Promoting Mental Health and Wellbeing among Older People

This essay will discuss promoting mental health and encouraging wellbeing, the focus group is the older people with age 60 and above, we will talk about what is mental health and wellbeing, the impact on the group selected, and how to implement using different interventions, using primary and secondary impacts. We will discuss the five ways of wellbeing framework, what it meant and how we can apply it to the intervention. This will take us through what is health inequalities and equity issues.

This research will see us discuss how public health professional could evaluate interventions and it can be evaluated to the mental health and wellbeing. And it will be wrapped up with our findings and our thoughts on the conclusion.

BACKGROUND:

Adults between the ages of 60 or more make huge commitments to society as relatives, volunteers and dynamic supporters of society (Who.int, 2019). Albeit some still have great psychological wellness, many are in danger of creating mental health, neurological disarranges or substance use difficulties, just as other medical issues, for example, diabetes, hearing misfortune and osteoarthritis (Aseniorconnection.com, 2019). As people age, they are bound to encounter various conditions at the same time. (Who.int, 2019).

BASELINE STATISTICS:

In the world today, people are ageing fast and the percentage of the world’s older adults is estimated to almost twice that by 12 to 22 per cent between 2015 and 2050(Aseniorconnection.com, 2019). It is expected to grow from 900 to 2 billion people in absolute terms over 60 years of age (Marak, 2019). Elderly people are facing special, recognizable physical and mental health challenges (Who.int,2019).

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Rationally and neurologically disarranges (RNDs), which speak to 17.4 per cent of years with disabilities (YLDs) represent more than 20 per cent of 60 years old and more seasoned grown-ups and 6.6 per cent of all incapacities among individuals over 60 years old (Marak, 2019). Dementia and discouragement are the most well-known sickness in this focus gathering, influencing 5 to 7 per cent of the world’s more established populace, with 3.8% being influenced by tension and 1 per cent of the issue of medication use, which is occasionally ignored or misdiagnosed (Who.int,2019).

KEY RISKS FACTORS:

There are numerous hazard factors for emotional wellness problems every day. More experienced people can encounter life stressors that are common to everyone and in later life this progressive misfortune in limits and a reduction in utilitarian capacity (The World Health Organisation, 2019). For example, more seasoned adults may experience reduced portability, Chronic pain, fragility or other health problems for which long-term care is required. They may also experience events such as deprivation or a decline in socioeconomic status or retirement.

All these stressors can lead to loneliness and psychological distress which will require a long- term care for this focus group (who.int,2019). E.g. Older adults living with physical conditions such as heart disease are more likely to develop depression than those with good health. (Mentalhealth-uk.org, 2019). Elderly adults are also vulnerable in terms of abuse of their dignity and respect, including verbal, physical, financial, psychological and sexual abuse. Five topics that elderly people say are important for their mental health and well-being were identified in the British Later Life Mental Health and Wellness Survey (Mentalhealth-uk.org, 2019)The types of discrimination they experience are:-

Participation in cultural and political life
Relationship – friends and family, they want to feel part of the community
Health – physical and mentally sound, and access to care
Income – fear of not having enough income

HEALTH AND WELLBEING:

The WHO defines health as “state of complete physical, mental, and social well- being and not merely the absence of disease”(WHO, 2010). whereas Wellbeing is tied in with feeling better and working great and includes a person’s understanding of their life; and a correlation of life conditions with social standards and qualities. (The University of Edinburgh, 2019).

There is a two-way relationship between wellbeing and health: Health influences wellbeing and wellbeing itself, health is one of the most important things that people say about well- being. Physical and psychological wellness influence wellbeing, however, mental health and wellbeing are independent proportions, mental health is not just the opposite of mental disease. (GOV.UK, 2019).

Wellbeing exists in two dimensions:

Subjective wellbeing (or personal wellbeing) directly asks people how they think and feel about their own well- being and includes aspects such as life satisfaction (evaluation), positive emotions(hedonic) and the purpose of life ( eudemonic)(Rees, 2019).
Objective wellbeing is based on basic human rights and needs, including food, physical health, education, safety and so on. A goal well- being can be measured through self-reporting (e.g. Ask people if they have a specific condition of health or more objective measures (e.g. Life expectancy and mortality rates) (Rees, 2019).

The World Health Organization (WHO) understands the meaning of well- being as “physical, mental, and social prosperity” of these components, mental prosperity has been verifiably misjudged and often overlooked. Over the last five years, the WHO has effectively reached the boundaries that anticipate access to emotional well- being and the combination of psychological well- being in public health around the world (Who.int, 2018).

Health care is the maintenance or improvement of well-being through the prevention, determination and treatment of disease, illness, injury and other physical and mental impairments in individuals (Ons.gov.uk, 2019). Healthcare is delivered by well-being experts (suppliers or specialists) in united fields of well-being. Doctors and specialist partners are a part of these well-being experts. E.g. Dentistry, midwifery, nursing, medications, optometry, audiology, pharmacy, brain science, word-related treatment, active recovery and other welfare professions are all part of the human services. It includes work done in primary care, secondary care and tertiary care, as well as in public health.

