Health promation Essay Example

Schizophrenia among the Chinese immigrants

Schizophrenia

Health Issue

The Chinese immigrants are often at rather high risks of experiencing depression as well as schizophrenia. This is primary as a result of the issues which are about trying to be integrated into the Australian society (Klimidis, Hsiao & Minas, 2007). Schizophrenia is a mental disorder which is usually associated with some significant and devastating costs both to the societies as well as the patients (Klimidis, Hsiao & Minas, 2007). Australia consists of about 168,685 total immigrants and out of this number; about 30,000 of them are from Chinese alone each and every year (Saha Et Al., 2005). As by the census that undertaken in 2011, Sydney was considered as the major home to about half of the Chinese Australians who are there by immigration (Saha Et Al., 2005). These immigrants make up about 4% of the entire Australian population as well. Out of the 30,000 Chinese immigrants in Australia on a yearly basis, approximately 13,000 of them have had symptoms of schizophrenia which is about a half of this population on an annual basis (Bradley Et Al., 2006). Some of the major causes of schizophrenia include the feelings of victimization, social defeat, as well as discrimination among other causes. Schizophrenia among the Chinese immigrants presents them with significant risks of some lifelong social adversities which consequently leads to the decrease in the life expectancy levels to between 10-25 years (Wong, Lam & Poon, 2010).

Among the social determinants of schizophrenia include social support, social integration, as well as social position. About 14% of the Chinese immigrants with schizophrenia acknowledged that they lack the required social support which has in turn affected their social networks (Lam, Jorm & Wong, 2010). According to studies, the lack of adequate support to the Chinese immigrants leads impacts their styles of coping which may in turn impact their styles of coping in the new environment and ultimately result in mental depression (Mellor Et Al., 2013). Regarding social inclusion, it is rather weak which means that the Chinese immigrants undergo some social challenges that may result them to having high risk levels of being exposed to schizophrenia (Choi Et Al., 2012). They will tend to feel discrimination which then hinders their ability to be integrated in the new Australian community. About their social position, the Chinese immigrants are sometimes treated differently because of their ethnicity, background, socioeconomic status, among other reasons. These social positions are major determinants of the mental health of this group because of the stress that is linked to it therefore high risks of schizophrenia (Hsiao Et Al., 2006).

Regarding the PHC priorities, the health issue is concerned with the management of the condition. The management of the condition is the best which can be done because the Chinese immigrants may already have been subjected to these levels of social stress even before they get into Australia. Therefore, preventing it may not be effective as it should be. On the other hand, although screening is important, there should be efforts of assisting them even after screening so that schizophrenia may be tackled in a holistic manner. Additionally, according to the Australian Health Promotion Association (AHPA), the aim of Australia is to advance the health of every person in Australia regardless of the background through supporting the practice of health promotion, effective leadership and overseeing health equity (James Et Al., 2007).

Project Description

Following that the increased risks and levels of schizophrenia are primarily determined by social factors, the project will focus on handling it from a social approach through a program known as the Assertive Community Treatment (ACT). This is a project which will entail some domiciliary visits, community outreach, active case management, high frequency contacts, as well as a 24/hour availability to be able to address any crisis support (Macleod, Elliott & Brown, 2011). ACT has been utilized in several occasions more so within the context of the interventions of service level channeled towards the management of schizophrenia. The ACT has proven to enhance the contact with the necessary mental services, tends to reduce the number of hospital admission and bed usage following schizophrenia, and increases the victims’ satisfaction with themselves and the community in which they are a part of (Wiley-Exley, 2007).

Strong evidence on the effectiveness of ACT in managing levels of schizophrenia has depicted that when the schizophrenia victims are subjected to ACT, they have close contacts with the mental health services when need be and usually live independently as well as remain in employment for longer periods (Ito, Setoya & Suzuki, 2012). Additional evidence has also depicted that ACT usually enhances the quality of life of these individuals.

