TOBACCO CONTROL

Policy Analysis on Comprehensive Tobacco Control Strategy for England

Policy Analysis on Comprehensive Tobacco Control Strategy for England

Background/justification for Study

The Department of Health's discussion article on the future tobacco command scheme for England identified that while the Government has taken activity to decrease smoking uptake and assist persons who desire to stop, more activity is required (Department of Health 2010).

Purpose of the Research

Specifically, it inquired what more could the Government and other public services manage to decrease smoking occurrence in people.

Potential Benefits arising from the Study

To assist announce this discussion method and later principle development the Department of Health requested, in February 2010, a fast short reconsider on persons and smoking in England. The reconsider addressed three questions:

1. What are the current patterns and trends in smoking in people in England by key socio-demographic variables (sex, age, socio-economic status, and ethnicity)?

2. What is known about why people start and continue to smoke?

3. What is the current tobacco control policy context and future policy options on smoking prevention and cessation for people in England and their likely effectiveness?

Research Design; Bardach Analysis

Community Mental Health

The community mental health care system has grown rapidly since its initial Federal funding in 1963. In order to offset increasing reliance upon inpatient treatment in the state hospitals, the federal program proposed a highly decentralized system of care, based upon community "catchment areas."

More than 450 of these catchment areas (varying in population from 75,000 to 250,000 persons) have developed the services required by the act and have been designated Community Mental Health Centers (CMHC). Each CMHC has been permitted considerable discretion in determining its own program priorities and in the number of facilities to be established to provide the mandated services. Some CMHC's have chosen to provide all of the services from a central facility, but others have established an extensive system of satellite. Presumably, it was anticipated that a high level of local CMHC discretion over programs would (in theory) permit a more sensitive structuring of community programs.

The practical risks are high, however, that no program will emerge, or that large local institutions will dictate the form and extent of services and eliminate choice It is not clear why the satellite is essential beyond the fuzzy notion of access, which can be accomplished by other mechanisms. Neither is it clear to communities and individual residents what needed community functions can be performed successfully in such facilities. The promotion of community mental health care obviously consists of more than demonstrating that community opposition to neighborhood facilities is economically groundless. Moreover, opposition to the placement of discharged mental patients in the community is not allayed by evidence of a lower crime rate among them. There are, as yet, no clear benefits from the program, in terms of treatment outcomes, community improvement, or problem-solving competency, to warrant community support for satellites. The benefits of community-based mental health care are not being hindered only by narrowly based community opponents, however; the level of performance and expertise in ...