Mental Health ServicesChapter 9Introduction Should the mentally ill capable of harming themselves or others be involuntarily committed to a hospital is an important issue to be resolved in the mental health field. National attention was focused on mental illness by three former presidents: John F. Kennedy Jimmy Carter Ronald ReaganIntroduction Almost all levels of government have become involved with the problem of mental illness. Mental illness is on of the major health problems of America. The private sector is virtually uninvolved in the struggle to combat the problems of mental illness.Beginnings in Mental Health The first social workers to be allied with the mental health establishment worked in hospitals. The percentage of Americans estimated to be suffering from at least one psychiatric disorder is 20 percent. An estimated four to five thousand mental health facilities have been established, including such agencies as community mental health centers, state and county hospitals, private hospitals, V.A. psychiatric services, residential treatment centers for children, free-standing hospitals and clinics.Elements of the Mental Health Network One of the most important elements of the mental health service network is the community mental health center (CMHC). The mental health network includes both prevention and treatment. In the past 30 years more than 700 of the centers have been put into operation, but 2,000 are needed. Existing centers provide mental health care to millions of Americans.Elements of the Mental Health Network Community mental health centers are designed to provide mental health services to people living in the community, close to home and family. The services of the center: Must be coordinated with the provision of services by other health and social service agencies Must be available and accessible promptly When medically necessary, must be available and accessible 24 hours a day, seven days a week.Essential Elements of Comprehensive Mental Health Mental health services today can be classified as being pluralistic. They include: 24 hour crisis services Case management services Day treatment services Outpatient treatment Residential treatment Hospitalization (two types)Mental Hospitals Mental hospitals are an important part of the mental health service network and generally fall into three categories: State and county hospitals Veterans Administration Hospitals Private hospitals * Large state hospitals are believed to be negative in their effect on patients.Social Work in the Mental Hospital The social worker is concerned with all aspects of the patients relationships within the hospital, as well as to their family and community. Patients respond best to treatment when they understand and cooperate with it and trust the staff. Rehabilitation can be achieved best when the patients interest in family, employment and the community is sustained while undergoing treatment. The social worker assists the patient in using the family and community resources for protection and restoration to normal activities.Aftercare Facilities Aftercare services are to assist in the re- socialization of patients. One specialized aftercare facility is the halfway house providing living arrangements. It provides opportunities for re-establishing work, family, and social relationships on a gradual basis under sheltered conditions.Therapeutic Clubs Therapeutic clubs are one of the newer developments in aiding those who have been mentally ill. Fountain House is the first such facility believing: People with emotional disabilities have productive potential Work is important for everyone Everyone needs social relationships People need adequate housingOutpatient Psychiatric Clinics Outpatient clinics are widely used for the care of emotionally disturbed children. Through interviews and testing, a diagnosis is made. Treatment is planned that will alleviate the problems by modifying the childs unacceptable behavior. Difficulty in disciplining, temper tantrums, poor relationships with peers and siblings, and poor adaptation to school are the more frequently encountered problems.Residential Treatment Centers for Children (RTC) It is estimated that there are as many as 2 million children under the age of eighteen who have emotional problems severe enough to warrant urgent attention. There are 10 million to 15 million more who would benefit from psychiatric help of some kind. Services to children have not been developed in a coordinated, effective fashion.Jails and Prisons Two areas in desperate need of expanded mental health services. 1.9 million men and women were incarcerated in 2000 and is expected to reach 2.3 million in 2005. Most jails and prisons have inadequate mental health services especially those who suffer from alcohol and drug dependen