Empowering Users of Health Social Care Services

Empowering Users of Health Social Care Services Table of Contents Introduction Case Study 1 Case Study 2 Question 1 Analyzing the presenting factors affecting decisions to self-medicate The risks most likely to occur Measures to minimize the risk Advantages and Disadvantages of Jean’s self-medication Should Jean be encouraged to self-medicate at this time Case Study 3 Question 2 Question 3 Question 4 Question 5 Question 6 Conclusion Bibliography Introduction With the passage of laws and legislations, organizations in the health and social care sector have adapted their policies and systems to ensure the service users’ rights. Increasing importance is being given to promoting and maximizing the empowerment of service users in residential cares. Factors affecting loss of independence, non-participation and social exclusion of service users are being addressed with greater importance. Organizations are adapting according to the needs of the users. Case Study 1 Care plan: Goals of need Desired Outcomes Ways of achieving it Who is responsible Time Scale Employment Improved self-respect Partnership with day center Care Manager 2 months Entertainment Decreased level of stress and boredom Engaging in creative activities Care Manager 2 months Social Interaction and Emotional Needs Increased level of belongingness and connecting to other residents Engaging in group activities Care Manager 4 months During the last 20 years or so there have been many changes in the health and social caresystems. The catalyst for changes has been the legislations and laws to ensure and maximize the rights of service users. With the passage of such legislations organizations had to change their policies and practices. And thus the organizations had to follow a standard of service to sustain. These legislations have given increasing amount of rights and empowerment to the users. The NHS and community act of 1990 introduced a system of care which encouraged users to exercise their rights and make informed decisions about their health care. (Thomas, Mason, Ford) The acceptance of these laws made service providers design their services centering on the needs of the individual. And therefore, has brought significant changes in company policies and practices. Another legislation promoting the rights of users is human rights act of 1998. (Thomas, Mason, Ford) It has given the recourse to individuals wi thin UK courts if they feel their rights have been infringed. It includes 16 rights including right to life, right to freedom, security and right to a fair trial. While making policies organizations have to be aware this act, and realize every person has the same right. The organization will need to make sure one person’s rights are not infringed while maintaining another person’s rights. Participation and independence of users is vital to achieve the best possible outcome. Organizations promote service users’ participation by implementing an effective care planning system. A care plan is a written documentation of an individual’s fundamental needs and desired outcomes. It also includes how the desired outcomes will be attained. In managing the process, it is central to carefully consider the individual in the process. To promote participation of residents, the organization needs to reflect that it is planning a service around the agreed upon needs and desired outcomes of the user rather than fitting a person into the service it offers. The design and content of the care plan might vary. But it is important to correctly identify the desired outcomes. All aspects of daily living should be considered while preparing a care plan, and the process should start by gathering information from important sources. It is important to involve the user in the process. Involvement of the residents in the 6 stages of care planning is essential in order to provide better service. (Thomas, Mason, Ford) Need Assessment: Involving the user by agreeing dates and times, explaining how it works and ensuring the staff will involve the user from the early stage of the care planning process. Developing the care plan: The opinions, expectations and worries of the residents should be considered while developing the care plan. The staff will need to make sure the resident has clearly understood the process. Intervention and support: Once the goals have been agreed upon, the staff will need to start on implementation of the plan. Ongoing negotiations with the user must be considered in achieving the best end result. Monitoring and review: Encouraging the users to provide feedback is essential. It is also important to note the progress made and take into account any weaknesses. Statutory review of the package: The residents view is important; it also involves the view of outside agencies. Agreement on goal setting: The residents should be full involved in future goal setting process. The user should be encouraged to share what he has achieved. The organization needs to reflect on these stages and clear understanding of the issues should be ensured. The process should have options to monitor progress and make changes accordingly. There should be the option of trying something different if the initial plan doesn’t work. This way the individual will be more involved. Case Study 2 Question 1 Analyzing the presenting factors affecting decisions to self-medicate Fast Relief from ailments: Self-medication gives the individual quick relief from ailments. Identifying the ailment as trivial: When patients consider the ailment or sickness to be trivial that can be cured easily, they don’t go to the doctor. Rather they self-medicate themselves. Perceived Medication Knowledge: If the individual perceives his/her medication knowledge to be sufficient, he/she decides to self-medicate. Saving time and money: Going to the doctor means spending valuable time and money, self-medicating saves the hassle of going to the doctor and spending money. More control in care: when an individual self-medicates, he/she is in full control of her treatment. This gives the person an independence of care. Education Level: The education level and understanding of the risks might also affect the decision to self-medicate. Easy availability of drugs without prescriptions: The ease of access to drugs without prescriptions is also a factor affecting the decision to self-medicate. The risks most likely to occur Incorrect diagnosis: The individual might incorrectly diagnose his/her illness, and incorrect medication can worsen