Health Policy And The Social Determinants

Health Policy And The Social Determinants INEQUALITIES IN MENTAL HEALTH Introduction and definitions: Mental health is described by the World Health Organization (WHO) as: a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO 2001a, p.1). According to NHS website every year in the UK, more than 250,000 people are admitted to psychiatric hospitals and over 4,000 people commit suicide (http://www.nhs.uk/conditions/mental-health/Pages/Introduction.aspx , accessed 20-4-2010) Mental health inequality is a long standing problem that has been tackled for decades by epidemiologists, sociologists and health professionals. And because this problem has both strong social and health aspect there is no unified approach to identification and resolution. From Sociologists viewpoint inequality with mental health is a problem that has two main explanations: people are poor because they have mentally illness that makes them unable to keep work probably (social selection), or they become mentally ill under the stress of being poor (social causation). However, in modern psychiatry other factors are believed to involve in the etiology such as genetic factors, diet, and hormonal disturbance which interact with personality disorders or emotional state to produce mental illness. The problem of inequality is not only about serious mental illness but we can expand the definition of mental health inequality to include everyday feelings which is considered by United Kingdom Department of Health to be public health indicator: How people feel is not an elusive or abstract concept, but a significant public health indicator; as significant as rates of smoking, obesity and physical activity (Mental Well-being Impact Assessment ,2009) The table below gives examples of those factors that promote or reduce opportunities for good mental health (DOH 2001): MENTAL HEALTH PROTECTIVE FACTORS INTERNAL PROTECTIVE FACTORS EXTERNAL PROTECTIVE FACTORS EMOTIONAL RESILIENCE physical health self esteem/positive sense of self ability to manage conflict ability to learn CITIZENSHIP a positive experience of early bonding positive experience of attachment ability to make, maintain and break relationships communication skills feeling of acceptance EMOTIONAL RESILIENCE basic needs met food, warmth, shelter CITIZENSHIP societal or community validation supportive social network positive role models employment HEALTHY STRUCTURES positive educational experiences safe and secure environment in which to live supportive political infrastructure live within time of peace (absence of conflict) MENTAL HEALTH DEMOTING/VULNERABILITY FACTORS INTERNAL VULNERABLE FACTORS EXTERNAL VULNERABLE FACTORS EMOTIONAL RESILIENCE congenital illness, infirmity or disability lack of self esteem and social status feeling of helplessness problems with sexuality or sexual orientation CITIZENSHIP poor quality of relationships feeling of isolation feeling of institutionalisation experience of dissonance, conflict, or alienation EMOTIONAL RESILIENCE needs not being met hunger, cold, homelessness/poor housing conditions etc. experience separation and loss experience of abuse or violence substance misuse family history of psychiatric disorder CITIZENSHIP cultural conflict experience of alienation discrimination the negative experience of being stigmatised lack of autonomy the negative experience of peer pressure unemployment HEALTHY STRUCTURES value systems effects of poverty negative physical environment Table 1: factors that promote or reduce opportunities for good mental health What is the evidence on mental health inequalities? Socio-economic status: Community-based epidemiological studies across countries and over time have consistently identified an inverse relationship between Socio-economic status and prevalence rates of schizophrenia .The ratio between the current prevalence (defined as period prevalence up to one-year prevalence) of the disorder among low-SES and high-SES people was 3.4, whereas the ratio for lifetime prevalence was 2.4 (Saraceno et al,2005), and in Britain, twice as many suicides occur among people from the most lower SES (Blamey A et al ,2002). There are five hypotheses to explain this relation (Hudson 2005): Hypothesis 1: Economic stress. The inverse SES-mental illness correlation is a speci ¬Ã‚ c outcome of stressful economic conditions, such as poverty, unemployment, and housing unaffordability. Hypothesis 2: Family fragmentation. The inverse SES-mental illness correlation is a function of the fragmentation of family structure and lack of family supports. Hypothesis 3: Geographic drift. The inverse SES-mental illness correlation results from the movement of individuals from higher to lower SES communities subsequent to their initial hospitalization. Hypothesis 4: Socioeconomic drift. The inverse SES-mental illness correlation results from declining employment subsequent to initial hospitalization. Hypothesis 5: Intergenerational drift. The inverse SES-mental illness correlation is a function of declines in community SES levels of hospitalized adolescents between their  ¬Ã‚ rst hospitalization and their most recent hospitalization after turning 18 Age: In elderly: National Institute for Mental Health in England (NIMHE) has reported the following point regarding mental health problems in elderly : 3million older people in the UK experience symptoms of mental health problems the annual economic burden of late onset dementia is  £4.3 billion which is greater than that for stroke, cancer and heart disease combined dementia affects 5% of those aged over 65 and 20% over 80 10-15% of all older people meet the clinical criteria for a diagnosis of depression these numbers are set to increase by a third over the next 15 years (NIMHE, 2009). Mental health problems in elderly often go unrecognised. Even where they are acknowledged, they are often inadequately or inappropriately managed (DH 2005c). The UK inquiry into mental health and well-being in later life (2006) identified five factors that influence the mental health of older people: discrimination (for example, by age or culture); participation in meaningful activity; relationships; physical health (including physical capability to undertake everyday tasks); and poverty. in children : WHO states, that the à ¢Ã¢â€š ¬Ã… ¾development of a child and adolescent mental health policy requires an understanding of well-being and the prevalence of mental health problems among children and adolescents(child and adolescent mental health policy, 2006) However, there is an evidence that levels of distress and dysfunction during childhood are considerably high between 11 per cent and 26 per cent, while the severe cases that require interventions are around 3-6 per cent of people under 16 years of age (Bird et al.1988; Costello et al. 1988). Emotionally disturbed children are exposed to abuse or neglect in their family of origin, with estimates up to 65 per cent (Zeigler-Dendy,1989). Gender: Women and Mental Health Mental health problems are more common among women than men with higher incidence rates of depressive disorder than men (Palmer, 2003). There are many factors to explain this, first: Socio-economic factors such as poverty and poor housing conditions cause greater stress and fear of future amongst women. lack of confidence and self-esteem may be the results of educational factors such negative school experiences , Living in unsafe neighbourhoods cause stress and anxiety amongst women , dependency on prescription drugs (for depressive and sleeping disorders) often leads to anxiety. Men and Mental Health Men tend to be more vulnerable to mental health problems and suicide than ever before due for a number of reasons including: Men in general are less likely to talk about their problems or feelings or to admit that they have depression. Men are less likely to seek help for mental and emotional health problems. Unemployment has a greater impact on men in general. Some mental disorders are more serious in men for example suicide is the leading cause of death among young men. The rate for young men aged 10-24 years is higher among those from deprived communities compared with those from affluent communities. Men also experience earlier onset of schizophrenia with poorer clinical outcomes (Piccinelli, 1997) Risk groups for mental illness in men include (DHSSPS,2004): Older men: they are less willing to use health services because of the perception that these services are for older women. Divorced men because they have less support available from family , and services designed to meet the needs of this group is particularly. Male victims of domestic abuse -especially boys in rural areas. Gay and bisexual men few services are available to help men deal with problems such as homophobic bullying and harassment. Male survivors of sexual abuse lack of co-ordinated support for adult survivors of abuse Fathers despite examples of good practice, men have comparatively less access to support services than women, to enable them to cope with the stresses of parenthood. Bereaved men lack of appropriate services specifically targeted at men who have experienced bereavement. Men in rural areas particularly isolated in terms of service access. Young offenders inadequate psychological services in juvenile justice centres despite the high proportion of young people entering the juvenile system with a range of mental health problems. Ethnic group: A review by Commission for Healthcare Audit and Inspection,( Count me in, 2009) noted that Rates of admission were lower than the national average among the White British, Indian and Chinese groups, and were average for the Pakistani and Bangladeshi groups. They were higher than average among other minority ethnic groups particularly in the Black Caribbean, Black African, Other Black, White/Black Caribbean Mixed and White/Black African Mixed groups with rates over three times higher than average, and nine times higher in the Other Black group. Employment Status and Mental Health Having a job helps to maintain better mental health than not having one, but this is not always true as many factors involve For example, jobs which are unsatisfactory or insecure can be as harmful to health as unemployment (Wilkinson et al , 2003). Anxiety about job security, lack of job control, perceived effort-reward imbalance, negative relationships in the workplace, including bullying and harassment can have negative mental health consequences. According to OSC Health Inequalities Review (2006) people with a common mental disorder are five times more likely to be unemployed, and if they have work they are more likely to be excluded, people with an identified mental health problem are twice as likely to be on income support and four to five times more likely to be getting invalidity benefits. A person with a diagnosis of a psychotic illness leaves him with only a one in four chance of being in employment. Geographic variation: Studies result on geographic variation of mental illness are inconsistent , for example Hollie has concluded that In mental health problems there is substantial variation at the household level but with no evidence of postcode unit variation and no association with residential environmental quality or geographical accessibility. It is believed that in common mental disorder the psychosocial environment is more important than the physical environment (Hollie et al, 2007) On the other hand, a recent Swedish study of 4.4 million adults found that the incidence rates of psychosis and depression rose with increasing levels of urbanisation (Sundquist K.et al.,2004). Another study by Royal Commission on Environmental Pollution shows that people from densely populated areas had a 68-77% and 12-20% higher risk of developing any psychotic illness and depression respectively when compared to a control group in rural areas. Within urban areas the rates for psychoses map closely those for deprivation and the size of a city also matters; in London schizophrenia rates are about twice those in Bristol or Nottingham (Royal Commission on Environmental Pollution, 2007a, 2007b). Disability and Mental Health: Definition: According to Disability Discrimination Act (1995) (DDA) A person has a disability if he has a physical or mental impairment which has substantial and long-term adverse affect on his ability to carry out normal day