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Question: Write an Essay on Evolution of Mental Health Care. Answer: Mental illness is a medical term in which the thinking ability, cognition, emotional and functioning of daily activities gets disrupted. Schizophrenia, panic disorder, post traumatic stress disorder, bipolar disorder, obsessive compulsive disorder are some of the mental disorders of serious type. This disorder can occur at any stage of life and within any kind of races or economical status. Proper therapeutic plan with active participation of the individual can cure the illness. Therefore in order to understand the theories behind the strategic care planning it is important to have an overview of the historic timeline of mental health care with proper understanding of various forces that have shaped the nursing system of mental illness which will be discussed in this following essay. Historic view of mental health care. Mental illness in 1700s has been thought to be a type of demonic possession or to some it was punishment on religious views and was caged in. Hippocrates was the innovator for the treating the mentally disordered people not based on any superstitious views in the early 5th century. His treatment patterns were based on altering the environment or the occupational type along with use of certain medicines. The superstitions related reasons for the mental disorder persisted in 18th century too. The first opening of the lunatic ward started at Pennsylvania Hospital, Philadelphia in the year 1752 (Deutsch 2013). The latest medicines used at that time were with ice bath till the patients became unconsciousness with regular shock treatment. Draining out bad blood out of the patients body was one of the infamous modes of treatment ending their lives (Sahakian and LaBuzetta 2013). Contributors. The unhealthy and dangerous conditions of the mentally ill patients implanted for administrating better surviving conditions by the activist named Dorothea Dix in 1840s (Nguyen-Finn 2012). She then with the help from the state government established many psychiatric hospitals and also initiated a setting for human therapies and curing them but still there stayed lacunae in training particularly the female attendants in caring the mentally disordered patients. Shock therapies were used on soldiers who experienced psychiatric traumas due to after effect of civil war. With no new treatments available, the treating conditions started deteriorating to miserable conditions again. In the middle of 1800s, 20 hospitals were built for mental health disorder treatment (Williams and Doessel 2017). After 1878, an official system of mental disorder treatment started in Boston College in United States by training the nurses formally based on psychiatric care (Corrigan, Druss and Perli ck 2014). The first school for training the nurses on mental health care was first started in McLean, Massachusetts in 1880 which was bizarre in the beginning (Thomas 2015). The first formal handbook on mental health care was Handbook of Attendants of the Insane published in 1885 (Williams and Doessel 2017). The main aspects of caring was based on Kind and compassion. Peter Nolan in 1993 said that the attendants role of performance varied from centre to centre and the underlying causes and treatment strategies for mental illness was still unknown. Later in 1930, a new act was released named The Mental Treatment Act in which the patients were asked to sign under Psychiatric facilities and made them understand that the patient would be released after they get fit with choices allotted to them (Jones and Sidebotham, 2013). A physician was involved to diagnose along with psychiatric personnel to lay hold the stigma off if any from the facility. Linda Richards was considered as Americas first psychiatric trained nurse. Richards started training centers in several hospitals for the psychiatric nurses in 1899. She provided education to doctors and many other n urses reflecting the mental health nursing values as she believed that the training received by the nurses in the normal hospitals were not enough. Her contributions made a positive effect on the future of the psychiatric nurse named Hildegard Peplau including the other mental health care nurses at present (Townsend 2014). Theories. The various theories regarding the mental health started to abound from 1900. It was Sigmaud Freud who converted the opinions of public relating the mental health based on personality. According to his theory, the mental disorder occurred in individuals whose childhood issues which went unresolved (Shedler 2012). Following him, came the theory of Harry Stack Sullivan, an American psychologist, in which he stated that behavior patterns correlates with the urge to meet ones need by interacting others and trying to neglect the feeling of discomfort (Rutan Stone and Shay 2014). With the advent of several such theories on psychology, public interest started to grow in this area with the need of more professionals for mental health care. The National Mental Health Act was assigned into law on 3rd July, 1946 by Harry Truman, the president at that time. The main objective of this act was to incorporate more research in this illness and provide help to the states to form clinics and treatment institute along with training more educated professionals on mental health (Grob 2014). This recognition of dealing only with mentally disordered patients made the nursing of the mental health care as a profession that is viewed at todays time. In 1970s, standard cares were developed by the American Nurses Association which was to be incorporated by the professionals in this field. The standards recruited effective management of mentally ill patients. The standards implemented acted precursors at present time. This association for the health care nurses started a certification program on nursing in this field for providing special training in psychiatric nursing (Grove Burns and Gray 2012). The Stigma. Addressing mental disorder, the stigma associated to it should be mentioned. It is a phenomenon worldwide that operates by encouraging the general population to stop avoiding or discriminating the individuals with mental disorders (Henderson Evans-Lacko and Thornicroft 2013). With this deinstitutionalization emphasize on considering the mentally ill individuals as the family members and in communities. At present time, physicians and families are focusing more to treat them in a friendly environment rather than admitting them in the mental institute through group therapy. One of the support groups is The National Alliance for the Mentally Ill who not only supports the patients but the members of the family too (Northouse et al. 2012). This action can reduce the cost of treatment and provide wellbeing of the person. But still stigma persists today surrounding the mental health illness that turns the people away from them. Various forces shaping mental health. Mental illness imposes a profound burden on economical point of view both in individual and community level. The individual with mental disorder are usually the poorest as neither they nor their family members can engage in any kind of work. The countries with decreased economical condition face the problems