the medical condition even more. Delaying Medical help: Self-medication can provide temporary relief. However it can further worsen the situation if the individual delays to obtain medical help by temporarily relieving illness. Adverse reactions: Medications might have severe re-actions that are not so frequent. And the same medication might have different reaction on different people. What works on most people might have a severe reaction on an individual. Self -medication can be dangerous in this respect. Drug Interactions: If an individual on a prescribed meditation routine takes additional medications without consulting his/her doctor; the combined effect of the drugs can have severe impacts. Wrong dosage: A drug that might be very effective and crucial in the relief of a particular ailment can have the opposite effect if taken in a wrong dosage. Measures to minimize the risk Since the practice of self-medication is unavoidable; authorities need to take measures to minimize the risks associated with it. Health Education campaigns: Making people educated about the risks of self-medication can decrease the risks to a certain extent. Running health campaigns will develop the user’s skill in diagnosing oneself with trifling sicknesses, without asking a doctor. It will also help the patient to know the right drug, right dosage, right way of taking it and potential side-effects of a drug. Implementation of legislations: Authorities should ensure that laws and legislations on providing drugs from pharmacies are strictly followed. Drugs that can cause life threatening situations should never be provided without prescriptions. Clearly communication the crucial information: The drugs that are commonly takenforailments considered as self-recognizable; should contain the information on their packaging about how to take the drugs,how they react when taken with other drugs, the side-effects as and how tomonitor them, how long the drug can be taken, the dosage above which the drug can become dangerous etc. Advantages and Disadvantages of Jean’s self-medication Self-medication can be favorable for patients, healthcare specialists, and the pharmaceutical industry if the drugs are used in the proper way. However, it can create life threatening situations as well. Advantages: Self-medication givesJean greater independence and empowerment in making decisions about treatment of minor sicknesses. It helps Jean to prevent ailments that do not require a doctor. It helps her save precious time and money. Disadvantages: She has the risk of misdiagnosing a disease. She might take drugs in the wrong doses. The drugs can have side effects that might not be frequent and apparent at the beginning, but they might gradually develop life-threatening illnesses without showing any symptoms. The drugs might have adverse reaction while taken with other drugs. If she takes self-medications and temporarily treats ailments avoiding professional help when it is necessary, the ailment might become more severe. This might ultimately cause her to spend more money. Should Jean be encouraged to self-medicate at this time No, Jean shouldn’t be encouraged to self-medicate at this time. She has just been discharged from the hospital and she might not be fully recovered. The drugs that she took during her stay at the hospital might still have effects on her body and self-medication may have adverse reactions with those drugs. Also, before her admission at the hospital she had faced difficulty sleeping and had been forgetful. These could be signs of side-effects caused by self-medications which weren’t apparent at the beginning. But due to prolonged duration of self-medicating these problems have manifested over the years without showing prior symptoms. Continuing her self-medication at this time would be very risky because of these reasons. Case Study 3 Question 2 When a person reaches adulthood his/ her nutritional needs reduce. Generally, adults need to eat a healthy diet containing carbohydrates such as bread, potatoes, rice or pasta, protein such as meat, eggs, cheese or à ¯Ã‚ ¬Ã‚ sh, and fruit and vegetables. The intake of fatty and sugary foods should be little.To support Mr. H in meeting his dietary needs, it is essential to recognize if he has any deficits as well. With the help of a nutritionist, his dietary needs should be properly identified. A chart should be made listing the daily nutrients necessary for Mr. H and the foods that can meet these needs. However, the care doesn’t end there. Good Nutritional care doesn’t only include providing safe and nutritious food according to the specific needs of the individual. It goes beyond that. Mr. H should be provided what he wants, when he wants, and where he wants it. And in doing so, maintain the safety of the Mr. H and others around him should be ensured. Moreover, it is fundamental in providing quality service to ensure that Mr. H’s choices are respected and heard, and his independence is promoted. Since Mr. H has mood swings, however; it might not be possible to listen to his every whim. But it should be made sure that he doesn’t feel frustrated. As he is forgetful, it is necessary to make sure he takes his food in time. And keeping a track of his food intake will also be useful. It is also necessary to make his meal times enjoyable. It might have greater and significant impact in his mental health. Dining with other members might also improve his learning abilities and social skills. Providing quality service entails giving the service user independence and empowerment. Because of this, it is important to support Mr. H to cook his meal. It will make him feel empowered and give control. Also, not giving him the chance to cook might make him frustrated which might cause him to do something harmful to others and himself. Since he is semi-independent, it is necessary to appoint a supervisor to make sure he doesn’t harm himself or others. The materials used to cook or cut the ingredients should be safeguarded. He should be under constant supervision the whole time. Question 3 Risk taking can be petrifying, for the individual concerned as well as the family members. According to the National Minimum Standard relating to risk states that service users should be supported to take risks as they are free to lead an independent lifestyle. By following a system and identifying how risks can be analyzed and lessened, calculated risks can be taken. There can be various benefits of risk management for the service users including learning new skills, amplified