to day activities In the light of this definition we can focus on mental health inequality of three groups of people: à ¢Ã¢â€š ¬Ã‚ ¢ People suffer socio-economic disadvantage caused by stigma and discrimination associated with their mental health problems. à ¢Ã¢â€š ¬Ã‚ ¢ People with both mental health problems and physical disabilities. à ¢Ã¢â€š ¬Ã‚ ¢ People with physical disabilities, whose experience discrimination and stigma because of their physical impairment and become mentally ill because of this experience. Disabled people are more likely to experience stress and emotional instability than those who are not disabled. a report by the Equality Commission for Northern Ireland (2003) has found that whilst 34% of those who were not disabled had experienced quite a lot or a great deal of stress in the last 12 months prior to the survey, the percentage rose to 52% for disabled people. Experiences of depression within the last 12 months were higher among women who were disabled (44%) than men (34%). Conclusion: Inequality in mental health is as important as any other form of health inequality, however the interaction between social and personal level in mental illness makes it more difficult to address different kinds of mental health Inequalities associated with it. Question 2 : word count (2000) Tackling inequalities in mental health Introduction: Mental illness, among other disorders, is widely considered as a significant determinant of both health and social outcomes and many studies have spotted mental health disorders as both consequence and cause of inequalities and social exclusion. Mental health diseases have two distinct characteristics as a public health problem: first very high rates of prevalence; secondly : onset is usually at a much younger age than for other health problem , Mental health diseases effects all areas of peoples lives : personal relationships, employment, income and educational performance. (Friedli and Parsonage , 2007; McDaid , 2007) Who is at risk for mental health problems? Defining risk groups enables policies makers to determine how to manage available resources to achieve better health equality. Furthermore, these groups are the main targets for health equality promotional programs. A review of recent evidences on mental health inequalities can help to define the large groups at risk: à ¢Ã¢â€š ¬Ã‚ ¢ People living in institutional settings: such as care homes or those in secure care or subject to detention. à ¢Ã¢â€š ¬Ã‚ ¢ People living in unhealthy settings and who may not be reached by traditional health care such as veterans or the homeless. à ¢Ã¢â€š ¬Ã‚ ¢ People with physical and/or mental illness, people misusing drugs, people with alcohol problems, people who are victims of violence and abuse. à ¢Ã¢â€š ¬Ã‚ ¢children whose parents have problems with alcohol or with drugs, children whose parents have a mental illness and looked after and accommodated children, à ¢Ã¢â€š ¬Ã‚ ¢ People from groups who experience discrimination. Key policies: These policies can be long term policies focusing on deep change over long period or short term seeking fast results such as health promotion. Long term aims: Inequalities in mental health are not only about equality of access, but also about quality of access. In the year 2009 Mental Health Foundation has published a report on resilience and inequalities in mental health (Mental Health, Resilience and Inequalities ,2009) This report mentioned four priorities for action: 1-Social, cultural and economic conditions that support family life: This can be done by reduce child poverty , parenting skills training and high quality preschool education , increasing access to safe places for children to play, especially outdoors, inter-agency partnerships to reduce violence and sexual abuse. 2- Education that helps children both economically and emotionally by: schools health promoting programs, involving teachers, pupils, parents and supporting parents to improve the home learning environment (HLE) support social, sports and creative achievements, as well as academic performance 3- Reduce unemployment and poverty levels and promote and protect mental health by: Supporting efforts to improve pay, work conditions and job security. Facilitate early referral to workplace based support for employees with psychiatric symptoms or personal crises to prevent employment breakdown. 4- Tackle economic and social problems, which cause the psychological distress. Such as housing/transport problems, isolation, debt, beside that art and leisure centres can help to reduce stress too. However, these strategies take long time to be effective, that means the need for more rapid actions or short term aims. Short term aims: Mental health promotion: To build an effective strategy to promotion for health equality the following points should be achieved: à ¢Ã¢â€š ¬Ã‚ ¢ Comprehensive: Mental Health promotion is not only the responsibility of health services alone; other sectors of society should join that effort. à ¢Ã¢â€š ¬Ã‚ ¢ Based on evidence à ¢Ã¢â€š ¬Ã‚ ¢ Based on the needs of the local communities, and with the agreement of these communities. à ¢Ã¢â€š ¬Ã‚ ¢ Subject to evaluation: The strategy should be subject to critical evaluation and can be changed when necessary. A good example of such strategy is the Mental health national evidence based standards which have been issued by The National Service Framework for Mental Health (DOH 1999). The purpose of these standards is to deal with mental health discrimination and social exclusion associated with mental health problems. And that can be achieved by promotion: promote mental health for the whole society, working with individuals and communities Stop discrimination against individuals and groups with mental health problems, and take steps towards better promotion for their social inclusion. Tackling inequalities for special risk groups: The Suicide prevention strategy: One of the best example is the strategy based on work by (DOH 2002) and The NSPSE (National Suicide Prevention Strategy for England), the report was the result of literature review of suicide prevention programs around the world and has reached the following goals: 1. To reduce the risk in key high-risk group. 