BIPOLAR AFFECTIVE DISORDER IN ADULTS

Introduction

Bipolar Disorder (BD) is a mental illness that cause severe change in mood (high and low) that affects the sleep pattern, thinking, behaviours and others of the individuals. The people with bipolar disorder is seen to feel at times overly happy and energised and experiences feeling of sadness, sluggish and hopelessness in another period (Rowland and Marwaha, 2018). In this essay, the health inequality and diversity effect on health and health needs of the adults affected by bipolar disorder is to be discussed with focus on areas like Bromley and Croydon. The process and impact of needs assessment regarding bipolar disorder in adults along with impact of difference social factors related to bipolar disorder is to be discussed. For those working on related topics, seeking healthcare dissertation help can provide valuable insights and support.

Effect of socio-economic, cultural and environmental factors regarding Bipolar affective disorder in adult

The socio-economic factors are society-related economic factors that are responsible for influencing prevalence and management of health. The key socio-economic factors related to health are education, employment and income (de la Serna et al., 2017). As mentioned by Crișan (2018), lack of education regarding bipolar disorder as health issue leads the people to remain unaware of the health consequences of the health problem and way of detecting it at the early stage. This is because without education regarding the health problem, the people are unable to detect the presence of symptoms of the disease that is mainly mood disorder as well as fails to determine the steps to be taken for managing their health out of no knolwdege regarding whom and where to approach for treatment regarding the health issue. As argued by Mousavi et al. (2021), lack of perceived understanding regarding susceptibility, risk and effect of the disease impact the health of the people affected by the health issue to get worsen with time. This is because of the lack of their inability in deciding early health intervention for them. This is evident as in the UK, it is mentioned that 1.3 million people are affected by bipolar disorder which is 1 in 50 people to be affected by the disorder (bipolaruk.org, 2014). However, it is also mentioned that 9.6% of the cases of bipolar disorder in the UK remain undiagnosed due to lack of presence of effective education regarding the disease among the individuals (Hughes et al., 2016, NICE, 2019).

The employment is another socio-economic factor that influences the health of the people and develops inequality. This is because the nature of employment in which people are involved influence their physical and mental health due to the work pressure and occupational circumstances created at work (Strassnig et al., 2018). As argued by Hakulinen et al. (2019), bipolar disorder is associated with increased rate of unemployment. This is because unemployment leads people to remain in bad mood out of feeling of inefficiency to earn and support their family (Strassnig et al., 2018). This is evident as in the Newham, nearly 994 people are found to be affected by bipolar disorder whereas in Croydon, 916 individuals are found to be affected by the disorder (newham.gov.uk, 2015, croydonobservatory.org, 2016). In comparison to the two Councils, it is revealed that the rate of unemployment in Newham is 14% whereas in Croydon is 5.4 % (newham.gov.uk, 2018, nomisweb.co.uk, 2018). This indicates that unemployment that is risk factor for bipolar disorder is present in increased percentage at the Newham compared to the Croydon area due to which more incidence of the disease is seen in Croydon compared to Newham. As argued by Strassnig et al. (2018), the nature of employment and occupation is found to be responsible in raising bipolar disorder among the employed people. This is because increased job-difficulty creates increased mental pressure which leads the individuals unable to control their mood. This is evident as the study by O’Donnell et al. (2017) mentioned that high degree of depression and increased work conflicts are related to development and worsening of the bipolar disorder among the individuals.

The income and financial status also influence to create health inequality among the people regarding bipolar disorder. As mentioned by Hakulinen et al., (2020), lack of effective financial ability and income lead people to develop worsening of their mood disorder. This is because without adequate money the people affected by mental health issues are unable to bear the financial burden required for accessing healthcare that are not covered by the government or Medicare. For example, in areas such as Tower Hamlets and Newham the percentage of people living below the poverty line and earning less are 39% and 37% respectively whereas in the areas like Bromley and Bexley it is seen that only 15% and 16% are living under poverty and earning les than average (trustforlondon.org.uk, 2018). It has led increased amount of people affected by bipolar disorder and associated mental illness to be present in Newham and tower Hamlets compared to Bromley and Bexley. This is because apart from assistance from the NHS, people from Bromley and Bexley are seen able to access additional health support for enhancing their health regarding bipolar disorder and ensure them better mental health (newham.gov.uk, 2015, england.nhs.uk, 2017).

