Discuss The Importance Of Service User Participation Social Work Essay

Discuss The Importance Of Service User Participation Social Work Essay Traditionally, people experiencing mental health problems were removed from society and placed in asylums across the country, indefinitely (Thornicroft and Tansella, 2002, pp. 84-90). Patients within the mental health system were expected to take a compliant role in the management of their care and leave the decision making to the professionals. In todays society that is not the case. In this assignment the writer will begin by exploring the publication Vision for Change while discussing the main theme of this publication which is the importance of service user involvement and the importance of empowering the service user in the mental health system of Ireland (Ireland, Dept of Health Children, 2006). To empower the service user requires the control of power to be transferred from the professionals to the now known Service User. The writer will discuss the effect of this change and the importance of this change within the mental health system. The Mental Health Act 2001 requested th e closure of many asylums and the move towards a community based model of care. The deinstitutionalisation of many patients and relocation back into the community required changes in the way the psychiatric nurse and service user operate. Evidence has shown the importance of service users participation in research, education and in practice through out the mental health care system. The writer in this assignment will discuss the importance of service user participation in the delivery of psychiatric nursing care, focusing on the nursing assessment using a holistic approach. Finally, the writer will discuss the importance of service user participation in the remaining stages of the nursing process; the nursing diagnosis, outcomes, planning, implementation and evaluation while exploring the need for a therapeutic relationship between service user and psychiatric nurse to complete the nursing process successfully. With people experiencing mental health difficulties, who now reside in the community, it is vital that service users become involved in the development and delivery of mental health services, such as self-help services, drop-in centres, and in providing assistance with activities of daily living. The aim of this is to sensitise society to the need of integrating people with mental health difficulties back into community life. As quoted in a Vision for Change; Service users must be at the centre of decision making at an individual level in terms of the services available to them, through to the strategic development of local services and national policy. To use a slogan of the disability rights movement: nothing about us, without us. To reduce the stigma attached to people with mental health difficulties the term patient was changed to service user, as most of the care they receive is provided in the community. The Mental Health Act, 2001 suggests the term patient is used to describe someone who is involuntarily admitted. Patient does not therefore refer to all individuals in an approved centre. In the Vision for Change it states that the correct way to describe someone with a mental health illness was to see the person before the illness, for example someone with anorexia nervosa was not to be described as an anorexic rather than as a person with anorexia nervosa. Stereotyping in mental health is as damaging as any other stereotype (Ireland, Dept of Health Children, 2006). People, who experience mental health difficulties, can be the experts through their own experience (Bee et al, 2008, pp. 442-447). Psychiatric nurses remain the largest staff group involved in the provision of mental health care, (Bee et al, 2008, pp. 442-447). Therefore, to ensure the mental health care service abides by legislation, it is vital for psychiatric nurses to re-evaluate their role to ensure priority is given to including the service user. An Bord Altranais recommend that a holistic approach is adopted and it is listed as one of the requirements in nurse registration education programmes (An Bord Altranais, 2005). It is fundamental that the service user participates in the nursing assessment especially where the holistic model of assessment is used. The biopsychosocial model uses a holistic view, addressing the biological, psychological and social factors contributing to a persons mental health problems. According to Boyd (2004, p.190) it proposes a person-centred treatment approach which addresses each of these elements through an integrated care plan agreed with service users and their carers and involves participation of the service user throughout the assessment. This assessment requires the service user to answer a series of questions, some being of intimate nature about themselves. This enables the assessor to obtain relevant information required in making a nursing diagnosis. To ensure accurate nursing diagnosis it is critical that the services user listens carefully to the questions asked and is completely honest when answering the questions. This process also requires the service user to be patient while the assessor records the data received. However, it is important to remember that an initial assessment can occur when a service user is first admitted into psychiatric care. According to Boyd (2004, p.194) the assessor must have empathy and an understanding of how difficult it is for a person to discuss intimate details of ones lifes to a complete stranger, even if it is in the persons best interest. Although the nursing assessment is the starting point of the nursing process, the writer feels that service users participation remains of equal importance throughout the nursing process. The freedom of information act 1997 requires that all services users can request access to any information stored about them. While, it is now a legal requirement for service users to be involved at all stages of the nursing process, the writer suggests that it is imperative that the service user is informed of the nursing diagnosis. This will empower the service user, by encouraging the service user to find relevant information regarding their diagnosis which can assist in them becoming experts of their own mental illness. Following the diagnosis it is required by law that the psychiatric nurses discuss all details of the outcome with the