Developing Primary Mental Health care in Ireland: An analysis of Future Scenario Construction as a m

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Developing Primary Mental Health care in
Ireland An analysis of Future Scenario
Construction as a method to enhance public
mental health nursing.

• Jarlath F. Mc Kenna
• Lecturer in Nursing, School of Health Sciences
• Waterford Institute of Technology

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The burden of neuropsychiatric disorders in each
region of the world
(Murray and Lopez, 1996).
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• Simply to be a human being is to be a futurist
  of sorts.
• (Ogilvy, 1992)(p.26)
• We must always remain in the position of
  beginning. We must always be prepared to rethink
  our most cherished versions of the future.
• (M. Foucault in R. Devetak, 1995, p.46)

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On Definition

• Scenarios were first defined by Kahn and Wiener
  (1967) as
• attempts to describe in some detail a
  hypothetical sequence of events that could lead
  to plausibly to the situation envisaged.(p.262)

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• 1. Analyse elements of a larger problem or may be
  used to produce an impression or picture of
  future developments
• 2. Highlight a larger range of possibilities
  that must be considered
• 3. Force the clinican, researcher, policy maker
  and others to examine unfamiliar futures
  possibilities
• 4. Illustrate these possibilities

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• 5. They force the analyst to deal with practical
  details and dynamics that can be avoided in the
  treatment of abstract theoretical formulations
• 6.    Illuminate interactions (psychological,
  social, economic, cultural, political)
• 7.      Scenarios may illustrate certain
  principles, issues or questions that could be
  lost or ignored
• 8.   Scenarios may provide opportunities to
  compare and contrast outcomes of real past
  events with the present and future
• 9.   Scenarios may also be used as artificial
  case histories and historical anecdotes
  where there are minimal previous exemplars.

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Critique

• Some scenarios may be unjustified
• Analysts must consider both unpleasant outcomes
  and pleasant outcomes of scenarios
• Some scenarios may be divorced from the real
  world resulting in useless, misleading
  information

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Description and characteristics of the approaches
to future scenario contexts
 
Synthetic
Normative
             
Basic Contexts
Alternative Futures
Alternative Futures
Scenarios
Empirical
Intuitive
Scenarios
Morphological
Extrapolative
 
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Scenarios and Visioning

• 1. Developments in the technology sector and
  access to global markets now threatens
  companies and may result in exogenous shocks
  in their operating environments
• 2. Policy arenas need to respond to long term
  needs
• 3. Appropriate new tools are required to
  apprehend the future and link its needs to
  current decisions.

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Identification of the key independent and
dependent variables
Analysis of key roles and strategies
Construction of plausible scenarios on the basis
of assumptions regarding key variables
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New technology Global Information Evidence Based
Practice
New power structures between statutory health
providers and agencies
Significant social and multicultural change and
givens Increased incidence of mental stress and
unwellness
What are the projected needs of Community Mental
Health Care in Ireland 2024?
An evolving model Of Irish Community, culture,Fam
ily and person
Legislative response? Positive Mental Health
response? Primary Care response? Needs
response? Carers response? Intellectual
disabilites response? Children and Adolescent
response? Minority groups response? Specialist
mental health services response?
New relationships within the community environment
How will future generations measure and evaluate
our success?
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Autonomy
Governance
Scenario 1 Scenario 2
Mental Health Care Managers
Community Mental Health Nursing
Scenario 3 Scenario (n)
Interdependence
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Primary Mental Health CareBuilding the capacity
for Mental Health and well-being

• Macro
• Government Interdepartmental team on Public
  Mental Health not simply mental illness
  management.
• Create Meta-Strategy to guide sustained Public
  Mental Health progress at national and local
  level.
• Fixed appropriate exchequer funding to meet
  specific Public mental health targets over a
  twenty year period,2004- 2024.
• National Mental Health Education Convention.
• National Mental Health Council.
• Mental Health Promotion

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Primary Mental Health CareBuilding the capacity
for Mental Health and well-being

• Intermediate
• Develop a health culture that enables
  intra-discilinary partnership and consensus
  building
• Re-build the foundations and th.e potential
  capacity for mental health and well-being.
• Intra-disciplinary mental Health research.
• Community mental health nurses who are clincial
  and advanced practitioners in leading mental
  health Promotion.

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Rebuild through our proactions

• Re-build parenting skills in our local parish
  communites.
• Re- learn how to listen, talk and have meaningful
  relationships with others.
• Re-build the self-esteem and confidance of
  children, adolescents and adults.
• Re-build the capacity for balance, tolerance and
  moderation in our society.
• Re- enhance personal awareness and skills to
  tolerate uncertainty.
• Reject new wave individualism and embrace the
  rebirth of the attributes of Irish Community.

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Rethink our most cherished versions of the future
Primary Mental Health Care Community Mental
Health Nursing buiding the capacity for Mental
Health and well-being in response to a changing
Ireland
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Good Primary Mental Health Policy needs to be
deliverable

• Is it the case that we have developed mental
  health policy which is enormously difficult to
  deliver, either efficiently or effectively ?

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Those who make things happen Those who think they
make things happen Those who watch things
happen Those who wondered what happened Those who
didnt know anything had happened (THE
HUMINGBIRD)