Key policies to reduce Health care management: (Ons.gov.uk, 2019)

Fig.1. Source: (Ons.gov.uk, 2019)

HEALTH PROMOTION:

Many within and outside the field of mental health and health promotion recognise the need to assemble, review and generate evidence about the tangible benefits of mental health promotion, this includes the relationship between social and cultural factors and the mental health of individuals and communities. (Mentalhealth-uk.org, 2019).

The mental health of older people can be improved by promoting a healthy lifestyle, Active and Healthy Ageing (Adaa.org, 2019). Mental health promotion for older adults involves creating living conditions and environment that supports wellbeing and allows people to lead a healthy life. (Hubley, Woodall and Copeman, 2018)

Promoting mental health depends largely on strategies to ensure that older people have the necessary resources to meet their needs (GOV.UK, 2019), such as providing securities and freedom, adequate housing support, social support, health and social programmes targeted at vulnerable groups, e.g. people living alone, rural area, those who have chronic, mental or physical illness. This promotion emerged as evidence for the effectiveness of interventions and the public health policy and practice implications (GOV.UK, 2019).

They create programmes to prevent and deal with older people abuse and community development programmes. From the above description, we can identify and differentiate mentally healthy and mentally unhealthy.

MENTALLY HEALTHY	MENTALLY UNHEALTHY
They show respect to others and are aware of themselves. Understands their limitation and can tolerate others They understand that all behaviour is casual and motivate positive behaviour	Not aware of their own self Do not understand their own limitations, hence they can’t understand others. They can’t understand the cause of their behaviour, and cant motivate anything positive

INTERVENTIONS:

What is an intervention?

Interventions in public health are designed to improve health for people or at risk subgroups. Problems such as diet and smoke are complicated multifactorial aetiology (Craig et al., 2008). Early intervention means that psychological instability is discovered and treated in the early stages. The ability to treat psychosis early incredibly increases the chances of the individual being able to appreciate a healthy and productive future.

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There is no currently available medication to cure Dementia, but much can be done to support and improve the lives of the people with dementia and their carers and families (Nolan et al., 2011). This can be implemented through early diagnosis, which will promote early optimal management. Identifying and treating accompanying physical illness, and by detecting and managing challenging behaviour and providing information and long-term support to the carers (Nolan et al., 2011).

Prompt recognition and treatment of mental, neurological and substance use disorder in older adults is essential, both psychosocial interventions and medicines are recommended.

Five ways to wellbeing framework:

The Five Ways of Wellness is a simple and accessible way of demonstrating activities that can improve and maintain mental health and well- being. They were created by NEF (the new economics foundation) for Foresight, the UK government’s future thinks tank, as part of the Mental Capital and Wellbeing foresight project. (GOV.UK, 2019). This framework is meant to be positive and engaging, exemplary and non- prescriptive, but based on the wide-ranging scientific evidence gathered by the project. They are

Connect – E.g. Building social relationships, spend time with family and friends.
Be active- E.g. Regular physical activity.
Take notice-Mentally “present,” focus on awareness and appreciation.
Keep learning-Be curious about the world, try new stuff.
Give- Make a positive contribution to the lives of other people.

The Five Wellness Clubs have been incorporated into their work by groups as varied as GPs and other healthcare professionals, mental health commissioners, artists, religious groups, community and volunteer agencies and local authorities. (Aked and Thompson, 2019) .The range of uses was striking, far beyond the idea of “Five Wellbeing Ways “as a set of messages for the promotion of health. The Five Ways to Wellbeing are based on scientific evidence of the behaviour of individuals. If people incorporate more Five Ways activities into their daily lives, this evidence suggests that their well- being will improve (Aked and Thompson, 2019).

Community level intervention:

The term “community ” often refers to the community as an intervention setting. As an environment, the community is primarily defined geographically and the location where interventions are carried out. Such interventions may take place throughout the city, using mass media or other methods, or in community institutions such as neighbourhoods, schools, churches, places of work, voluntary agencies or other organisations. (Kenneth R. McLeroy, 2019). There are two types of intervention, primary and secondary interventions.

Prevention includes a wide range of activities known as Interventions, which is aimed at reducing risks or threats to health(iwh.on.ca). Although there are three categories: primary, secondary and tertiary, we will be looking at primary and secondary intervention.

The primary intervention aims to prevent diseases or injury before it occurs, this is done by preventing exposures to hazards that causes this by altering unhealthy and unsafe behaviours that can lead to this disease or injury and increase awareness to preserve this disease or injury from occurring (iwh.on.ca). In the case of my focus group (older people) this group are prone to accidents, due to their fragile posture and their mental state of mind. A safety check should be carried out regular within their home, if under the community or social care .E.g.

To mandate safe and healthy practices by banning and controlling the use of hazardous products (asbestos).
Introducing healthy eating through eating well and exercising, and avoid things like smoking, and
To encourage early immunisation against infectious diseases.