The cultural factor effect mental illness like bipolar disorder by creating presence of different attitude and perception regarding the health issue (AlAteeq et al., 2018). As mentioned by Zhang et al. (2020), in some cultures such as the South Asian communities, the mental illness is not considered as shame in the society. This is because they consider presence and revelation of people in the family with mental disorder is negative for their family reputation as it is mental illness is considered as stigma in the communities. It is evident from the saying of Prof. Dinesh Bhugra who mentioned that South Asian in the UK has high amount of shameful feeling to accept any nature of mental illness or mood disorder like bipolar disorder and others (Bilkhu, 2016). Thus, it has led people of the South Asian cultural group to show increased prevalence of mental illness like bipolar disorder compared to the others (mentalhealth.org.uk, 2019). The environmental stressors such as grief, depression and sleep-disturbances are responsible for influencing the cause and worsening of bipolar disorder. This is because they are responsible for creating increased imbalances in the neurotransmitters or hormones released from the body which lead to negatively impact the brain, in turn, making the individual unable to enhance their mood and face worsening of mood disorder like bipolar disorder (AlAteeq et al., 2018). The study by Ashok et al. (2017) mentioned that failure of the dopaminergic neurotransmitters and lack of management of homeostasis in the body is responsible for creating mood disorder such a bipolar disorder. This indicates that hindrance in the biological environment of the body is a key responsible factor to raise the condition of bipolar disorder in people.

Impact of health inequality and diversity on healthcare and health needs regarding Bipolar disorder in adults

The health inequality like lack of effective health education regarding mental health impact on the health of the people to develop worsening condition and high prevalence of the disease (Hayes et al., 2017). However, presence of effective education helps in higher diagnosis of the disease and ensure enhanced health outcomes are received by the people (Adams, 2020). For example, in Croydon area in the UK, increased focus has been made by the council to create better awareness and education regarding bipolar disease. This is to make people identify they are being affected by the disorder and seek assistance to diagnose the health issue at the earliest. It has led the area to create progressive diagnosis of increased number of people affected by bipolar disorder (croydonobservatory.org, 2016). However, in the UK, effective approach in all areas are not been taken for creating awareness and education regarding bipolar disorder. It has led many individuals to suffer negatively and face worsening of the disorder which has led the people to even die (bipolaruk.org, 2018). This is evident as it is mentioned that on an estimation nearly 800 people in the UK have died due to bipolar disorder through suicide as they lacked effective education and support in controlling the disorder at the early stage (bipolaruk.org, 2018). Thus, it has created the health need of presence of increased awareness and education regarding bipolar disorder ion all parts of the UK so that people can access early diagnosis of the disease and lead life with well-being.

The presence of stigma regarding mental disorder due to inequal cultural thoughts of certain communities impacts the people to cause harm or abuse to the physical health of the mentally-ill patients. This is because the individuals think that mentally-ill people are weak and are to be get rid to lead a better life (bipolaruk.org, 2018). For instance, in the UK, it is reported that nearly 67% of the people suffering from bipolar disorder has faced abuse or harm in the society and is currently facing undiagnosed post-traumatic stress (bipolaruk.org, 2018). Thus, health inequality regarding bipolar disorder has created the health need of accessing effective support from the healthcare organisation so that they can access safe care without any fear of abuse or harm which worsens their condition. In contrast, the presence of health diversity regarding any health issue cause cultural competency in arranging care services for all and ensures enhanced delivery of care to all in the community (Flowers et al., 2019). For example, the Bipolar UK organisation present in the Bromley, UK is seen to arrange and provide diversified care for all affected by the bipolar disorder so that they are able to develop greater control of their life. This has affected many lives of the people living in the borough who are affected by bipolar disorder to be controlled so that they are able to maintain normal mood and led a health life with effective mental ability (bromley.gov.uk, 2018).

Process and impact of health needs assessment

In healthcare, needs assessment is required because it helps the service providers understand the need of the people related with their health and the specific care to be provided to the patient to ensure their enhanced health (Miskowiak et al., 2018). The process of need assessment in health initially includes determining the scope of the assessment. In this context, the purpose of the assessment, the resources required, people to be involved and other are to be identified. This is to determine which activities are to be covered for the topic for which the needs assessment is been made (Rabinowitz, 2017). For example, the initial steps of needs assessment regarding bipolar disorder in adults require to determine the purpose of the assessment that is whether to reduce to the prevalence of the disorder or manage it or create awareness regarding it and others. Moreover, the resources required for the purpose being planned in regarding dipolar disorder among adults is to be determined. This is because scope of the assessment helps to produce the list of actions to be taken in regard to manage bipolar disorder in adults.