2. To promote mental well-being in the wider population. 3. To reduce the availability and lethality of suicide methods. 4. To improve the reporting of suicide behavior in the media. 5. To promote research on suicide and suicide prevention. 6. To improve monitoring of progress towards the target for reducing suicide. Women and Mental Health: Preventing: The results of UK-based survey (Williams, 2002) shows that mental health services for women: Do not meet womens mental health needs. Can replicate inequalities. Can be unsafe for women. Can be insensitive to the effects of gender and other social inequalities, such as race, class and age However, in their response to a survey conducted in England and Wales, women said that they wanted services that: à ¢Ã¢â€š ¬Ã‚ ¢ Keep them feel safe. à ¢Ã¢â€š ¬Ã‚ ¢ Promote empowerment, choice and self-determination. à ¢Ã¢â€š ¬Ã‚ ¢ Place importance on the underlying causes and context of their distress in addition to their symptoms. à ¢Ã¢â€š ¬Ã‚ ¢ Addressee important issues relating to their roles as mothers, the need for safe accommodation and access to education, training and work opportunities. à ¢Ã¢â€š ¬Ã‚ ¢ Value their strengths, abilities and potential for recovery. (DH, 2002a) These points are important to build a need-based action plan for better equality in health services. Men and Mental Health: Preventing: The Equal Minds conference workshop which had special focus on men and mental health listed five service design features targeted at mens mental health and well-being (equal minds, 2005): à ¢Ã¢â€š ¬Ã‚ ¢ Accessibility and flexibility of services regarding time, location. For example, Select places familiar for men, Men Only sessions run by male staff, make use of some activities, such as sport and physical activity programmes. à ¢Ã¢â€š ¬Ã‚ ¢ Holistic approach, works on the person as a whole, not just on mental health. à ¢Ã¢â€š ¬Ã‚ ¢ Early intervention to prevent anxieties and concerns build up, especially in stress and anger management. à ¢Ã¢â€š ¬Ã‚ ¢ Trust and confidence are important to solve problems of identity and role that can underlay mens anxieties and self-perceptions or lack of self-esteem. Ethnicity and Mental Health: Preventing: The main problem in this field was the barriers to access services. Barriers include: à ¢Ã¢â€š ¬Ã‚ ¢ Language. à ¢Ã¢â€š ¬Ã‚ ¢ Stereotyping. à ¢Ã¢â€š ¬Ã‚ ¢ Lack of awareness or understandings of mental illness. The report Inside Outside (Sashidharan, 2003) which addresses mental health services for people from black and minority ethnic communities in England and Wales. Suggest that patients from all minority ethnic groups are more likely than white majority patients: à ¢Ã¢â€š ¬Ã‚ ¢ To follow aversive pathways into specialist mental health care. à ¢Ã¢â€š ¬Ã‚ ¢ To be admitted compulsorily (there are differences also between ethnic groups at all ages). à ¢Ã¢â€š ¬Ã‚ ¢ To be misdiagnosed. à ¢Ã¢â€š ¬Ã‚ ¢ To be prescribed drugs and Electroconvulsive therapy (ECT), more than talking therapies. à ¢Ã¢â€š ¬Ã‚ ¢ To have higher readmission rates and stay for longer periods in hospital. à ¢Ã¢â€š ¬Ã‚ ¢ To be admitted to secure care/forensic environments. à ¢Ã¢â€š ¬Ã‚ ¢ Their social care and psychological needs are less likely to be addressee within the care planning process. à ¢Ã¢â€š ¬Ã‚ ¢ To have worse outcomes. A strategic approach in Ethnicity and Mental Health: In England and Wales a framework have been developed for action for delivering race equality in mental health (DH, 2003b) The framework focuses on three building blocks which are essential to improved outcomes and experiences of people from black and minority ethnic communities: à ¢Ã¢â€š ¬Ã‚ ¢ Information of better quality and more intelligently used. à ¢Ã¢â€š ¬Ã‚ ¢ Services which are more appropriate and responsive. à ¢Ã¢â€š ¬Ã‚ ¢ Increased community engagement In other words any approach should take in consider both quality of health services and the socio-economic disadvantages experienced by people from ethnic communities. Some suggested steps for this approach may include: Providing interpretation and translation services beside mental health service to insure highest possible quality. Adopting equalities practice in mental health services, that mean better understanding for cultural identity, the impact of racism, and culture differences in expression of mental distress. Developing assessment and diagnostic tools that can better assess patients from different backgrounds and ethnicities. Ensuring that services understand and respect spiritual requirements for different cultures. Ensuring access equality to culturally appropriate services including, counseling, psychotherapy and advocacy. Addressing common problem for people from black and minority communities, such as housing, employment, welfare benefits, and child-care. Disability and Mental Health: people with disabilities may experience high levels of socio-economic disadvantage due to discrimination and stigma , this group need a special interest regarding mental health services , they are liable for what Rogers and Pilgrim (2003) described :inequalities created by service provision. Mental health services for disable people should be customized to their needs, some recommendations for such services may include: Promotion for mental health, well-being and living with disability. Early intervention: for people who show symptoms for possible mental illness. Personalised care based on individuals needs and wishes Stigma: work for better social inclusion and tackling stigma and discrimination associated with some disabilities. Elderly and mental health: In order to achieve better equality for this group, policy makers should insure better access to mental health services on the first place. In the year 2005 the Department of Health published a report titled Securing Better Mental Health for Older Adults to launch a new programme to bring together mental health and older peoples policy in order to improve services for older people with mental health problems. The National Directors for older people and mental health promoted the dual principles of: à ¢Ã¢â€š ¬Ã‚ ¢ Delivering non-discriminatory mental health