In dealing with schizophrenia, many of these Chinese immigrants have always been subjected to the standard community care with the aim of enhancing their social integration, inclusion, and position in the new community that they are a part of. However, the standard community care and treatment usually fails to take into account the medical aspect of the condition which entails giving these victims some pharmaceutical products to strengthen their mental abilities and capacities (Lucksted Et Al., 2012). Additionally, in these standard community care programs, the schizophrenia victims are not empowered always to access the mental services whenever they feel some levels of discrimination or any form of mental disorder (Lucksted Et Al., 2012). The follow-up programs are also not quite effective. This is then what makes ACT program effective when managing schizophrenia among the Chinese immigrants to Australia.

High levels of schizophrenia have resulted in the Chinese migrants to be homeless because of the social depression and discrimination that they often undergo. In this case, the ACT program is usually associated with some long periods of follow-ups of between two to five years (Smith Et Al., 2009). This has then been linked to reduced levels of homelessness as well as few days of visiting the hospitals. Additionally, these victims usually tend to have enhanced service engagement, strong symptomatic remission, as well as high levels of adhering to medical treatment when compared to when they are subjected to the standard community care treatment (James Et Al., 2007). Therefore, in a nutshell, what makes the ACT program unique from the common community standard care treatment of this group of people is that it combines social treatment and medical treatment which proves to be more effective as compared to just being subjected to the social treatment.

Objectives

Regarding this project, there are various objectives which are intended to assist the Chinese immigrants manage schizophrenia. They include;

• Improve the quality of life of the Chinese immigrants through reducing by about 7% the number of them who lose their employment because of incompetence following their mental issues.

• Increase the number of Chinese immigrants by about 10% who engage in the various community programs.

• Reduce by about 9% the number of Chinese immigrants who are homeless because they are unable to address their mental issues hence cannot be productive in the society.

• Reduce by 11% the number of hospital visits following schizophrenia condition.

Strategies

The schizophrenia victims who will be in their first episode of the mental condition will be subjected to an early treatment which will be in the context of a particular specialist. It will entail early care and intervention model. In this particular strategy, it will be multidisciplinary which will precisely entail;

• Educational and vocational interventions

• Family interventions and involvement if possible

• Assertive and/or engagement approaches

• Access to the psychologically interventions as well as informed care

The second strategy will be to oversee community intervention with the schizophrenia victims. This will be considered to be a priority especially in those victims who have some persistent schizophrenia victims or those who are at high relapse risks. Precisely, there will be about ten sessions which will be over a period of three months for this to considered an efficient dose. The community intervention will specifically entail;

• Psycho-education

• Problem-solving

• Communication skills

Budget Estimate

Staff Salaries-the staff will include the medical professionals who will be engaged in the community hospitals, allowances to the members of the community groups, AHPA workforce, and other individuals who will have an input in the ACT project.	The rate will depend on the level of expertise and contribution to the program. 10 Doctors ($50) per day 3 Community groups each with 7 members ($15) per group member per day AHPA workforce who will be 15 ($20) as an allowance per day Project Manager $60 per day Other people involved in the project for different purposes like giving directions etc. $5 each	$150,000 Approximately $8,000
Resources-Resources will include things like maps, stationery, research equipment, among other resources that may be required in any stage of the project		Approximately $27,000
Administration costs
	50c/ kilometer
Evaluation
		$544,500

Timeline Estimate

Strategy	Timeline
Selection of Staff and Community Members	1 Month starting September 2017
Selection of Hospitals
Seeking Partnerships
Educational and vocational interventions
Family interventions and involvement if possible
Assertive and/or engagement approaches
Community Interventions
Evaluation	2 months ending September 2019

Evaluation

In the evaluation process, a pre-project survey will be conducted to obtain the percentage Chinese-Australian employees and their performance levels, the number of the Chinese victims who visit the hospitals following schizophrenia treatment, as well as the number of Chinese immigrants who are homeless because of schizophrenia symptoms. After the program implementation, a post-survey will again be undertaken in the same areas to evaluate if the program implementation attained the objectives that were stipulated earlier.

