Background and problem
Over the past half a century, specialists in the field of prevention and primary care comprising of the U.S. preventive service Task Force (USPSTF) have come up with some proposals intended to boost the health status for children and pregnant women. Over the same period, research has emerged regarding the health requirements for the many individuals who are suffering from mental health problems. The USPSTF recommendations do not capture the health requirement for the individuals with mental health problems. Camden has in the past several years experienced the problems of increasing mental and illness among its population. According to the World Health Organization (WHO) report of 2010, the rate of mental health and illness has been in the rise in Camden area. Drugs use, low level of income and homelessness are among the major causes of mental health problems ( Reavley, et al., 2010) . Majority of the people live in desperation and stress, with others embarking on too much alcohol consumption, smoking and use of other drugs to enable them get over the desperation moments. Some population is mentally ill, resorting to live in streets and become unproductive to the society. Families and individuals who are experiencing mental health problems are unable to cope with stress, making them unproductive and therefore cannot contribute to building and development of the society. Unable to take part in any active development of the community, this group of individuals can become a burden to the society because they will rely on the productive population for them to survive. This can stagnate the growth and development of the community because every individual’s contribution is necessary in building a stable and well developed community. As a result of this, the wellbeing of this population needs to be taken care of so that the community to enable them get out of their mental health issues and live a healthy life like other people. There has been growing bodies of research to identify the causes of death among children, but not much has been done to concerning the need to care for the wellbeing of the individuals with mental health problems. As a result of this gap, I have come up with the program “working together for the mental health” as proposal that can be implemented to help cater for the welfare of individuals with mental problem and assist them undergo rehabilitation that can change their lives towards positive living.
Background and history of “working together for the mental health”
Working together for mental health is the use of community support to promote the wellbeing of the individuals suffering from mental health problem. The origin of working together for mental health can be traced back to over fifty years. Australia was the earliest known nation to adopt the program to help solve the problem of mental health. The program was developed in 1960s to engage the community members in helping improve the lives of their fellow community members who were suffering from mental health issues ( Reavley, et al., 2010) .
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The previous literature focused the role of the village counselors who were specialists in offering the necessary advice to the affected community members to make them have mental stability. They were to provide guidance and counseling to the community and act as agents of change who were to fight for the wellbeing of the community ( Richards, et al., 2010) . They were to fight for the inequalities witnessed in the community where only the privileged high-income individuals had mental stability while the less privileged individuals had continuous depression and mental instability. While many policymakers turned away their attention from the community guidance and counseling workers, other scholars had shifted their attention to the program attracting attention from the World Health Organization concluded that working together for mental health is a better program in improving the welfare of the community members who were suffering from mental health.
Using a sense of community as a solution to improve healthcare services for homeless famili es
According to Sarason, psychological sense of community is “the perception of similarity to others and the acknowledgment of interdependence with the willingness to maintain this interdependence by giving to others what one expects from them and a feeling of being a larger part of dependable and stable structure”. McMillan and Chavis defined a sense of community as a feeling that members have a belongingness and matter to each other and that members needs will be met through a commitment to one another. McMillan and Chavis discussed the various sense of community which can help solve this problem. The various sense of community is as discussed below.
Membership
Membership is the sense of emotions that one has invested part of oneself in becoming a member and therefore has the right to belong ( Limber, 2011 ). As a result, members would feel being part of the community and develop a feeling that they should help. Membership has four elements which can be used in solving the community problem.
Boundaries: Membership has boundaries. In a community, there is a feeling of those who belong and those who do not belong to the community. This sense of belongingness creates emotional safety and creates an intimacy within an individual to develop own community. As a result of the feeling of affection towards own community member, individuals will be willing to take part in the program meant to improve the wellbeing of the population with mental health problems. They will be willing to provide counselling and advice to the affected individuals on how to recover from the situation and live a healthy life. Without the feeling of belongingness and intimacy towards one’s community members, members will be unwilling to offer any emotional support and assistance to the people with mental illness.
Emotional safety: It is a broader feeling of security established by the membership to provide and protect group intimacy. According to Limber (2011 ), when members know who is in the society and why it creates trust and openness and one develops a heart to help improve own community and its members.
A sense of belongingness and identification: It involves the feelings, beliefs, and expectations that an individual fits in the community. This creates the feeling that one is part of the community and thus has a responsibility to play. This feeling will make people willing to take part in helping those with mental health problems improve their health situations through guidance and counselling as well as emotional and financial support. It makes people feel as being part of the community and therefore the need to develop their community by helping the less privileged.