and care services available on the basis of need, not age and à ¢Ã¢â€š ¬Ã‚ ¢ Holistic, person-centred older peoples health and care services which address mental as well as physical health needs Here, it is essential to emphasis the importance of specialist mental health service for older adults. Sexual Orientation and Mental Health: In this group health promotion plays a great role to address the mental problems associated with sexual orientation. PACE organization has drawn up a set of practice guidelines for working with lesbian, gay and bisexual people in mental health services (PACE guideline.2006). The guidelines suggest promoting services and resources specifically for LGB people, including services such counselling and advocacy provided by LGB organisations. In response to these guidelines and studies about LGB such as (McNair et al, 2001). Mental health services for LGB people should: Reflect upon the homophobia and heterosexism that LGBT people may experience within mental health services. Enhance awareness of LGBT people problems, and the forms of discrimination and social exclusion they may face. Consider the nature of a culturally competent for LGBT people Preventing in Mental Health Problems: people with mental health problem are in need for resilience factors that enable them to recover from mental distress and to fight the effects of discrimination and stigma, we can name some of these factors such as confiding relationships, social networks, self-determination, financial security, however, support health services are essential for individual recovery and to achieve socially inclusive accepting communities (Dunn, 1999). Examples for these services can be found in report on Mental Health and Social Exclusion which has been published by Social Exclusion Unit. The report included a 27-point Action Plan aimed at tackling stigma and discrimination, focusing on the role of health and social care in addressing problems of social exclusion, unemployment, and supporting families and community participation through ensuring access to goods and services such as housing, financial advice and transport (SEU,2004). Beyond this report, it is important that policy makers be aware of connection between inequalities and mental health as a result and a cause, this will encourage more holistic approach that aim prevention on the long run. Conclusion: It is essential to put the different recommendations on mental health inequalities into everyday practice , for example a recent study by Glasgow Centre for Population Health found that policies are not driving practice for reducing inequalities in mental health within primary care, and the primary care organization studied is not conducive to addressing inequalities in mental health. (Craig, 2009). For that reason, it is the responsibility of government, health services and health professionals to put these strategies and plans into action to insure a better and healthier society.

Different Perspectives of Psychology Essay

What is psychology and how can people understand it better? Psychology is a scientific term used to understand how the mind and body works together. It is also the studying of human behavior and the understanding of other people’s thoughts and behaviors as well. To comprehend psychology and how it has evolved since its beginning, people need to know and comprehend some perspectives or theories that have been used in the past. Some examples of the different theories are: behaviorism, cognitive, humanistic, structuralism and psychodynamic. By having a basic knowledge of the different perspectives, it will help us have a better understanding of how psychology works today. HISTORY OF PSYCHOLOGY Throughout history, people have been curious about the mind and how it works. It all started around the fifth century B.C., when there was a great debate over the mind-body concept. There were many questions on whether or not the body was connected with the mind, and if they were connected, how was it possible. Plato and Aristotle, who were Greek philosophers, had two different views of this concept. Plato claimed that the mind and body were two separate parts and it would remain the same even after death. He also believed that when people are born they will possess all the knowledge they will ever have in their lifetime, and during their life the education they receive will be based on what they already knew. Aristotle, on the other hand, had the total opposite view compared to Plato. He felt that the body and mind were interlinked together and were made of the same matter. He also thought that the knowledge was not inborn, but instead it was due to the lack of experience or understanding in the world (Editorial Board, 2011). Aristotle believed that all matter which includes the human body was made up by four key components. These components were called: earth, air, water, and fire; they were known as the pillars of science. Through the use of scientific technology, which started around late 19th century, psychology spread to the studies of understanding the mind and how it works. By 1879, a doctor named Wilhelm Wundt started the very first scientific research laboratory in dealing with psychology in Leipzig, Germany. Wundt used a method known as introspection to help better understand why a person would do a certain action, and he was also known to be the founder of structuralism which is one of the theories used in psychology (Editorial Board, 2011). PERSPECTIVES OF PSYCHOLOGY BEHAVIORISM Behaviorism is a perspective that was discovered by a Russian physiologist named Ivan Pavlov. It shows that learning can be taught through rewards or punishments which are related with a certain behavior. His studies showed that dogs would be salivating because they heard the ringing of the bell which was associated with their food. He thought it was a definition of learning and so the behaviorist approach was born. Other psychologists, such as John Watson and B.F. Skinner, had a strong hand in developing the behaviorism perspective (Editorial Board, 2011). Skinner believed that behaviorism had changed dramatically since it was first introduced by Pavlov. Skinner introduced the behavior analysis