service user. The psychiatric nurse needs to ensure that the service users values and beliefs are priority when planning the outcome. If any treatment is deemed necessary for the road to recovery, then it is compulsory that the service user is capable of understanding the effects of the treatment proposed, this requirement is stated Under the Mental Health Act, 2001: the service user must be capable of understanding the nature, purpose and likely effects of the proposed treatment and the consultant psychiatrist has given the patient adequate information in a form and language that the patient can understand, on the nature, purpose and likely effects of the proposed treatments (Section 56). Factors for consideration include the capacity to comprehend and decide, risks involved, patients wishes to be informed, the nature of the procedure and the effects of information on the service user. The service user must be informed of the benefits of taking the medication prescribed, for what duration the medication is to be taken and what side affects may occur when taking the prescribed medication. Forcing an unwilling inpatient to receive medication has been considered an unnecessarily coercive, traumatic, and even punitive assault on a persons privacy. It has been stated that the patients refusal of medication is indicative of a gap between their experience and understanding of the medication and the intention of the prescribing physician. (Kaltiala-Heino et al, pp. 290-295) In todays mental health care system, many service users receive treatment in the community; therefore, it is critical that services users listen to information regarding their prescribed medication while raising any concerns they may have. Planning and the implementation stages of the nursing process are not possible without the involvement of the service user. Communication and agreement between the service user and the psychiatric nurse is necessary. Potential obstacles need to be pointed out, and methods of overcoming these obstacles, discussed. Potential risk areas for the service user needs to be discussed and a therapeutic risk assessment carried out by the psychiatric nurse to ensure the service user is not at risk or danger of harming themselves or others. Awareness of patients perceptions of their impaired quality of life gives psychiatric nurses important information for planning individually tailored interventions (Pitkà ¤nen, A. et al, 2008, pp. 1598-1606). Finally, the evaluation stage evaluates client progress and reviews plans in accordance with evaluated data in consultation with the client. Evidence shows that the evaluation of a services users experience is of vital importance in shaping the future of service users outcomes within the mental health service. It also enables the psychiatric nurse to take the necessary steps required to ensure that the individual service user is satisfied with the service received. The Department of Mental Health, UK stated that the experience of service users, including those from black and minority ethnic groups, is a recognised national marker in the performance of the UK mental health services. In 2006, the UK National Service Framework (NSF) in line with the Mental Health Unit of the Regional Office for Europe carried out a systematic review of empirical service user views and expectations of UK-registered mental health nurses. Feedback from this review was both positive and negative, with servi ce users holding mental health nurses in high regard. However; feedback also reveals that there was a strong need for nurses to be more effective in interpersonal communication and relationship building, whilst spending more time with the service user (Bee et al, 2008, pp. 442-447). Throughout the nursing process it is necessary for a therapeutic relationship to exist between the service user and the psychiatric nurse to. Relationships are central in fostering and maintaining hope (Byrne et al 1994). Psychiatric nurses are required to have a genuine interest in services users, listening in a non judgemental way to what is being said. In a user-led study evidence has shown service users identified the importance of therapeutic relationships and how they inform patient experiences. Communication was highlighted by all participants as necessary. One participant in the survey quoted; As soon as you come they can see that you are angry. Then someone will say, sit down, lets talk about it, make a cup of tea. Failure to establish a therapeutic relationship between the service user and the psychiatric nurse can result in negative patient experiences. Participants identified coercion as the main reason for failure to establish a therapeutic relationship (Gilburt, H. et a l, 2008). Conclusion: The writer in this assignment briefly exposed the treatment of patients within the mental health care prior to the introduction of the Mental Health Act 2001 and the publication of Vision for Change. Then, the writer discussed the major changes within the Mental Health Services as a result of this act and publication. The Mental Health Act 2001, focused on the closure of many asylums and a community based model of care to be adopted, however, both the Mental Health Act and the Vision for Change also focus on the importance of service user involvement and empowering the service user. The writer demonstrates how a new psychiatric and service user role was required to adapt to policy changes within the Mental Health Service and to ensure all parties were adapting to policy requirements that aims at service user involvement at all stages, thus; empowering the service user. The writer reports how the publication Vision for Change also hoped at reducing stigma by aiming to involve services users in developing and delivering mental health services. The writer mentioned the importance of service user involvement in research, education and practice, while focusing on the practice area by exploring the nursing process, starting with the assessment. Evidence is clear that it is not possible for a psychiatric nurse, even with the necessary skills required to proceed with the nursing process without the participation of the service user at all stages. The writer concluded this assignment by exploring evidence which reveals that service users regard a therapeutic relationship and good communication between the service user and the psychiatric nurse of high importance.