due to lack of mental health care services and poor financial and low social protection as most of their money are spend behind buying medicines. Countries such as Ethiopia, Uganda shows evidence for major depression due to poverty and income variability (Uthman et al. 2014). Some evidential studies have shown that 10% of children and 16% of young individuals experiences mental disorder globally (Thirlwall et al. 2013). In many income-earning countries it has been reported that mental disorders if left untreated in childhood stage can have a long lasting socio economic effect in the adult stage. The consequences were found to be increased cri minal offense, lack of education attainment, lack of employment and difficulties in personal relationships (Houser Belenko and Brennan 2012). The children of mentally disordered parents also get affected laying the impact on education and health development (Wahlbeck and McDaid 2012). The sickness of the parents makes them unaware about their childs well being. The countries with low income faces the major problem due to health crisis where the child either gets deprived from the school or though received education, have impact on their mental health. The inequity starts before attaining adult stage, with 2.5 times more depressed mood within people of young age with declined socioeconomic status (World Health Organization 2014). The prevalence of mental disorders is well addressed in high-earning countries with an increased recognition in the countries with medium and low earning countries. Thus a profound lacuna exists in studies to understand the problems with strategic principals for mental disorders prevention. There are some groups are people who are exposed to enhanced risk of psychiatric disorders due to determinants. Preventive actions for mental health care are a crucial part to improvise the population of the mentally ill people. At present, on historical context the present political, socio, economical and political forces have shaped the conditions of the mental health care. The countries having less political liberty with unstable political environment and poor monitoring services effect the vulnerability within the population of mentally ill (Funk Drew and Knapp 2012). The turbulent determinants affect the mental health which has been demonstrated with the declined and fluctuating life expectan cy reported in Federation of Russia following the fall of Soviet Union (World Health Organization 2014). In between 1992-2001 there was an increased death rate within adults belonging to middle ages which were expected to be due to cardiovascular disorders and sudden injuries leading to death. The underlying cause behind the excess mortality was alcohol misuse and it was evident that psychological factors were the potential pathways for the death (Garcy and Vger 2012.). Analyzing eight countries of Soviet Union formerly should that psychological distress was more prevalent in female than the male individuals. The reasons for mental disorder were linked with social and economical factors that incorporate poverty, lack of education, lack of employment, disabilities, and no such personal support. In a transversal study on socioeconomic status in both the gender was found that social depression was the main cause of mental disorders in Russian Federation and Poland. Apart from social de privation, inequality in the income level can totally deprive the capabilities of the individual person. Income variation can bring out variation in multiple other domains such as education, employment, active participation in the community and health related matters. Analytical based research studies from 26 countries of European Union Territory in between 1970-2007 have showed that with every rise of 1% in unemployment led to 0.79% suicidal cases in people less than 65 years (Frasquilho et al. 2016). Further studies have also revealed that the reason behind the depression was due to unemployment status and insecurities in job were related to mental health. Various cases were evident from Sweden and thereof Spain in between 1980-2005 and showed that in Spain increased unemployment rate was directly correlated with rising suicidal rates in a short term basis. Whereas in Sweden the 1992 crisis on financial terms showed a steep increase in the unemployment rate and was not found to be related with the increased suicidal rates (Blasco-Fontecilla et al. 2012). Legal Policies. At present an increased recognition of population with mental health disorder has become crucial in the socio and economical prospects. The Mental Health Atlas in 2011 has showed that the member states under WHO have created policies regarding the mental disorders the covers 72% population of the world. Along with this, countries weighing 71% have implemented their own plan and about 59% have developed their legislation in mental health care although there lays a significant gap among various countries (World Health Organization 2014). It was noted that countries with high-earning covered 92% of the population in the legislation of the mental health whereas the countries with low income covered only 38% of the population (Engster 2015). It was necessitated to take balanced approach considering both the promotion of mental health and subsequent preventions taking the inequalities in health and social determinants into focus. But the countries thriving through poor earn ing status were found to be exposed more to the problems arising due to mental disorders, the causes being social deprivation, stress levels, increased exposure to violent lifestyle and malnutrition. These are some of the factors that are not looked after by policymakers (Newman and Newman 2017). In the past decades, the government of Australia took the initiative to reflect the issue related mental health and promoted mental health in a positive way. Subsequently, they also approved its National Mental Health Strategy by introducing policies and mental health planning (World Health Organization 2012). Recently, the government of Australia formed a framework to improvise the mental health management by reforming and thereby providing policies of mental health plans. They also considered the education system, employment status, different diseases and cultural diversity (Martinez et al. 2015). Various community related approaches played a vital role by providing support through joined venture in promoting mental health, preventive strategies and interventional settings. The policy developments were found in other regions such as New Zealand and Scotland, where the attention was focused on the social, educational, economical and political features influencing the mental state of the population (Bleich et al. 2012). The mental health with disorders is thus influenced by social, economical, educational and political forces to a great extent. Variation in social status was found to the common reason behind the occurrence of many mental disorders. Thus, if proper care is taken about the daily life conditions starting from prenatal, during childhood to school going age, after that in working age to older age can improvise the population of mental health and hence the risk associated can be reduced. 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