concept into the psychology field. He also established himself in the contribution of behaviorism by introducing his concept of operant behavior by publishing an article called The Behavior of Organisms in 1938. Skinner was known as the main representative for behavior analysis, and behaviorism was shaped from the works of Skinner. From the 1950s to the 1980s, American psychology was believed to be shaped by Skinner’s work more than any other psychologists during this period (Watrin & Darwich, 2012). PSYCHODYNAMIC Psychodynamic is a perspective in psychology that was discovered by a medical doctor named Sigmund Freud. It shows that hidden or unconscious thoughts could be the cause of present traumas or aliments, and by remembering them it would usually more often than not relieve their troubles and cure them. Freud also used psychoanalysis on his patients to help figure out what was going on with them. Psychoanalysis is a process where the patients would talk about their problems and try to figure out what was going on with them. There were a couple of other psychologists who made some contributions to the psychodynamic theory who were known as Neo-Freudians. Neo-Freudians are people that are psychologists who will give a lower profile to Freud’s work about the sexuality part of the psychodynamic theory, but still help to further the cause of the theory (Editorial Board, 2011). Karen Horney was one of those people. She believed that to have a healthy relationship, you need to be raised with trusting relationships with dependable parents that would meet the needs of security for their children. She is known to be the first women to study the field of psychology through a women’s point of view (Editorial Board, 2011). An example would be if someone was afraid of a long-term commitment and they did not understand why, you could use the psychoanalysis approach which is part of the psychodynamic perspective and figure out why. By using the psychodynamic theory, a person could find out that because of a the person’s father leaving them at a young age it could cause them to be afraid of a long-term commitment and by addressing this problem they could resolve their issues and move on with their new life. Even though many people have contributed to the development of psychodynamic theory, it has been popular because of Sigmund Freud who had made the most noteworthy influence to the theory and also to psychology itself (Editorial Board, 2011). HUMANISTIC The humanistic theory was introduced about two centuries ago through the writings of J.C.L. Simonde de Sismondi. It deals with how the person has basic needs that need to be met and those needs are: material, social, and moral. These needs deal with the physical aspect rather than the mind. The works of Sismondi were more basic than the works of Abraham Maslow, who developed the hierarchy of basic needs. The Maslow’s hierarchy of basic needs is elaborated more than the works of Sismondi and it is considered to be a facilitator for the humanistic perspective and a role for security for human development (Humanistic Perspective, 1999). He also felt that if the person did not satisfy all of their basic needs, then they cannot recognize their gifts to their fullest (Editorial Board, 2011). Carl Rogers was an innovator in the field of humanistic psychology and he advocated a medicinal technique called client-centered therapy. He believed that all people have an interior core, or true self, and that it can be unclear if a person is absentminded with increasing the approval of other people. He also believed in using unconditional empathy or approval and understanding which is known today as active listening (Editorial Board, 2011). Making sure a person has the basic necessities like food, water, air, shelter, and sleep, then a person is on the right path for self-discovery and using the humanistic theory could help with it as well. SIMILARITIES AND DIFFERENCES SIMILARITIES BETWEEN THE PERSPECTIVES 1. They are each a force in psychology 2. They each have a relationship between the patient and the therapist 3. They each had a specific person that contributed to each of the perspectives DIFFERENCES BETWEEN THE PERSPECTIVES 1. They each deal with a different part of the body or mind 2. They each had a different contribution to psychology 3. The therapists uses different types of theory for each of the perspectives CONCLUSION Psychology is a fascinating field that studies the mind and how it works. It is important to have a basic knowledge about psychology, no matter what profession a person has. Everybody works with people, and having the understanding and knowledge about people and what they think will come to be valuable. Understanding the history of psychology and the perspectives that have contributed in developing the field of psychology today is important to any person who will be working with other people. References Editorial Board. (2011). Introduction to Psychology. Words of Wisdom, LLC. Retrieved from http://wow.coursesmart.com/9781934920565/id0002#. Humanistic Perspective. (1999). In The Elgar Companion to Consumer Research and Economic Psychology. Retrieved from http://www.credoreference.com/ entry/elgarcrep/humanistic_ perspective Watrin, J., & Darwich, R. (2012). On behaviorism in the cognitive revolution: Myth and reactions. Review Of General Psychology, 16(3), 269-282. doi:10.1037/a0026766 Retrieved from: http://search.ebscohost.com.proxy.cecybrary.com/login.aspx?direct= true&db=pdh&AN=gpr-16-3-269&site=ehost-live

English as a Second Language in Thailand Education

