, complementary approaches, such as the formulation of health policies, or the implementation of health programmes developed by the World Health Organisation (WHO), or the adoption of specific legal instruments. Moreover, the right to health includes certain components which are legally enforceable.

In the human rights discourse and practice the right to health has been and continues to be a contentious arena. Primarily located within legal frameworks that focus on civil and political rights, the right to health is more frequently being used to challenge abuses of health by invoking social and economic rights, even though this places the right to health on slippery terrain that is not as internationally accepted as civil and political rights. Likewise, access to healthcare is often incorrectly cast as synonymous with the right to health. However, while this remains true in some ways (particularly when it comes to social and economic inequities in healthcare access) the right to healthcare should not be viewed as categorically the same. In practice, the right to health is often favored, as the right to health care is seen as too narrow in focus. At the same time, the right to health is also seen as too demanding, because for some it implies a right to be perpetually healthy, which is an impossible standard. In turn, the right to health care is too narrow to include important factors like safe environmental conditions or adequate sanitation. Thus, the right to health is an umbrella term that implies a variety of practical requirements.A right to health is one of a range of socio-economic rights for which many states have accepted an obligation under international law. However, in practice socio-economic rights are rarely given the same status as civil and political rights. This article discusses the rationale for rejecting socio-economic rights and examines the basic rights challenge to such neoliberal arguments. The article concludes with an examination of the potential for promoting a right to health in a globalizing world.: Inequity and Madness addresses the two most important notions concerning the rights of people with mental illness: first, that human rights and duties are complementary and that both must be considered in constructing a framework for mental health care. Second is that we must strive for equity in developing mental health programs.Modern human rights, born in the aftermath of the second world war and crystallized in the Universal Declaration of Human Rights in 1948, reflect a broader, societal, approach to the complex problem of well-being. While health is mentioned only once in the document, human rights are about the societal preconditions for physical, mental and social well-being. Health care professionals are generally unaware of the key concepts, meaning and content of modern human rights. But they are learning that promoting and protecting human rights may be essential for promoting and protecting health. Health and Human Rights: A Reader, including contributions by doctors, lawyers and government representatives, is the first comprehensive anthology of essays in this new field to address the balance between public health and human rights awareness. The essays in this collection cover issues including ethnic cleansing, world population policies, women's reproductive choices, the Nuremburg Code and AIDS and HIV policies and treatments. It is an essential introduction to the developing field of health and human rights.

Most developed societies recognise the existence of a basic right of access to health care of appropriate quality, considering it a positive welfare right. It can even be one of the most important achievements of pluralistic and secular societies. The basic right of access to health care of appropriate quality is a fundamental humanitarian principle that should be enjoyed by all citizens of all countries, and the international community should recognise the obligation to promote these ideals by any means available. Indeed, although social rights such as health care demand citizens’ solidarity to be enjoyed, only with the universalisation of social rights will humanity be more equal in the future.The right to health care access is crucial to the pursuit of an effective equality of opportunities in a free and inclusive society. Diseases, deficiencies and disabilities, by restricting the opportunities that otherwise would be within the reach of the individual, should be regarded as unfair situations and not just the result of random forces of nature. That is, all citizens should have the necessary resources for an acceptable physical and psychological performance, thus being enabled to access a reasonable and appropriate range of social goods.Health care access might be considered as a right of individuals and communities that should be implemented by the joint responsibility of citizens and society. Each state should promote and ensure access for all citizens to health care within the limits of the human, technical and financial resources (Abel-Smith 1994). However, health care necessarily has to compete with other social goods, so the only logical and consistent conclusion is that if we want a health system that effectively guarantees the access of all people, the resources should be used in treatments with proven effectiveness and with the least possible waste. That is, the implementation of a universal right to health care access should be based on a set of structuring principles:Equal opportunity,Solidarity,Evidence-based practice.