The secondary intervention refers to interventions that have been undertaking to reduce injury or disease, that is, all specific treatment-related strategies, and the tertiary prevention would include treatments that will reduce disabilities and all forms of rehabilitation, to avoid a relapse of this illness. (Health.mo.gov. (2019). This preventive strategy needs to be implemented at a specific period before the onset of the mental disorder or issues, in order for the effect applied to be effective there (www.euro.who.int)

Should be regular exams and screening test to detect diseases in early stages, e.g. mammograms to detect breast cancer.
Usage of medication prescribed e.g. aspirin to prevent further occurrence of heart attack or stroke.
Working environment should be supervised and modified to limit injuries sustained at work, e.g. installation of lift instead of manual handling.

WHO,(Nytimes.com, 2019), also has played an important role in prevention and promotion in mental health since in the ’50s, Over the years there have been several resolutions passed by World health organisation and World health assemblies, urging his members to undertake steps towards prevention and promotion in mental health.(who.int).

To understand this we need to understand why the intervention of services to this focus group, we channel it to Inequity in health and health care, this is referred to the inequalities that are judged to be unjust or unfair from derived results from the social processes (Russo and Russo, 2012). Equity in care requires active engagement in planning, implementation and regulation of health systems to make an unbiased accountable person to arrange and address the needs of all members of the society (Theobald and Cooper, 2012). This information can be identified, through information about death, illness and health services, this can be indicated through the use of demographic or socioeconomic groups(ons.org).

Currently, in England, is been researched that people living in the least deprived areas live 20 years longer in good health than people in the deprived areas(publichealthmatters.gov.uk).

Evaluation:

The primary reason for evaluation is to gain insight into existing or prior initiative (Gargani and Donaldson, 2011) therefore, evaluation is the social and technical practice of gathering and using empirical data to make judgements of quality about the entity of being evaluated (Green and South, 2006). The social practice- involves relationships and interaction with ‘stakeholders’, which are individuals or group who has a ’stake’ in the programme been evaluated. The technical practice side relies on other methodologies of social science (gathering data and reports). And the valuing practice yields judgements on the quality of a particular intervention.

To improve and account for public health, an effective programme called evaluation has to take place among public health professionals, by involving procedures that are useful, feasible, ethical and accurate (healthknowledge.org.uk). This evaluation framework will help health professionals to plan a program, it is a practical and non-prescriptive tool(cdc.gov). There are steps and standard to be followed in this framework which will help to understand the program and how it is evaluated. The programme is used to apply different elements for planning effective health strategies, and improve the existing programs (Porter, 2016).

The framework is composed of several steps that must be considered to evaluation to take place (Porter, 2016).

The Users: is the user that the evaluation is created for. This involvement is required for clarifying the intended purposes, questions and purposes, and preventing the evaluation from being misguided.
Questionnaire: this is a way information is generated from the evaluation, by creating evaluation questions with the stakeholders.
Methods: this evaluation is derived from feedbacks on research options particularly in the area of social, behavioural, and focus group.
Gathering evidence: An evaluation cannot be completed without credible information about the primary users. e.g. evidence should be perceived by stakeholders as relevant and believable.

THE IMPACT AND WHAT HAS CHANGED

Four UK mental health organizations are working together to enhance people’s lives (Mentalhealth-uk.org, 2019).

The only UK- wide advice services to support 4 millions of UK citizens with financial and mental health issues have been launched by Mental Health & Money Advice. 70,000 people have been visited on our website since our launch last November, 83 per cent of whom found the information useful(Mentalhealth-uk.org, 2019).

In Wales, Hafal has supported over 70 + services year- round directly to 5,000 people with mental illness and 1,000 caregivers. Hafal’s partner with local services such as Cyfle Cymru has been able to help over 3,000 people out of work suffering from mental health or drug abuse to get a job.
In Northern Ireland, Mind Wise bolstered 6000 grown-ups living with a psychological instability including 3,500 through the criminal equity frameworks, 125 connected in the venture for youngsters and 1370 through support services.
In Scotland, Mind Scotland support provided more than 50,000 hours of support to people and provided 17 services to support 1,300 mentally ill people.
Rethink Mental Illness is the largest provider of voluntary mental health services in England, with more than 200 services and 150 support groups. From psychological therapies, crisis and recovery centre to peer support groups and housing services, Rethink Mental Illness helps thousands of people throughout England directly every year.

CONCLUSION:

Health is a massive and complicated issue to deal with, different theories and meaning, and it all seems like a never-ending story. There are more groups in the society that need more help than the other due to either social factor, demographical or lifestyle situation. The main focus of this research is to see how this has applied to my focus group (Older people), in terms of interventions and need assessments.

My focus group was on the older people, who are the most vulnerable in the group from the background research in promoting mental health and wellbeing. A lot of plans has been put in place in terms of health care services, and the NHS long term plan(LTP) on prevention to save 500,000 of lives over the next 10 years, which the Chief Executive Duncan Selbie says ‘it will mark a turning point on how we provide healthcare across England ‘.

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