Public Health Assignment: System Thinking for Mental Health

Question

Task: To prepare for this public health assignment, choose one public health issue (e.g. diabetes, obesity, cancer, heart disease, mental health, substance misuse, air pollution, water and sanitation, road accidents, suicide, etc.) in any country and examine how systems thinking can help to identify the broader system issues, and recommend solutions for better management. This is a research based assignment which requires conducting literature review on the selected topic on the specific country context.

Then in approximately 1500 words (+/- 10%), please answer the following questions considering your selected public health issue and country context.

• Describe the public health issue from systems thinking perspective (consider all direct and indirect factors and explain the complexity of the issues or interconnectedness of the issues)
• Explain the roles of stakeholders, both within the health system and in other sectors in addressing this issue (consider intersectoral action perspective)
• Drawing on research evidence, explain the obstacles (e.g. lack of cooperation among stakeholders or lack of shared vision and leadership, feedback delay, lack of healthy policy, fragile and fragmented health system, funding limitation, time constraints) that are preventing the application of systems thinking and intersectoral approach to the issue.
• Based on the identified obstacles and literature, offer suggestions (e.g. developing shared vision, cooperation and leadership, policy change or reform, creating supportive environment, strengthening, and reorienting health system, increased budget allocation, empowering community and individuals) for how systems thinking and an intersectoral approach could be applied to the issue.

Answer

Introduction
System thinking is a crucial aspect that has developed its field of inquiry in the 20th century. Mental health issues constitute an increasing and large part of the burden of disease worldwide (Sweeney et al. 2018). The provision, as well as the prevention of adequate mental healthcare facilities, are crucial public health issues. It has been found that mental health issues are highly prevalent across different countries although there has been an adequate level of public investment made to tackle the problem of mental health issues (Rustaman et al., 2018). This study will highlight the mental health problem as the crucial public health issue in Australia. Further, it will also discuss the public health issue from the perspective of the system thinking process, the role of stakeholders within the health system as well as the other sectors involved with the health issue. The report will also highlight the obstacles that will prevent the application of system thinking in the mental health issue as well as suggest adequate recommendations to tackle the issue.

Description of the public health issue in Australia
According to WHO, mental health is considered as the state of well-being in which the individual realizes his/her potential to cope up with the stress in life, enhancing productivity to contribute his/her best in the economy (Mental health in Australia: A Quick Guide, 2019). In Australia, it has been found that the framework of mental health services is highly complex where there exists an adequate level of funding between the state, territory, and the Australian Government. According to the Australian Bureau of Statistics, it has been found that 45% of Australians experience mental disorders during their lifetime while only 20% of the individuals experience mental disorders during the previous year (Mental health in Australia: A Quick Guide, 2019). The Department of Health has stated that they do not possess any such plans to carry out improved surveys on the issue of mental health.

According to the survey carried out by the Australian Bureau of Statistics, it has been found that 4.8 million Australians are suffering from behavioral or mental health conditions in 2017-2018 (Mental health in Australia: A Quick Guide, 2019). This indicates that there has been an increase of 2.6% of the patients suffering from mental health problems from 2015-16 where the increase in cases was mainly due to the increase in the number of individuals suffering from anxiety. It can be said that the cost of this mental illness varied among the employees in the workplace. The cost estimate was found to be 412.8 billion in 2015-2016 (Mental health in Australia: A Quick Guide, 2019). It is the responsibility of the Government to tackle the adequate level of funding for regulating mental health services in Australia in consultation with the state or the territorial government.

Influence factors
The concept of system thinking is used in analyzing the complex problem of mental health issues. With the help of system thinking, there will be proper attempts made for the addition of the new theories or the methods that are used in the analysis of the global health system. The positive aspect linked with the mental health issue in system thinking provides scientific insight to understand the elements linked with the analysis of the health outcomes, the models of the association between the elements that assist in the alteration of the processes, the design as well as the policies linked with the resultant process (Freeman et al. 2017). Further, the system thinking approach also helps in the improvement of the safety, value, and quality of the health outcomes linked with the mental health processes. This system approach is likely to improve the health outcomes through consideration of the multiple elements linked with caring for the patients and the other factors influencing the health system.

It has been found that the policymakers of the mental health aspects often face complex decisions that must be justified through a deeper knowledge of the health system as well as the assessment linked with varied choices. There also exist different types of evidence linked with the health policy that uses the scientific evidence to assist the policy-makers in the decision-making process posing equality, efficiency as well as effectiveness. On the other hand, it can be said that the system thinking approach takes into consideration the entire health system rather than considering it in parts and thus considering the accounting behavioural system with its complexity and over time (Papero et al., 2018). There have also been attempts made to classify the taxonomies included with the mental health interventions, the services, and the professionals in health systems to know the accurate performance and the provision through the allowance of comparison between the system.