Personal investment: It is an essential contributor to a person’s feeling within the community. According to McMillan, working for the community makes one feel of having earned a space in the community, and as a result of personal involvement, a community will be more valuable. This feeling will make one willing to participate in community healthcare services to improve the health of the individuals with mental health problems. Members will be willing to take part in helping these individuals get recover from stress and desperation that results from mental health problems, making that person feel a stronger bond of being a member of the community.
A common symbol system: The symbol creates a distance between members and non-members. It is what the members of the community identify with as belonging to a given community. Once the identity and share of a universal symbol, one will be able to develop the feeling of care and the need to help the members of their community who are suffering from mental health.
Influence
It involves building trust among community members. Once trust is built, people will be willing to participate in helping the community grow. As a result, people will be ready to take part in the programs meant to improve the welfare of the people suffering from mental problems.
Integration and fulfillment of needs
There is need to have value and create a connection with members of the society as asserted by Finnbogadóttir, Dykes and Wann-Hansson (2016) . By seeing value in the community, the members will be willing to participate in solving various community problems to improve the lives of others. They will be willing to participate in helping improve the wellbeing of the individuals with mental health issues.
Shared emotional connections
A stronger emotional bond created between the members of the community is the driving force towards helping the need to assist individual members of the community. Having a strong emotional attachment to community members creates the drive to help those in needs in the society. People will be willing to participate in helping people with mental problems have live a positive life. The members of this community have shared emotions and connections which is the unifying point for building the community.
The role of diversity
Camden community has a large population of individuals who share many beliefs and values. They all speak a similar language and share the norms and values. Majority of the community members have relatively low income with an average living standard. The community consists of mainly Christians, although there are few Muslims. The share of common faith helps in creating the feeling of love towards each other. The intimacy within community members leads to one’s willingness to help the individuals with mental health problems improve their life and live positively. The community mainly inter-marry, creating more unity and identity by every member of the community.
The proposed program
The proposed program is working together for mental health. The program aims at involving all the community members in the solution to the problem of mental health in many individual members of the community. The goal is to promote good health and prevent mental health problems and addictions through the universal health promotion activities in the community. The society will be involved in the various activities including combating discrimination and social exclusion through campaigns for anti-stigma among the community members. It also aims at educating the community on the awareness of mental health problems. The program will also ensure the individuals with mental health are able to afford housing, food and better living conditions. In addition, it will address the issues of stigma at workplace by implementing a policy that promotes inclusion and tolerance of all the society members. The program will target the vulnerable groups such as people in prisons, people struggling with drug addict as well as survivors of child abuse and domestic violence. The community will be mobilized and educated on the need to offer guidance and counselling to such affected individuals. They will also be trained on how to offer emotional and social support to the affected community members to enable them live a positive life free from stress and past trauma.
Evaluation models and empowerment evaluation principles
Various methods will be used to evaluate the implementation of the program and measure the achievements. The various evaluation tools that can be used include:
Goal-attainment model: Here, the outcomes of the program will be evaluated on the short-term and long-term to measure what has been achieved. The outcomes are measured against the goals and targets set to identify if there is any deviation ( Cousins, et al., 2013). In five years period, the target is to reduce the effects of mental health in the community by 50%. People with mental health issues are unproductive thus slowing down the growth rate of the community. If there is any deviation from the planned target, appropriate measures are taken to make necessary corrections.
System evaluation: This process involves evaluating the process in the type of quality and quantity and measure the achievement. This program will be evaluated by the quality of the outcome and services provided as well as the quantity of the outcome. Quality will be based on how efficient the program assists the individuals with mental health problems and whether it has any change in their conditions. The quantity will be determined by how the lives of these people will have been improved as result of the program.
Formative evaluation: This evaluation occurs during the implementation process. It aims at providing relevant information required to achieve the goals of the program as well as improving the program. This program if adopted will use this technique to ensure the implementation team has the relevant information required to implement the program effectively.
Impact evaluation: The impact evaluation assesses the effects of the program on the intended participant ( Katula, J. A. 2011). In this program, we will assess the impact this program has on the wellbeing of the individuals with mental health problems. It will assess whether the condition of the individuals suffering from mental health problems have increased over the intended period. If the program is found to have no impact on the targeted group, the whole system will be reviewed to identify where there could be a problem.