The importance of English as a world language, the advance of technology and education reform envisaged by the new Thai Constitution are key determinants for new developments for English language teaching and learning in Thailand in this decade. This paper will first focus on the role of English and the problems of English language teaching in Thailand. It will also touch on the part of education reform which is related to English language teaching. Then, it will state what has been planned or already done to improve the English language teaching and learning situation in Thailand, now and in the future. The role of English in Thailand is quite important as it is in many other developing countries. New technology and the adoption of the internet have resulted in a major transition in terms of business, education, science, and technological progress, all of which demand high proficiency in English. With the economic downturn in Thailand a few years ago, a large number of Thai companies have embraced cooperation regionally and internationally. Mergers, associations, and takeovers are common and English is used as the means to communicate, negotiate and execute transactions by participants where one partner can be a native speaker of English or none of the partners are native speakers of English. However, Thailand has always been a country with one official language, Thai. We are proud that we have never been colonized. Another reason for having been a country with one language is the concept of national stability. There have been proposals to make Thailand a country with two languages, Thai and English, but this has never materialized due to the abovementioned reasons. English can, therefore, be at most the first foreign language that students must study in schools. Hence, Thais’ level of English proficiency is low in comparison with many countries in Asia (e. g. Malaysia, Philippines, and Singapore). According to the speech given by the Minister of the Ministry of University Affairs on March 6, 2000, the average TOEFL scores of Thais are the same as for Mongolians but higher than for North Koreans and Japanese. Researchers on the topics of needs and wants of English in workplaces have also suggested that the English curriculum in Thai universities cannot meet the demands for English used in the workplace. The skills used most at this level are listening and speaking which are not the focus skills in the Thai tertiary education English curriculum. It can be said that up to now English language teaching in Thailand has not prepared Thais for the changing world. Thailand will lag behind in the competitive world of business, education, science and technology if the teaching and learning of English is not improved. Here are some comments concerning the importance of English and the problems of English language teaching in Thailand. Dr. Rom Hiranyapruek, director of Thai Software Park, stated that English is as important to the domain of information technology as other infrastructures. Thais have high proficiency in technology but because of our below average English competence, we cannot make much progress in terms of science and technology. Mrs. Arunsi Sastramitri, director of the Academic Training Section of the Tourist Authority of Thailand, stated that tourism is the main source of inc ome in our country. However, Thai graduates who are in the tourism industry have a poor command of English. This has contributed to misunderstanding and a negative attitude towards Thailand. 2 What has caused the difficulties in English language teaching and learning in Thailand especially in the primary and secondary schools? According to Biyaem, 1997, the teachers and learners face the following difficulties: For teachers, there are many obstacles such as : – heavy teaching loads. – too many students in a class (45 – 60) – insufficient English language skills and native speaker cultural knowledge. – inadequately equipped classrooms and educational technology. university entrance examinations which demand a tutorial teaching and learning style. As for the learners, they wish they could speak English fluently but most of them think that English is too challenging for them to be competent because of these difficulties: – interference from the mother tongue (Thai) particularly in pronunciation, syntax, and idiomatic usage. – lack of opportunit y to use English in their daily lives. – unchallenging English lessons. – being passive learners. – being too shy to speak English with classmates. – lack of responsibility for their own learning. However, it is not only the level of English competence that inhibits Thailand from being able to keep pace with the rapid changes that are taking place everywhere around us, Thai education, as a whole, does not enable Thais to cope with this fast changing world. Thailand’s new constitution, adopted in 1997 has, therefore, established the National Education Act which creates the most radical education reform in Thai history. This education reform to be implemented between 1996 and 2007 involves four main areas: school, curriculum, teacher and administrative reform. Its main concern is that learners have the ability to learn and develop. Learners are the most important component and lifelong learning must be encouraged. A twelve-year basic education will be provided free to all Thai students. In 2005, there will be an Office of Quality Assurance, whose task is to oversee the quality control of education at every level and in every aspect. Schools are to be given more autonomy. There will be greater involvement by families and local communities in school policy and administration. An independent and learner–centered approach is a must, and analytical learning instead of rote learning will be incorporated. Teacher education will also be a focus. Teachers will have to undertake research and develop teaching abilities as well. With the importance of English as a world language and the changes that come with the National Education Act, plus the challenges of new technology, what follows will discuss the English language teaching and learning scenario in Thailand in this decade. 1. More international programs As of last year, there were 56 international schools around the country. There were three foreign colleges and universities in Thailand. In private Thai universities, there were 77 undergraduate, 30 graduate and five Ph. D curricula using English as the language of instruction. In governmental higher education institutions, there were 143 undergraduate, 205 graduate and 77 doctoral international programs in English which have been established either independently by Thai institutes or have links with overseas institutes. It is expected that most new programs to be opened in universities in the future will be international programs.