Business Studies Customer Needs Essay Essay

‘Lees Heginbotham & Sons Ltd ’provide floor covering and high quality carpets all over the UK. The services that it provides are: * free estimating, * free carpet removal, * a quality fitting to your standard * a free car park adjacent to the shop. * Competition? ‘Lees Heginbotham & Sons Ltd’ has quite a bit of competition. It is placed close to the ‘Spindles Shopping Centre’. Also there is another carpet shop quite close by to ‘Lees Heginbotham & Sons Ltd’ called ‘Roll Ends’. But ‘Lees Heginbotham & Sons Ltd’ is placed just off a high street and advertises around the country. Also, just about a mile away is another carpet shop, placed in the middle of a retail park. This could offer some competition for ‘Lees Heginbotham & Sons Ltd’. This is an image of the carpet right about a mile away from ‘Lees Heginbotham & Sons Ltd’.’Carpet Right’ is surrounded by other shops and is placed in a retail park. This is a bonus for customers to go to ‘Carpet Right’ because there are other furniture/carpet shops in the retail park and a there is a bigger car park. ‘Carpet Right’ is also placed around a busy motorway, so this means that many people passing will know that there is a carpet shop and probably go there in the future. * Where is it? This map shows ‘Lees Heginbotham & Sons Ltd’ symbolised by the ‘A’ marker. This shows the regional area around the shop. As you can see, the shop is near to Manchester and has an excellent motorway link which can enable customers to travel to the shop conveniently. The satellite map above shows ‘Lees Heginbotham & Sons Ltd’ via the green circle. It also shows ‘Spindles Shopping Centre’ by the red circle. The blue circle shows ‘Lees Heginbotham & Sons Ltd’ competition ‘Roll End Carpets’. The map also shows the surrounding area of the shop and the local businesses of the shop. There are also a number of bus stops around the shop; this allows customers to travel to the business easily. There is also a tram link currently being made on ‘Union Street’ and this will then enable customers to travel to the shop easily and quickly. * The shop The picture above shows the front of the shop. As you can see the name of the business is clearly displayed all the way round it. This picture shows the inside of the shop. As you can see there are many rolls of carpets on display so the customers can experience the carpets before they buy it. This picture shows the rear of the shop. As you can see there is a car park for the customers. * The website This is a screen shot of the Google search I did to see how easy it was to find my business on the internet. As you can see it is the fifth business to come up on the search engine so it is very easy for the customers to find it. Here is a screenshot of the home page of ‘Lees Heginbotham & Sons Ltd’. You can see easily one of the types of carpets that they fit and in the bottom right hand corner their shop (the red circle). At the top of the page it shows the tabs which direct customers easily to the relevant section (the green circle). One way that ‘Lees Heginbotham & Sons Ltd’ meets its customer need is by training its staff. They do this so that the staff know how to do their job and deal with any customers. Training them helps the staff to know how to deal with any problems in the business and what to do in different situations. Training the staff also gives them better knowledge of the product itself so that they can advise customers as to what carpet would suit their budget and requirements the best. A second way that ‘Lees Heginbotham & Sons Ltd’ meets customer needs is by the quality of their service. They have to do this to eliminate and exceed whatever their competition is doing. A way that they do this is by giving its customers: free estimating, free carpet removal, a quality fitting to your standard and a free car park adjacent to the shop. By doing this ‘Lees Heginbotham’ can add this to and advertisement and this will increase customer satisfaction. A third way that ‘Lees Heginbotham & Sons Ltd’ meets customer needs is by dealing with any complaints from customers. If there are any customer complaints ‘Lees Heginbotham & Sons Ltd’ will have to deal with it immediately. ‘Lees Heginbotham & Sons Ltd’ will have to be polite with the customer even if they are not. If ‘Lees Heginbotham & Sons Ltd’ deal with a customer complaint quickly this might increase customer satisfaction.