Article 1
Tappis, H., Freeman, J., Glass, N., & Doocy, S. (2016). Effectiveness of interventions, programs and strategies for gender-based violence prevention in refugee populations: An integrative review. PLoS currents , 8 .
This article addresses the use of principles of improvement, community ownership and community knowledge in a prevention program to stop gender-based violence in the community. According to Tappis et al. (2016), community ownership is useful in making the individuals feel that the project is meant to benefit them and as a result, they will be actively involved in its implementation and success. They also believe in creating community awareness and knowledge among community members. Knowing the program to be implemented and its importance promotes the community involvement and thus their contribution towards the project.
Article 2
Finnbogadóttir, H., Dykes, A. K., & Wann-Hansson, C. (2016). Prevalence and incidence of domestic violence during pregnancy and associated risk factors: A longitudinal cohort study in the south of Sweden. BMC pregnancy and childbirth , 16 , 228-228.
This article addresses the significant organizational learning and capacity building in community prevention program to end the issue of intimate partner violence in the healthcare setting. Organizational learning has been used to facilitate knowledge sharing with other institutions in the community.
Article 3
Wilcox, S., Laken, M., Anderson, T., Bopp, M., Bryant, D., Carter, R., ... & Parrott, A. W. (2013). The health-e-AME faith-based physical activity initiative: Description and baseline findings. Health Promotion Practice , 8 (1), 69-78.
In this article, community ownership and community knowledge are used in a program to help improve the healthcare of the community. Community ownership is useful in motivating the community members to participate in the program through free contribution towards the project ( Wilcox, S. at al. 2013).
Various empowerment principles will be used to make the program successful. These principles are discussed below:
Community ownership: The program will be owned by the community members because this is their program aimed at saving the lives in the community. The community will be actively involved in the planning although to other stages. This program relies on the contributions of the community members thus their exclusion will make the project fail. They will be involved in the management of the whole program, and it will be the volunteers from the community that will be relied upon to be the community health service providers. Community participation and ownership has been proven to work in many health programs in other societies.
Accountability: The program will ensure there is accountability on the use of the resources mobilized from the community. Honesty and transparency is the foundation of any successful implementation of a program. When the funds collected are misused by those in charge, there will be no any successful implementation. The management must account for any resources given to them towards this project. The community will get motivated and willing to contribute more when they trust that their funds are used appropriately where deserved.
Democratic participation: The program will be a democratic process where one will only participate at will. No one will be forced into it, but rather those who will have seen the importance of the program will be encouraged to join. The success of any program depends on the willingness of the participants to make it a success thus democratic participation will be promoted. At the same time, every community member must be given equal opportunity to participate in the program. There should be no application of double standards in the participation where some people have seen more privilege than others. Democracy will increase the motivation of the participants to work towards the success of the program. This principle was applied in the program to prevent communicable diseases, and the results were positive.
Capacity building: Strengthening of the skills, knowledge, and abilities of the members of the community will be required. Members require the skills to enable them offer guidance and emotional support to the affected individuals improve their wellbeing and make them live a positive life away from drug addictions and desperation. Capacity building is done by training volunteers to gain some skills necessary to provide healthcare services as well as guidance and counselling knowledge. Increasing people’s skills is important in the implementation and development of the program. When skills and abilities of participants are enhanced, the overall project will be successful. This principle has been used previously, and it has always produced best results.
Community knowledge: It is important that the community have knowledge and awareness about the program to be implemented. The success of the program will how the community responds to it, and therefore making them knowledgeable will lead to successful implementation. The community needs to know the importance of the intended program, how it will be implemented and the expected change to that could result from it. The knowledge about the program will increase their participation in the implementation of the whole project. It had been previously used in the health.
Approaches to community and social change
The seven approaches that will be used to implement the program and ensure it is successful include:
Conscious rising: Conscious rising empowers the individuals to develop their solutions to the problems they face. In this program, the individuals with mental health problems can be given awareness on how to control their situations and make them come up with their own solutions to the problems they face. It can be done with the incorporation of the principle of community knowledge. The community members and the affected individuals can be given some knowledge on how to deal with mental health issues. With conscious rising, the solution to the problem using this program will become simpler.
