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For People With Learning Disabilities and Mental Health challenges
Organisation: Three Cs that stands for ‘Control and Choice in the Community
This organisation is under operation for over 20 years to provide support for living in Lewisham, Southwark, Greenwich, Newham, Redbridge and Hackney.
Three Cs currently provide community support to 60-70 individuals experiencing learning disabilities, autism and mental health problems.
Types of support provided by the organisation include:
Community Support: For the individuals living on their own with a family, partner or someone to care.
Supported Living: For individuals living on their own or sharing with others, who are being supported to live independently.
Social Inclusion: for the individuals who want to volunteer, want to keep their jobs, want to meet other people, as well as those who wanted to be included in various activities and make new friends.
“Community” can be said to be a group of people who sees themselves or by any outsider as sharing common cultural, religious or other social features, backgrounds and interests, and that forms a collective identity with shared goals” (UNHCR, 2008, p. 14)
Community support is the system that was developed with the intention of providing extended support and assistance to individuals experiencing different forms of mental illness, as well as those who have learning or intellectual disabilities.
Community support services are often private or non-profit organisations that provide and promote services for the people with learning/intellectual disabilities and their families within the communities they live in. This is done in order to promote independence, improve their self-esteem and empower them to participate in the community.
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Health promotion was defined under the Ottawa charter has defined health promotion as the process of enabling people to increase control over and to improve their health. This process involves developing programs that engage and empower individuals to choose a healthy lifestyle and healthy behaviour (Cyril, Smith, and Renzaho, 2016).
Community health promotion is identified as the process of protecting and improving the health of the public, including, individuals and communities Health promotion also includes the planned activities, strategies and programs that are specifically designed to improve target population health outcomes (Fertman and Grim, 2016).
South (2014) informed that health promotion includes the strategies and programs that are focused on using community resources and assets, as the source of positive community capabilities for promoting health and well-being.
Health promotion for people with disabilities is mainly focused on reducing secondary conditions as well as promoting and maintaining functional independence, providing opportunities for social inclusion, and enhancing their quality of life (Scott and Havercamp, 2016).
The main role of a health promotion practitioner is to design, manage and promote health through applying effective health improvement programs and strategies. Health promotion specialists work towards raising the awareness of people within communities towards good health, the significance of adequate diet and the importance of physical exercise (Stellefson et al, 2020).
Health promotion in communities is specifically focused on managing the health behaviour of the target community and bringing improvement in their health and well-being. The role of health promotion practitioners for people with mental or psychiatric disabilities is focused on enhancing an individual’s self-managing skills, removing attitudinal barriers and enhancing participation in community-based programs (Rimmer, and Rowland, 2008).
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Learning and intellectual disabilities are neurological conditions, which significantly interfere with an individual’s ability to store, process and produce information (Scott and Havercamp, 2016). People with learning disabilities and mental health problems are often considered to be at a higher risk of chronic health problems in comparison to the remaining population.
Some significant health-related risk factors include:
Lack of physical activity
Lack of social support
An effective health promotion approach for this population is intended towards reducing disparities and promoting behavioural change (Abdi et al, 2015). Studies shave also identified that health promotion efforts targeting people with disabilities can have a substantial impact on their health behaviour
Community-based services for people with learning disabilities and mental health issues are based on organising and coordinating care around people in their communities and according to their needs.
Professionals working in communities are required to work together across Organisation and organizational boundaries. Evidence has also informed that professionals working within communities have to face clinical complexities and risks. Thus, they should be able to work collaboratively with other specialists to provide individualized care.
Health promotion is considered the most essential method of managing and promoting population health, by employing collective actions.
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Social capital can refer to the values that individuals hold and the resources that they can access and use. Such values and resources are collectively identified as the result of socially negotiated relationships and ties. The central assumption of the social capital theory is that social networks are the most significant and valuable asset.
For people with learning disabilities, and mental health difficulties, social capital could be a valuable network of reciprocal social relationships that could be accessed for support and inclusion (Mithen et al, 2015).
Social capital is identified as an important element for understanding communities, for working with them, as well as for developing new strategies for their regeneration. Therefore, social capital can also refer to the social relationships and pattern of reciprocal having enforceable trust.
Social capital theory helps community service organisations to gain effective resources that are necessary for resolving individual difficulties and providing extended support (Ehsan, & De Silva, 2015).
Social Cognitive Theory (SCT) was developed by Albert Bandura, which informs that a significant portion of an individual’s knowledge is gained by observing others in the social context, such as through social interactions, communication, experiences and influence of media (Hubley, and Copeman, 2018).
Environmental factors, as well as the actions of others, can have a significant influence on an individual’s health behaviour. SCT is popularly applied to health promotion policies, to bring desired health behaviour change, and empowering individuals by making them feel that they are capable of changing.