The second step of the need assessment in health include determining the assessment criteria to be focussed on examining the health disorder or disease (Rabinowitz, 2017). For example, for need assessment of bipolar disorder in adult, the needs assessment in the second step require to determine the health inequalities affecting the disorder, cause and risk factor of the disease and other. This is because the determination of the assessment criteria would help in examining and prioritising the health need regarding the disease-related with the focused community for individuals (Miskowiak et al., 2018). The third step of needs assessment in health includes planning for data collection regarding the topic. This is important so that existing information regarding the topic of reference can be gathered (Rabinowitz, 2017). For example, in making need assessment for bipolar disorder the data collection plan would direct the way relevant information regarding the topic can be gathered for its enhanced execution. The fourth and fifth steps of needs assessment in health includes collecting and analysing the data along with determine decision based on the data to prioritise the needs of the people (Rabinowitz, 2017). For example, these steps would produce the results of key health need to be met for the adults affected by bipolar disorder.

Conclusion

The above discussion mentions that bipolar disorder is mood disorder that is highly prevalent in the UK. The needs assessment mainly includes the steps such as scope analysis, determining assessment criteria, planning data collection, analysing data and applying criteria based on the data. The socio-economic factors such as income, employment and education influence the development of bipolar disorder ion adults. Moreover, the cultural factors contribute to create stigma regarding the disorder among the people which leads people avoid revealing the disorder. The impact of health inequality for bipolar disorder in adult is that it causes worsening of their health and at times mortality whereas health diversity ensures enhanced health care to be reached to adults affected buy bipolar disorder.

Continue your journey with our comprehensive guide to Biopsychosocial Care Analysis for Thomas.

References

Adams, C.D., 2020. A multivariable Mendelian randomization to appraise the pleiotropy between intelligence, education, and bipolar disorder in relation to schizophrenia. Scientific reports, 10(1), pp.1-10.

AlAteeq, D., AlDaoud, A., AlHadi, A., AlKhalaf, H. and Milev, R., 2018. The experience and impact of stigma in Saudi people with a mood disorder. Annals of general psychiatry, 17(1), pp.1-9.

Ashok, A.H., Marques, T.R., Jauhar, S., Nour, M.M., Goodwin, G.M., Young, A.H. and Howes, O.D., 2017. The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment. Molecular psychiatry, 22(5), pp.666-679.

Bilkhu, R, K., 2016, Why do many South Asians regard mental illness as taboo?, Available at: https://www.bbc.com/news/uk-england-36489893 [Accessed on: 8th March 2021]

bipolaruk.org 2014, Bipolar – the facts, Available at: https://www.bipolaruk.org/faqs/bipolar-the-facts [Accessed on: 8th March 2021]

bipolaruk.org 2018, Bipolar – the facts, Available at: https://www.bipolaruk.org/faqs/bipolar-the-facts#:~:text=The%20majority%20of%20individuals%20with,is%20one%20in%20fifty%20people. [Accessed on: 8th March 2021]

bromley.gov.uk 2018, BiPolar UK, Available at: https://www.bromley.gov.uk/directory_record/1210498/bipolar_uk [Accessed on: 8th March 2021]

Crișan, C.A., 2018. Lack of Insight in Bipolar Disorder: The Impact on Treatment Adherence, Adverse Clinical Outcomes and Quality of Life. Psychotic Disorders-An Update.pp.30-67.

croydonobservatory.org 2016, Croydon Joint Strategic Needs Assessment, Available at: https://www.croydonobservatory.org/wp-content/uploads/2016/11/Overview-Chapter-2012-13.pdf [Accessed on: 8th March 2021]

de la Serna, E., Sugranyes, G., Sanchez-Gistau, V., Rodriguez-Toscano, E., Baeza, I., Vila, M., Romero, S., Sanchez-Gutierrez, T., Penzol, M.J., Moreno, D. and Castro-Fornieles, J., 2017. Neuropsychological characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder. Schizophrenia research, 183, pp.110-115.

england.nhs.uk 2017, Commissioning for Value Mental health and dementia pack, https://www.england.nhs.uk/wp-content/uploads/2017/07/cfv-bexley-mhidp.pdf

Flowers, S.A., Baxter, N.T., Ward, K.M., Kraal, A.Z., McInnis, M.G., Schmidt, T.M. and Ellingrod, V.L., 2019. Effects of atypical antipsychotic treatment and resistant starch supplementation on gut microbiome composition in a cohort of patients with bipolar disorder or schizophrenia. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 39(2), pp.161-170.