Tax Income Payers - Free Essay Example

Sample details Pages: 5 Words: 1523 Downloads: 5 Date added: 2017/06/26 Category Finance Essay Type Research paper Did you like this example? TAX CUT POLICY ON PUBLIC DEBT Tax cut policy is reducing the rate of tax imposed by government. According to the economic theory, the immediate effect of tax cut is reducing real income that the government gets and increasing the real income of people whose tax rate was lowered. In the long run, there may be a reverse in effect on government income which depends on response of tax payers. Depending on the tax rate that was originally charged, a cut in tax provide corporations and individuals with incentives for investment which increase economic activity that even if the tax rate is low, the net tax revenue collected will be more. In general, macro-economic effects of tax cut are not predictable in the long run. This is because, they depend on the way tax payers make use of their additional income and how government adjusts when its income reduces. There are three idealized scenarios which are hypothesized. The first one is that, when government cuts expendi ture, the expenditure of tax payers increase and they spend more money on commodities that come from within the country. Macro economically, this combination is neutral but the free market economy advocates argue that economic welfare is improved, since people are more accurate than government by buying commodities they actually want. (Blundell, 1998). The other scenario is that, government maintains its expenditure and tax payers increase theirs and spend money on commodities from within the country, the combination brings about stimulus to the economy. Advocates of supply side economies argue that tax cut should lead to growth of the economy and bring about greater prosperity and if it is not managed well, it leads to inflation when government cuts tax and incurs debt in hope that tax cut economic stimulus is large enough to bring about long term increase in tax revenues and paying off the debt in future. If this fails to occur, government is left with severe budgetary crisis. When government maintain expenditure and incur debt, tax payers may save the income that increase or buy commodities from outside the country. This is not an inherently deflationaly condition but contributes to difficulties in balance of payment which have secondary deflationaly effects and results to government budgetary crisis which follows painful readjustments. In practice, a mixture of these effects may occur; the net effect of tax cut depends on balance between them and will be a function of overall state of national economy. (Faive, 1997). Impact of Tax Cut Policy on Public Debt Policy makers have argued that tax cuts which are financed by deficit do not benefit the economy so much. The recent tax cuts have not been of benefit to the economy as much as the economy would be benefited if it had matched by spending cuts. Tax cuts have added federal deficits and there is a burden which is imposed on future tax payers. Supply side tax cuts that reduce distortions in tax c ode spur economic growth and do not create large revenue loss. Any added debts that result from tax cut are compared against the gross domestic products to be generated. Supply side tax representing long term reforms of federal fiscal system are implemented regardless of current budget balance. By contrast, social policy tax cuts that do not simplify tax code and does not make it more efficient should be avoided and should be considered if they are matched with equal spending cuts. Numerous studies show that supply side tax cuts on the capital income benefit the economy. The taxation study committee presented results of macroeconomic simulation of personal and corporate income tax cut. It was found that, if cut in corporate tax rate was matched by spending, United States output was boosted twice as much in the long run as individual rate cut on the same magnitude of dollar. There are large positive growth effects if tax cut is offset by cutting the spending in order to avoid d eficit from increasing. Since the year 2001, federal tax legislation has mixed social policy cuts and supply side. Supply side tax cut represents 55% of recent tax cut which included reduction in individual rates, capital gain and dividend tax cuts, liberalization of savings account and small business expensing. The 45% tax cut is on social policy including 10% bracket of income tax and education tax benefits. Fiscal policies support recovery but return to large deficits is our major concern. When budget projections show large fiscal deficits over the next decade, recent emphasis on tax cut, security outlays and economic recovery come at eventual cost of interest rate having an upward pressure and crowding out of private investments and erosion of growth in productivity. Evaporation of surpluses of fiscal policy make budget less prepared to cope with retirement and put massive pressure on Medicare systems and social security with no cushion provided by earlier surpluses, there is no much time to deal with problem of insolvency before deficits of the government and there is increase in debt unsustainably leading to urgent need for meaningful; reform. (Blundell, 1980). Tax cut has long run supply side benefit and help mitigate budgetary costs. Federal deficits and ratio of debt to gross domestic product that are projected are manageable and remain below peak levels recorded in 1980s and early 1990s. The tax system puts disproportionate burden on corporate personal income, if compared with tax system that is consumption based, labor market saving and participation is discouraged and hence, less efficient economically. Discussing the Difference between Public Debt In neoclassical growth model, government controls both monetary and fiscal instruments which control supply of savings and demand for capital. In the equilibrium model, there is no relationship between economys capital intensity