The field of mental health counseling is evolving, growing, and changing. The pioneers of this change brought very important enhancements to the field of mental health counseling. Counselors are professionals who assist individuals and groups with their personal problems in order to help them become more self-sufficient. Individuals that specialize in mental health counseling concentrate on promoting optimum mental health through various programs and services. In this paper I will explain the history, changes, health and human services program development and changes in legislation as it applies to mental health programs and treatments. I will also discuss the training, licensing, certificate, and education of being a mental health counselor (Burger, 2011).
Introduction
In America there are a boundless array of cultures, races, and ethnicities. With this diversity comes incalculable energy and optimism. Diversity has enriched America by bringing global ideas, perspectives, and productive contributions to all areas of contemporary life. The enduring contributions of minorities, like those of all …show more content…
Americans, rest on a foundation of mental health. Mental health and mental illness require the broad focus of a public health approach. Mental disorders are disabling conditions. Mental health and mental illness are points on a continuum. The mind and body are inseparable. Stigma is a major obstacle preventing people from getting help (Burger, 2011).
Mental Health
Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior associated with distress or impaired functioning. People of all ages can be affected by mental illness; and individuals in different stages of life may be susceptible to certain kinds of mental disorders. Older adults have their own special mental health problems and needs. Treatment interventions such as psychotherapy and medication can benefit individuals with mental illness when tailored to meet the specific needs of each patient (World Health Organization, 2007).
Mental health is fundamental to overall health and productivity. Mental health is the basis for successful contributions to family, community, and society. Throughout our lifespan, mental health is the wellbeing of our thinking and communication skills, learning, resilience, and self-esteem. It is easy to dismiss the value of mental health until problems appear. Mental health problems and illnesses are real and disabling conditions that are experienced by one in five Americans. Left untreated, mental illnesses can result in disability and despair for families, schools, communities, and the workplace. Mental health takes a toll on society. The stigma surrounding mental illness is a powerful barrier to reaching treatment. People with mental illness feel shame and fear of discrimination about a condition that is as real and disabling as any other serious health condition (World Health Organization, 2007).
Although there have been many strides made in the advancement and efficiency of mental health services, their continued to be a pervasive set of barriers limiting the level of success in assisting those members of minority groups that have been diagnosed with a mental disorder. Social work practitioners must be at the forefront and exert tremendous effort to alleviate or minimize the effects of mental disorders and in every way possible seek out and eliminate every barrier that hinders the treatment of mental illness. Identifying the various types of barriers to mental illness treatment is a daunting task, but is essential in the continued improvement of attitudes, beliefs, techniques, policies, interventions, funding, quality of service, knowledge, and other areas that promote overall health and well being for those minority individuals diagnosed with a mental illness and their caregivers (World Health Organization, 2007).
History
Mental illness has been around as long as civilization. There have been dramatic changes in places where many are treated for mental illness. In 1950, many that were treated at institutions was moved and treated in community based facilities. Many suffered physical and mental abuse. There was use of physical restraints, straight-jackets and heavy arm and leg chains that deprived patients of their dignity and freedom. In the nineteenth century reformers, made great strides in promoting humane treatment of those with mental illness but conditions were still far from ideal. In 1990, National Mental Health Association played a leading role in the development of the Americans with Disabilities Act which protects mentally and physically disabled Americans from discrimination in such areas as employment, public accommodations, transportation, telecommunications, and state and local government services (Mental Health Association/history, 2012).
As years passed, NMHA continued to strive to fulfill their goals, spreading tolerance and awareness, improving mental health services, preventing mental illness, and promoting mental health. Its massive National Public Education Campaign on Clinical Depression, begun in 1993, continues to inform Americans on the symptoms of depression and provide information about treatment. NMHA also became involved in the struggle for parity of mental health benefits with other health coverage. The Mental Health Parity Act of 1996 was victory, barring insurance companies and large self-insured employers from placing annual or lifetime dollar limits on mental health coverage. NMHA was at the forefront with much effort to win passage of the bill.