According to Beeson, Whitney and Peterson (2017), social cognitive theory mainly emphasises addressing personal and socio-structural determinants. Therefore, in a comprehensive health promotion model, community health promoters focus on bringing a change in widespread detrimental health behaviour rather than changing individual behaviour.
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Buurtzorg’s model of care was developed in the year 2006, by a social enterprise in The Netherlands. This model is mainly based on providing integrated nursing and social care to people in a community setting.
This model is identified as an important model of promoting health and self-management in communities. According to Lalani et al (2019), this model is significant in terms of providing holistic and individual-centred care and support in any community, as the principles of the Buurtzorg model are transferable and applicable in most communities.
This model is mainly divided into found different levels, which target different needs of individuals by identifying the self-management individual, their informal network, support of a team of professionals and support of the formal network.
Tanke and Lee (2017) have argued that the Buurtzorg model employs the social capital in action, as it recognizes the significance of the formal and informal support networks that form social capital.
This model developed by NHS UK is focused on providing care and support to individuals with learning disabilities. This model emphasises multi-disciplinary and multi-agency working for health promotion and health creation among communities (NHS England, 2015).
This model describes the range of services and support systems that are placed within local areas and communities, depending on the needs of individuals with learning disabilities/mental health conditions and their family members and carers.
This model significantly includes the social support theory, which informs that effective social and emotional support is significant for the health and well-being of an individual. People with learning disabilities and mental health problems, often lack social and community support.
Therefore, the social model focuses on developing a capable environment, by promoting the significance of social interactions, encouraging individual participation in social and meaningful activities, as well as promoting greater independence and self-management (NHS England, 2015).
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This presentation provided a comprehensive understanding of the community services and support, the role of community support and health promotion practitioners. This presentation further provides an overview of different theories and models of promoting health and well-being specifically for people with learning difficulties and mental health problems.
Abdi, K., Arab, M., Rashidian, A., Kamali, M., Khankeh, H. R., and Farahani, F. K. (2015) ‘Exploring barriers of the health system to rehabilitation services for people with disabilities in Iran: a qualitative study.’ Electronic physician, 7(7), 1476.
Beeson, E. T., Whitney, J. M., an Peterson, H. M. (2017) ‘The development of a collegiate recovery program: Applying social cognitive theory within a social ecological framework.’ American Journal of Health Education, 48(4), 226-239.
Cyril, S., Smith, B.J. and Renzaho, A.M., (2016) ‘Systematic review of empowerment measures in health promotion.’ Health promotion international, 31(4), pp.809-826.
Ehsan, A. M., and De Silva, M. J. (2015) ‘Social capital and common mental disorder: a systematic review.’ J Epidemiol Community Health, 69(10), 1021-1028.
Fertman, C.I. and Grim, M., (2016) ’Health promotion programs: from theory to practice.’ John Wiley & Sons.
Hubley, J., and Copeman, J. (2018) Practical health promotion. John Wiley & Sons.
Lalani, M., Fernandes, J., Fradgley, R., Ogunsola, C., and Marshall, M. (2019) ‘Transforming community nursing services in the UK; lessons from a participatory evaluation of the implementation of a new community nursing model in East London based on the principles of the Dutch Buurtzorg model.’ BMC health services research, 19(1), 1-9.
Mithen, J., Aitken, Z., Ziersch, A., and Kavanagh, A. M. (2015). ‘Inequalities in social capital and health between people with and without disabilities.’ Social Science & Medicine, 126, 26-35.
NHS England. (2015) Supporting people with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition. service model for commissioners of health and social care services. Service model for commissioners of health and social care services. Available at: https://www.england.nhs.uk/wp-content/uploads/2015/10/service-model-291015.pdf [accessed 25 January 2021]
Rimmer, J.H. and Rowland, J.L., (2008) ‘Health promotion for people with disabilities: Implications for empowering the person and promoting disability-friendly environments’ American Journal of Lifestyle Medicine, 2(5), pp.409-420.
Scott, H.M. and Havercamp, S.M., (2016) ‘Systematic review of health promotion programs focused on behavioral changes for people with intellectual disability’. Intellectual and developmental disabilities, 54(1), pp.63-76.
South, J. (2014) ‘Health promotion by communities and in communities: current issues for research and practice.’ Scandinavian journal of public health, 42(15_suppl), 82-87.
Stellefson, M., Paige, S.R., Chaney, B.H. and Chaney, J.D., (2020) ‘Evolving role of social media in health promotion: Updated responsibilities for health education specialists.’ International journal of environmental research and public health, 17(4), p.1153.
Tanke, M., and Lee, T. H. (2017) Going Dutch: Using Social Capital in Health Care. NEJM Catalyst, 3(2).
UNHCR. (2008) A Community-based Approach in UNHCR Operations. Available at: https://www.refworld.org/pdfid/47da54722.pdf [accessed 25 January 2021]
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