Hakulinen, C., Musliner, K.L. and Agerbo, E., 2019. Bipolar disorder and depression in early adulthood and long‐term employment, income, and educational attainment: A nationwide cohort study of 2,390,127 individuals. Depression and anxiety, 36(11), pp.1080-1088.

Hakulinen, C., Elovainio, M., Arffman, M., Lumme, S., Suokas, K., Pirkola, S., Keskimäki, I., Manderbacka, K. and Böckerman, P., 2020. Employment status and personal income before and after onset of a severe mental disorder: a case-control study. Psychiatric services, 71(3), pp.250-255.

Hayes, J.F., Marston, L., Walters, K., King, M.B. and Osborn, D.P., 2017. Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014. The British Journal of Psychiatry, 211(3), pp.175-181.

Hughes, T., Cardno, A., West, R., Marino-Francis, F., Featherstone, I., Rolling, K., Locker, A., McLintock, K. and House, A., 2016. Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study. British Journal of General Practice, 66(643), pp.e71-e77.

mentalhealth.org.uk 2019, Black, Asian and Minority Ethnic (BAME) communities, Available at: https://www.mentalhealth.org.uk/a-to-z/b/black-asian-and-minority-ethnic-bame-communities [Accessed on: 8th March 2021]

Miskowiak, K.W., Burdick, K.E., Martinez‐Aran, A., Bonnin, C.M., Bowie, C.R., Carvalho, A.F., Gallagher, P., Lafer, B., López‐Jaramillo, C., Sumiyoshi, T. and McIntyre, R.S., 2018. Assessing and addressing cognitive impairment in bipolar disorder: the International Society for Bipolar Disorders Targeting Cognition Task Force recommendations for clinicians. Bipolar disorders, 20(3), pp.184-194.

Mousavi, N., Norozpour, M., Taherifar, Z., Naserbakht, M. and Shabani, A., 2021. Bipolar I disorder: a qualitative study of the viewpoints of the family members of patients on the nature of the disorder and pharmacological treatment non-adherence. BMC psychiatry, 21(1), pp.1-11.

newham.gov.uk 2015, Joint Mental Health Strategy for Newham, Available at: https://www.newham.gov.uk/downloads/file/76/mentalhealthneedsassessment [Accessed on: 8th March 2021]

NICE 2019, Bipolar Disorder, Available at:https://www.nice.org.uk/guidance/cg185/evidence/full-guideline-pdf-4840895629 [Accessed on: 8th March 2021]

nomisweb.co.uk 2018, Croydon unemployment rate comparison, Available at: https://www.nomisweb.co.uk/reports/lmp/la/1946157265/report.aspx#tabempunemp v [Accessed on: 8th March 2021]

O’Donnell, L., Himle, J.A., Ryan, K., Grogan-Kaylor, A., McInnis, M.G., Weintraub, J., Kelly, M. and Deldin, P., 2017. Social aspects of the workplace among individuals with bipolar disorder. Journal of the Society for Social Work and Research, 8(3), pp.379-398.

Rabinowitz, P. 2017. Community Tool Box: Section 23. Developing and using criteria and processes to set priorities. Lawrence, KS: Center for Community Health and Development, University of Kansas.

Rowland, T.A. and Marwaha, S., 2018. Epidemiology and risk factors for bipolar disorder. Therapeutic advances in psychopharmacology, 8(9), pp.251-269.

Strassnig, M., Kotov, R., Fochtmann, L., Kalin, M., Bromet, E.J. and Harvey, P.D., 2018. Associations of independent living and labor force participation with impairment indicators in schizophrenia and bipolar disorder at 20-year follow-up. Schizophrenia research, 197, pp.150-155.

trustforlondon.org.uk 2014, Poverty rates by London borough, Available at: https://www.trustforlondon.org.uk/data/poverty-borough/ [Accessed on: 8th March 2021]

Zhang, Z., Sun, K., Jatchavala, C., Koh, J., Chia, Y., Bose, J., Li, Z., Tan, W., Wang, S., Chu, W. and Wang, J., 2020. Overview of stigma against psychiatric illnesses and advancements of anti-stigma activities in six asian societies. International journal of environmental research and public health, 17(1), p.280.