There are special concerns for the mental health needs of youth in the juvenile justice system that is being neglected. There is a promise of reforming the juvenile justice system so that these needs are addressed (Mental Health Association, 2012).
The federal legislation of The Community Mental Health Centers Act of 1963 established centers throughout our nation. They offer inpatient care, outpatient care, and partial hospitalization; where they spend the day at the center and go home at night, emergency care and consultation, education and information to help prevent emotional disorders (Burger, 2011).
Legislation and Changes
In February 2012, Congress passed legislation that will affect the most vulnerable in our country. Medicare recipients currently receiving mental health outpatient services stand to be affected by the payroll tax legislation As a result of the new law, which President Obama is expected to sign, payment for Medicare outpatient psychotherapy services will be cut by 5 percent beginning on March 1, 2012. These cuts will impact funding not only for psychotherapy outpatient services, but to community behavioral health centers, state hospitals and private hospitals with mental and behavioral health units. We cannot afford to lose qualified, licensed mental and behavioral health Medicare providers. A loss of providers will negatively impact patient care and recovery (American Psychological Association Practice organization).
An estimated 450 million people worldwide suffer from mental or behavioral disorders. Research show these disorders are prevalent in prison populations. The high rate of mental disorders in prisons is related to several factors: the widespread misconception that all people with mental disorders are a danger to the public; the failure to promote treatment, care and rehabilitation, and the lack of, or poor access to, mental health services. Many of these disorders may be present before many go to prison, and further exacerbated by the stress of imprisonment. There are factors in many prisons that have negative effects on mental health, including: overcrowding, various forms of violence, enforced solitude or conversely, lack of privacy, lack of meaningful activity, isolation from social networks, insecurity about future prospects, and inadequate health services, especially mental health services, in prisons.
Jamie Fellner of the Human Rights Watch Program says that prisons have become the nation’s primary mental health facilities. The high rate of incarceration of the mentally ill is a consequence of underfunded, disorganized, and fragmented community mental health services. State and local governments have shut down mental health hospitals across the United States, but failed to provide adequate alternatives. Over the past two decades, prison mental health services in the United States have improved; usually because of prisoner litigation. But the surging number of mentally ill men and women entering prison has outrun the availability of services. Public officials have been unwilling to provide the funds necessary to ensure adequate treatment for all the mentally ill offenders who need it (Fellner, 2012).
Prisons are the wrong place for many people in need of mental health treatment, since the criminal justice system emphasizes deterrence and punishment rather than treatment and care. Legislation can be introduced which allows for the transfer of prisoners to general hospital psychiatric facilities at arrest, prosecution, trial, imprisonment. For people with mental disorders who have been charged with committing minor offences, the introduction of mechanisms to divert them towards mental health services before they reach prison will help to ensure that they receive the treatment they need and also contribute to reducing the prison population. The imprisonment of people with mental disorders due to lack of public mental health service alternatives should be strictly prohibited by law (Drew, Natalie 2005).
In July, 2012; the state Legislature of Tennessee, passed a bill that provided a way for people who are in prisons trying to deal with mental illnesses to get treatment without being committed to a hospital or facility full-time. They created a pilot program along with the Mental Health Association that will provide two years of funding for 10 people to be treated as outpatients each year through the Helen Ross McNabb Center. In order to get into the treatment program, a court order will have to be issued by a judge. The program is designed to prevent full-time commitment of people with mental illness whose behavior is putting themselves and others at risk for injury or jail time (Huntoon, P., 2012).
Culture and Mental Health
Each culture have systems of health beliefs to explain what causes mental illness, how it can be cured or treated, and who should be involved in the process. The extent to which patients perceive patient education as having cultural relevance for them can have a profound effect on their reception to information provided and their willingness to use it. Cultural issues play a major role in patient compliance. One study showed that a group of Cambodian adults with minimal formal education made considerable efforts to comply with therapy but did so in a manner consistent with their underlying understanding of how medicines and the body work (www.euromedinfo).