Social action: The program will employ a wide range of primarily voluntary initiative to bring change into the community. The masses will be mobilized to assist in bringing the change required. Social action incorporates social justice as it addresses and uses the conflict present in the social system to realize the goal of social justice and empowerment. The social action applies the goals of solving mass problems, improvement in mass conditions and influencing institutions and policies to bring about the desired change in the community.
Community development : The program is aimed at benefiting the community and brings the desired change to the members of the community through improving the wellbeing of the individuals suffering from mental health issues. As a program meant to benefit them, the community must, therefore, have ownership of the program and take it as theirs. Through ownership of the program, they will be willing to participate in the whole process of implementation and in making the necessary contributions required for the program to be successful. The community needs to see the program as part of them and develop a sense of identity with the program.
Community coalitions: The program will employ community coalitions and efforts to achieve the desired change. The successful implementation of this program requires unity and teamwork with all the community members who are the driving force in the whole program. The coalition will create sense togetherness and enhance teamwork that is essential to the success of the program.
Organizational consulting: The program will accommodate a long-term active partnership among the community leaders, organizations, and institutions as well as researchers to address the issues of trust, priority, and actions. Proper consultations between these organizations must take place during the whole process of implementation. It applies the principle of organizational learning where the program implementers acquire some learning from other institutions within the community. The principle of accountability must apply in the whole process to ensure resources are used appropriately. Accountability promotes trust between the community and the program implementers. Misuse of resources by the management must be avoided by all means if the program is to be successful. It can also deter donors from issuing more funds towards the program which may result in a financial crisis.
Alternative setting: The program will be implemented by creating a new environment through continuous improvements. The community must be made to see a change as the process continues. The principle of continuous improvement at every stage is critical in assessing the progress of the whole project. As the implementation goes on in stages, some level of development should be noticed. If no changes are observed in the lives of the targeted population, a review of the whole process is necessary for appropriate corrections to be made.
Policy research and advocacy: To pursue any sustainable developments and social justice, the program implementers must be able to influence and promote supportive policy frameworks and a conducive environment for organized giving and social justice . During the implementation, the team will work towards an enabling environment for the best practices and standards such as credibility, accountability, and transparency as well as enhancing collaborations between different institutions ( Richards, et al., 2010) . This favorable policy will facilitate successfulness of the whole program in solving the community problems.
References
Cousins, J. B., Whitmore, E., & Shulha, L. (2013). Arguments for a common set of principles for collaborative inquiry in evaluation. American Journal of Evaluation , 34 (1), 7-22.
Finnbogadóttir, H., Dykes, A. K., & Wann-Hansson, C. (2016). Prevalence and incidence of domestic violence during pregnancy and associated risk factors: A longitudinal cohort study in the south of Sweden. BMC pregnancy and childbirth , 16 , 228-228.
Katula, J. A., Vitolins, M. Z., Rosenberger, E. L., Blackwell, C. S., Morgan, T. M., Lawlor, M. S., & Goff, D. C. (2011). One-year results of a community-based translation of the diabetes prevention program. Diabetes care , 34 (7), 1451-1457.
Kitchen, P., Williams, A., & Chowhan, J. (2012). Sense of community belonging and health in Canada: A regional analysis. Social Indicators Research , 107 (1), 103-126.
Limber, S. P. (2011). Development, evaluation, and future directions of the Olweus Bullying Prevention Program. Journal of school violence , 10 (1), 71-87.
Reavley, N. J., Cvetkovski, S., Jorm, A. F., & Lubman, D. I. (2010). Help-seeking for substance use, anxiety and affective disorders among young people: results from the 2007 Australian National Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry , 44 (8), 729-735.
Richards, K., Campenni, C., & Muse-Burke, J. (2010). Self-care and well-being in mental health professionals: The mediating effects of self-awareness and mindfulness. Journal of Mental Health Counseling , 32 (3), 247-264.
Talò, C., Mannarini, T., & Rochira, A. (2014). Sense of community and community participation: A meta-analytic review. Social indicators research , 117 (1), 1-28.
Tappis, H., Freeman, J., Glass, N., & Doocy, S. (2016). Effectiveness of interventions, programs and strategies for gender-based violence prevention in refugee populations: An integrative review. PLoS currents , 8 .
Wilcox, S., Laken, M., Anderson, T., Bopp, M., Bryant, D., Carter, R., ... & Parrott, A. W. (2013). The health-e-AME faith-based physical activity initiative: Description and baseline findings. Health Promotion Practice , 8 (1), 69-78.