and inflation rate as measured by capital labor ratio or real interest rate. For these models, capital intensity is invariant to inflation rate if and only if indebtedness of government is insulated from inflation through compensatory action which is suitable either by central bank or government treasury. Conditions of neutralizing changes public debt and money are clarified. Capital intensity can not be engineered to every degree because available asset monetization by bank is finite and viability of money has an upper bound on the money rate of interest, through virtue of possibility of inflation, though we cannot drive money interest rate to zero. The government can choose capital, money interest or real money which is drawn fully for one of the models. Equilibrium theory of rate of inflation is constant with static models where level of price is homogeneous of degree one in the liquid and government has interest bearing obligation. Restrictive credit policy brings about recession in short run and has uneven effects in the long run o f the economy. Stabilization of prices should not depend on Federal Reserve policies but in order to stabilize prices, it relies on entire policy tools. Together with having the right tools and moral force of nation declaring the purpose of stable price level, there is need for improvement. (Kogan, 2003). Current Statistics on These Debts In February 2008, current budget of public sector had a surplus of $2.0 billion compare to surplus of 0.7 billion in February 2007. If we concentrate on one month isolation, we can get distorted picture because the movements are erratic. If we focus on financial year, we can get better overview. Between April 2007 and February 2008, public sector had a deficit of $ 5.7 billion and at same stage in 2006/2007 financial year, deficit was $3.0 billion. In general, there was deficit in public sector between 1991/1992 and 1997/1998 before getting surplus in 1998/1999. There has been deficit that has been recorded since 2002/2003. There was net b orrowing of $2.9 billion in February 2008 which compares to 2.5 billion in February 2007. The budget forecast was $36.4 for 2007/2008 which is net borrowing. Public sector net debt as percentage of gross domestic product was 36.0% in February 2008 compared with 35.5% in February 2007. Debt peaked at 43.8% in 1997. There was a steady fall of debt ratio when there was improvement in public sector finances where it reached a low of 29.8% in February 2002 and it has risen since then. In end of March 2008, debt forecast was 37.1%. There was net debt of $516.4 billion by end of February which compared with $481.96 billion one year earlier. At the end of March 2008, net debt budget forecast was $534.5 billion. The total public debt of United States called nation debt is the amount of money us federal government owns for creditors who hold their debt instruments. Debt which is held by public is federal debt held by individual, corporations, states and foreign government but not intergove rnmental debt obligations held by social security. The securities held by public include treasury bills, bonds, notes and state series securities. As at April 2008, total federal debt of United States was approximately $ 9.5 trillion, 79,000 dollars for each taxpayer in America. Of this amount, $5.3 trillion is debt held by public. If social security and unfunded Medicare are added, the figure rises to $59.1 trillion. In 2007, public debt was 36.8% gross domestic product ranking 65 worldwide. (Faive, 1997). REFERENCES Faive M. (1997). Tax cuts versus government revenue: Mackinac Center for Public Policy. Kogan R (2003): will tax cuts ultimately pay for themselves: Center on Budget and Policy Priorities. Blundell R. (1998): estimating labor supply responses using tax reforms: Econometrical. Don’t waste time! Our writers will create an original "Tax Income Payers" essay for you Create order

Summaries of Fifty Shades of Gray, Dr Jekyll and Mr Hyde,...

The Picture of Dorian Gray The story begins in an artists home in the city of London. The artist, named Basil Howard, is talking with his friend Lord Henry about his newly found inspiration otherwise known as Dorian Gray. They discuss how innocent and handsome he is which of course leads to Lord Henry asking to meet and talk with him. Basil, fearing Henrys potential inluence on Dorian, asks him to leave. As if on some certain que Dorian arrives and meets Lord Henry for the first time. From that point on Lord Henry manages to corrupt Dorian and forever change him to only act upon his own pleasures. Following this Basil completes the portrait of Dorian that he had been working on and presents it to him so that he can take it home for†¦show more content†¦Strange Case of Dr. Jekyll and Mr. Hyde The story begins when Mr. Utterson, Dr. Jekylls lawyer, is on his routine walk with his friend Mr. Enfield. While they are walking they witness this man who (later to be revealed as Mr. Hyde) tramples a little girl. When provoked by an angry crowd Mr. Hyde gives the family of the girl a check written by Dr. Jekyll. Later Mr. Utterson then recieves the news from Dr. Jekyll that Mr. Hyde would recieve his house in the case of his dissapearence or death. Nothing then really happens until the next year. Thats when a politician named Sir Danvers Carew was witnessed getting beaten to death by no other than the evil Mr. Hyde. When Mr. Utterson and his company of police go to Mr. Hydes in search to arrest him he is nowhere to be found. In the meantime Dr. Jekyll is feeling pretty great. He sets up a ton of Gatsby like parties that a lot of people attend including a man named Dr. Lanyon. Until one day both Dr. Jekyll and Dr. Layon both fall ill. Before he dies Dr. Lanyon gives Mr. Utterson a sealed document explaining to him to open it only if Dr. Jekyll dissapears or dies. A few weeks later Dr. Jekylls butler comes o Mr. Utterson and tells him that he needs to visit Dr. Je kyll because he is really worried about him. They then