Blood Wedding By Federico Garcia Lorca - 1485 Words

In 1930s Spain, the ritual of marriage became highly controversial as the 1931 Constitution allowed for divorce to be legal. This caused debate between older and younger generations. The elders of society still had their beliefs deeply rooted in the views of the Catholic Church-, which did not allow for divorce. Nonetheless, the younger generation was more prone to giving into desire and therefore was more open to the idea. The play Blood Wedding by Federico Garcia Lorca insinuates the strong importance of ritual in the 1930s. Due to this, in the play, ritual is revered and ironclad while desire is shunned. When Leonardo comes to the wedding of Bride the clash between desire and ritual is made evident. Nonetheless, ritual is made†¦show more content†¦However, when Leonardo whisks Bride away, ritual is threatened. Lorca also shows how desire should be kept hidden away in society by the running away of Bride and Leonardo being made off stage. He shows that people would rather pretend that desire does not even exist- making their running away hidden signifying that. Additionally, the setting of Act 3 adds to the feeling of desire. Forests have been known in plays to be a place of surrealism. Leonardo and Bride get married in the forest as their ability to be together is like a dream come true for them and it would not be possible anywhere else. In any other place, ritual would have had more precedence and strength because society endorses it due to the beliefs of the Catholic Church. All in all, desire is not imperative to society in the play and in that time period. Blood Wedding portrays ritual excessively; even the title â€Å"Wedding† is a religious sacrament. Thus, it should come as no surprise that Lorca encompasses ritual into the hunting down of Leonardo and Bride. As soon as everyone learns that the two are gone, Mother dispatches people to go look for them and says, â€Å"It’s come again: the hour of blood† (p. 44). From this phrase, one can see that â€Å"the hour of blood† has come before. It is an accepted ritual to hunt down and kill a runaway bride- or anyone who challenges ritual. No one is disturbed by the impending murder because it is a tradition- a way of living. Desire hasShow MoreRelatedAnalysis Of Blood Wedding By Federico Garcà ­a Lorca831 Words   |  4 PagesThe theater â€Å"Blood Wedding† is a folk tragedy which was produced by the Spanish dramatist Federico Garcà ­a Lorca. In this theater, there are five main characters, including Leonardo, the bride, the groom, the groom’s mother, and Leonardo’s wife. The author narrated the story in Episodic plot structure, in which the overall effect is cumulative, we need to see many scenes before we understand what is happening. The story happened on the day of a wedding in a village, among a couple and a man. 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Lorca’s plays aren’t just like any others, he was a success in his time as - â€Å"The plays will be analyzed according to plot and character, which will be combined because Lorca s plays are so well constructed that these elementsRead More So Long A Letter by Mariama Ba and Blood Wedding by Frederico Garcia Lorca1342 Words   |  6 PagesBa and Blood Wedding by Frederico Garcia Lorca Thesis: Characters that cause immense pain to another, especially to their consorts, succumb to death in the texts So Long A Letter and Blood Wedding by Mariama Bà ¢ and Federico Garcà ­a Lorca respectively. Death is one aspect of life that prevents a person from being invincible. It is one of the inevitable occurrences that a man has to yield to. In the texts So Long A Letter and Blood Wedding by Mariama Bà ¢ and Federico Garcà ­a Lorca respectivelyRead MoreBlood Wedding Analysis765 Words   |  4 PagesThe theater Blood Wedding is based on the tragedy of the Spanish dramatist Federico Garcà ­a Lorca. In this theater, there are five main characters, including Leonardo, the bride, the groom, the groom’s mother, and Leonardo’s wife. The Blood Wedding story happened on the day of a wedding in a village. A wealthy family has a large vineyard and the youngest son in the family is about to get married. Behind this coming marriage, the bride had been with a young man who’s name was Leonardo for sevenRead MoreFeminist Analysis on Blood Wedding2186 Words   |  9 PagesAnalysis Of Lorca’s â€Å"Blood Wedding† REHANA KOUSAR NIDA SARFRAZ Department of English Government College University, Faisalabad Pakistan Abstract: This study explores Feminism in Lorca’s play, ‘Blood Wedding’. Feminism asserts that women are treated as ‘sex objects’, non-significant other and witches. This study analyzes Blood Wedding at four levels; 1. Biological level 2. Linguistic level 3. Socio-cultural level 4. Psychoanalytical level coined by Elaine Showalter. Lorca deals with womenRead MoreAnalysis Of The Butterflys Evil Spell1826 Words   |  8 Pageshas followed the theme of Maeterlinck’s plays, The Blue Bird with their poetic and symbolist elements, Josà © more Guà ¡rico refers to a poem which Lorca destroyed in which a butterfly falls into the nest of cockroaches, is cared for by their until recovers her health again, young cockroach falls in her love but she flies away after rejecting his proposal. Lorca has followed the next poem The Discoveries of an Adventure onus Snail, in which the story of the snail’s meeting with a colony of ants and the