Each ethnic group brings its own perspectives and values to the health care system, health care beliefs and health practices that differ from those of the traditional American health care culture. Even though the expectation of many health care professionals is that patients will conform to mainstream values. These expectations have created barriers to care that have been compounded by differences in language and education between patients and providers from different backgrounds (www.euromedinfo).
Cultural differences affect patients’ attitudes about medical care and their ability to understand, manage, and cope with the course of an illness, the meaning of a diagnosis, and the consequences of medical treatment. Patients and their families bring culture specific ideas and values related to concepts of health and illness, reporting of symptoms, expectations for how health care will be delivered, and beliefs concerning medication and treatments. In addition, culture specific values influence patient roles and expectations, how much information about illness and treatment is desired, how death and dying will be managed, bereavement patterns, gender and family roles, and processes for decision making (www.euromedinfo).
Training and Education
In order to become a mental health counselor one must obtain a bachelor’s degree in counseling, psychology, education, sociology, or social work.
Most employment opportunities for mental health counselors require a master’s degree or a doctoral degree. Voluntary certification is available through The National Board of Certified Counselors. An internship, a taped sample of clinical work, or other professional experience, as well as passing a written examination is required to receive this certification. One aspect of counseling that is very helpful is the licensure that is granted to counselors by the state. This licensure establishes the viability and credibility of the counseling profession. Counselors are among the few licensed state health practitioners who do not require a PhD or a doctorate (American Mental Health Counselors Association,
2012).
For mental health counselors, becoming licensed means that a counselor can practice independently. Although licensure requirements may vary by state, licensure is always a way of demonstrating that a mental health counselor has met certain minimum professional standards. The requirement in the state of Louisiana is that licensed counselors possess master’s degree in mental health fields, have finished two years of clinical work with licensed or certified mental health practitioners following graduation and have passed state licensing exams (www.nbcc.org).
Future Directions in Mental Health
In the direction of future trends The National Institute of Mental Health future trends are to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. They will foster innovative thinking and ensure that a full array of novel scientific perspectives are used to further discovery in the evolving science of brain, behavior, and experience. As a result breakthroughs in science will become breakthroughs for all people with mental illnesses. They will promote discovery in the brain and behavioral sciences to fuel research on the causes of mental disorders, Chart mental illness trajectories to determine when, where, and how to intervene, Develop new and better interventions that incorporate the diverse needs and circumstances of people with mental illnesses, and strengthen the public health impact of NIMH supported research (National Institute of Mental Health, 2008).
In the future all Mental Health Workers will have the knowledge and skills necessary for professional practice, practitioners' roles and scopes of practice and the systems in which MHPs function are changing. As MHPs confront new realities, reassessment of the resources within each discipline's workforce, training agenda, and curriculum are warranted. The future of the MH professions depends on whether they can summon the resolve to respond to their collective challenges, settle internecine conflicts, and develop appropriate plans for adapting to the trends shaping their future (National Institute of Mental Health, 2008).
Conclusion
Counselors are professionals who assist individuals and groups with their personal problems in order to help them become more self-sufficient. Individuals that specialize in mental health counseling concentrate on promoting optimum mental health through various programs and services. They help individuals deal with suicidal impulses, self-esteem issues, addictions and substance abuse, stress management, job and career concerns, marital problems, educational decisions, and issues associated with aging. Beginning with the interview process, mental health counselors make observations that help them determine a treatment plan that will accomplish their client’s goals. They often use personality, aptitude, and psychological tests to determine more precisely the needs of a particular patient. They often work closely with other mental health professionals including psychiatrists, psychologists, and social workers to ensure that all of the patient’s needs are being met. Mental health counselors are also responsible for maintaining records of tests and counseling services, and making sure that all records are kept confidential. They frequently conduct research and report their findings in professional and trade journals (Mental Health Counselor, 2003-2012).
I our society today mental health counselors manage care environment and they are uniquely qualified to meet the challenges of providing high quality care in a cost-effective manner. Clinical mental health counselors practice in a variety of settings, including independent practice, community agencies, managed behavioral health care organizations, integrated delivery systems, hospitals, employee assistance programs, and substance abuse treatment centers (Mental Health Counselor, 2012).