Partnerships

In this project, there are various groups and partnerships that have been consulted. Among them are the community social groups, AHPA workforce, as well as two community hospitals. The different community groups have agreed to work in the project when it comes to the community intervention programs. Precisely, there are different community groups like religious groups, empowerment groups, and self-help groups. All of these groups have agreed to taken in a number of these Chinese-Australian victims of schizophrenia to help them with their problem-solving and communication skills as well as their psycho-education. In the same light, two community hospitals have also partnered with the program to offer the medical support for the ACT program. Precisely, in these hospitals, the schizophrenia victims will be going for medical check-ups and for any medical attention that they may need in the process of their management of the condition. The AHPA workforce is the governmental organization that has come in to offer some financial support and any data that may be needed in handling the project. Specifically, they have agreed to fund about 15% of the entire project budget and continue to be involved in every step of the project to oversee its success.

Sustainability

The ACT program for the Chinese-Australian victims is expected to run for about two years within which is the period that funding is being asked. However, the ACT program is expected to run in the long run. This is because the number of the Chinese immigrants is continuing to rise year after year which means that the risks of them obtaining schizophrenia will also increase. Therefore, the governmental body, AHPA, has resolved to incorporate ACT among their mandate but only if it proves to be effective in assisting this group of people. The primary reason why they have jumped in the project is so that they can walk through the implementation of the ACT program step by step. This is regarding the parties that are involved, the resources that are needed, and to evaluate the effectiveness of the program. With one of the mandate of AHPA being to oversee health equity as well as ensure that Australia is healthy regardless of their background, it has promised to take up the ACT project among its ways of overseeing health equity and promoting a healthy Australia amongst all of its citizens. Therefore, the sustainability of the project is assured following given that it is a governmental agency and its long term existence is almost guaranteed.

References

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Choi, I., Zou, J., Titov, N., Dear, B. F., Li, S., Johnston, L., … & Hunt, C. (2012). Culturally attuned Internet treatment for depression amongst Chinese Australians: a randomised controlled trial. Journal of affective disorders, 136(3): 459-468.

Hsiao, F. H., Klimidis, S., Minas, H. I., & Tan, E. S. (2006). Folk concepts of mental disorders among Chinese‐Australian patients and their caregivers. Journal of advanced nursing, 55(1): 58-67.

Ito, H., Setoya, Y., & Suzuki, Y. (2012). Lessons learned in developing community mental health care in East and South East Asia. World Psychiatry, 11(3): 186-190.

James, E. L., Fraser, C., Anderson, K., & Judd, F. (2007). Use of research by the Australian health promotion workforce. Health education research, 22(4): 576-587.

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Lam, A. Y., Jorm, A. F., & Wong, D. F. (2010). Mental health first aid training for the Chinese community in Melbourne, Australia: effects on knowledge about and attitudes toward people with mental illness. International journal of mental health systems, 4(1): 18-22.

Lucksted, A., McFarlane, W., Downing, D., & Dixon, L. (2012). Recent developments in family psychoeducation as an evidence‐based practice. Journal of marital and family therapy, 38(1):101-121.

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Mellor, D., Carne, L., Shen, Y. C., McCabe, M., & Wang, L. (2013). Stigma toward mental illness: a cross-cultural comparison of Taiwanese, Chinese immigrants to Australia and Anglo-Australians. Journal of cross-cultural psychology, 44(3): 352-364.

Saha, S., Chant, D., Welham, J., & McGrath, J. (2005). A systematic review of the prevalence of schizophrenia. PLoS medicine, 2(5), e141-e144.

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Wong, F. K. D., Lam, Y. K. A., & Poon, A. (2010). Knowledge and preferences regarding schizophrenia among Chinese-speaking Australians in Melbourne, Australia. Social psychiatry and psychiatric epidemiology, 45(9): 865-873.