Health system
Due to the changing aspect of the mental health issue, the importance of social determinants has been found to threaten the health aspect in Australia. The process of accountability of these changing health needs ensures that there should be promotion and promotion of the meant health needs in the long run. During the mid-twentieth century, there have been proper attempts made to identify the risk factors linked with mental diseases as well as the insufficiency of the mental health services and the hospitals (Altman, Huang & Breland, 2018). The Government of Australia is trying its best to tackle the intersectoral cooperation that is required for the establishment of the health approach across all policies. Further, it can be said that there also exists emerging evidence to support the different types of social determinants related to mental health through an emphasis on the need for collaboration among the involved individuals for the implementation of the policies and the formulation of design for a specific population.

The stakeholders also use varied tools to facilitate the groups of individuals with a common understanding of the issues linked with the inquiry and the action. This is also likely to assist the teams in understanding the generic patterns linked with the interaction system. The stakeholders also try to carry out mapping as well as an assessment of their position through carrying out a diagnosis of the views and well analysis of the position (Scholten&Granic, 2019). There should also be proper attempts made to carry out the continuous level of interaction with the other stakeholders involved in tackling the mental health issue. This is likely to reduce the uncertainty linked with the operational environment through the identification of the critical dependencies and the actors (Altman, Huang & Breland, 2018). As there exists both the internal and the external stakeholders in tackling the mental health issues, it can be said that there should be systematic attempts made for the development of a legislative framework, the regulations, and the laws linked with the system.

Challenges
As system thinking does not include the rejection of the traditional scientific views related to mental health, the entire aspect can be considered to be linear, mechanistic, spatial as well as temporal. There should be systematic attempts made to tackle the embedded processor and the precursors of the system thinking process (Berry et al., 2018). On the other hand, it can be said that the system thinking process also does not contain rigor. This is likely to create fallacy in the system and thus it can be considered to be opposed to analytic and scientific learning. As most of the techniques that are used in system thinking and modeling are linked to science and mathematics, they are not used in carrying out sophisticated and rigorous experiments (Van Os et al. 2019). System thinking linked with mental health can also be considered as a reductionist aspect associated with the boundaries of varied systems.

Recommendation
The development and the application of the system thinking methods and processes are likely to encourage research and development. There should also be systematic attempts to foster the thinking involved with the mixed-method system. On the other hand, it is also necessary to check the participatory needs and the system assessments accordingly. There should be proper attempts made in the maintenance and the establishment of network relationships through the creation of multi-level networks for the actions and the system. This will assist in studying the network of networks and therefore determining the efforts through fostering the system evaluation process position (Scholten&Granic, 2019). Further, it can be said that system thinking that is associated with the mental health issue also assists in the transformation of a system culture through the encouragement of vision and the paradigm evaluation process. There will also be systematic attempts made to engender systematic leadership accordingly and through improved means.

Conclusion
Thus, it can be said that the system thinking approach involves the interplay of systems that are required to improve the mental health system. It has been found that management of this complex health issue i.e. the mental health issue requires the multidisciplinary and the transdisciplinary teams who try to address and understand the complexities as well as the system thinking approach to reach that particular position. There have been proper attempts made to identify the stakeholders, the arguments, positions, and the interest linked with occupational health care. Therefore, it can be said that system thinking in mental health issues can be considered as the framework for solving and defining the problems of mental health patients.

References
Altman, M., Huang, T. T., & Breland, J. Y. (2018). Peer reviewed: Design thinking in health care. Preventing Chronic Disease, 15.

Berry, H. L., Waite, T. D., Dear, K. B., Capon, A. G., & Murray, V. (2018). The case for systems thinking about climate change and mental health. Nature Climate Change, 8(4), 282-290.

Freeman, D., Reeve, S., Robinson, A., Ehlers, A., Clark, D., Spanlang, B., & Slater, M. (2017). Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological medicine, 47(14), 2393-2400.

Mental health in Australia: A Quick Guide (2019).Parliament of Australia . Retrieved 19 March 2021, from https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1819/Quick_Guides/MentalHealth

Papero, D., Frost, R., Havstad, L., &Noone, R. (2018). Natural systems thinking and the human family. Systems, 6(2), 19.

Rustaman, N. Y., Firman, H., &Tjasyono, B. (2018, May). Development and validation of climate change system thinking instrument (CCSTI) for measuring system thinking on climate change content. In Journal of Physics: Conference Series (Vol. 1013, No. 1, p. 012046). IOP Publishing.

Scholten, H., &Granic, I. (2019). Use of the principles of design thinking to address limitations of digital mental health interventions for youth. Journal of medical Internet research, 21(1), e11528.

Sweeney, A., Filson, B., Kennedy, A., Collinson, L., & Gillard, S. (2018). A paradigm shift: relationships in trauma-informed mental health services. BJPsych advances, 24(5), 319-333.

Van Os, J., Guloksuz, S., Vijn, T. W., Hafkenscheid, A., &Delespaul, P. (2019). The evidence based group level symptom reduction model as the organizing principle for mental health care: time for change. World Psychiatry, 18(1), 88-96.