independence, self-esteem and participation. (Thomas, Mason, Ford)The risk management systems and policies should include recording recommendations and actions. A good risk assessment tool should be used, one that is not too lengthy but user friendly. Finally, review is also a crucial point in risk management. Putting all the policies at work, more responsible risks can be taken. Question 4 The management of medication is perhaps one of the most precarious tasks of a care worker. Regulation13 of theHealthandSocialCareAct2008talks about the management of medication in a residential care. It mentions that the registered individual is supposed to protect users against the associated risks resulting from unsafe use of medications, by different means of necessary arrangements for obtaining, recording, using, safe keeping, safe administration and disposal of medicines used for the purpose of the regulated activity. (The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010) People who follow this regulation will managemedicinescarefullyandappropriately,make surethatmedicinesareprescribedandgivenbypeoplesafely,maintain the guidanceonusing medication in a safe way. The management of medication follows a standard procedure including receipt, recording, storage, handling, administration and disposal. (Thomas, Mason, Ford). Receipt involves identifying what is required for each service user and attaining those medications. A clear ordering system should be maintained in order to ensuring effectiveness of the process. Clear records should be kept about medications of individuals, taking into account the confidentiality issues. Medications are personal information and should be kept confidential. The record should be in accordance with data protection act and National Minimum Standards. Planning storage of medication is very important. All medications should be under lock and key. Medicines should be taken out of the locked cabinet only when required and should be put back in it immediately after using. Question 5 Effective communication is the basis for involving service users in the decision-making process. For data to be valuable, it requires to be in a format that is understandable, reachable to people who need it. The communication procedures of an organization must consider the needs of service users and staff. a) Feedback:Creating an effective feedback mechanism can develop effective communication. By considering constant feedback from users, the organization can make sure the rights of the users are maintained. b) To promote and maximize the rights of service users the organization can create an effective information and communication strategy, suited accordingly to the needs of service users and staff. c) To make sure information is readily available, an integrated information technology system can be introduced which will enhance the quality of care and delivery of services. d) The organization should have clear communication principles including: transparency and honesty, use of apt language and variety in approaches of communication; compassion and understanding; effective listening. e) The organization should provide training for staff on how to communicate with users and care workers. f) It should develop efficient procedures for obtaining valid consent for examination, treatment and/or care; h) The organization canpublish a range of updated information about services, situations, and treatment, care and support options available. Question 6 Viewing people in residential cares as passive recipients of care, who are incapable to make choice and take control, contributes to loss of independence. Perceiving service users as powerless suggests that they cannot have both care and empowerment. Society’s negative view and attitude towards people who require social care services can also cause loss of independence. Lack of acceptance and dignity can also cause social exclusion and non-participation. When a service user feels he/she is not being listened to or being cared with dignity, the individual tends to participate less. When the individual thinks he/she has a choice and control over his/her health care decisions, the person is naturally encouraged to participate more. Above all, the general mindset of people who are around about people in residential care can significantly impact participation and independence of service users. Viewing them as incapable, powerless, and showing gestures that suggests they are differe nt can cause non-participation and social exclusion. Conclusion Empowering individuals in health and social care is vital to their treatment and wellbeing. However, organizations might face barriers and difficulties in doing so. The organization can achieve the best possible outcomes through careful planning, policy making, risk assessment, management of medication, providing what the service users wants and involving them in the decision making process. Bibliography The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. (n.d.). Retrieved from http://www.legislation.gov.uk/ukdsi/2010/9780111491942 Thomas, A., Mason, L., Ford, S. Care Management in Practice for the Registered Manager Award NVQ 4. Empowering Users of Health Social Care Services Empowering Users of Health Social Care Services Table of Contents Introduction Case Study 1 Desired Outcomes and Care Plan for Bob Small Case Study 2: Question 1 Factors Affecting Decisions to Self Medicate Possible Risks of Self Medication Measures to Minimize Risks Advantage and Disadvantage of Self Medication Should Jean be Encouraged to Self Medicate? Case Study 3: Question 2 Meeting Mr H’s Dietary Needs Managing the Tension to Help Mr H Cook Safely Question 3 Effectiveness of Organizational Risk Assessment Policies and Procedures Question 4 Current Legislation, Codes of Practice and Policies of Medical Administration Organization Medication Policy Question 5 Promoting Maximizing Rights of Service through Effective Communication Question 6 Factors Contributing to Loss of Independence, Non Participation Social Exclusion Conclusion Bibliography Introduction Empowerment in health and social care reflects the balancing of rights among the various stakeholders in this sector such as the users, the governments and the service providers. The rights of the user are mostly focused on with an aim of maximizing it, while government and the service providers set policies and procedures to do so. Case Study 1 Desired Outcomes and Care Plan for Bob Small Goals of Need Desired Outcome Ways of Achieving It Who is Responsible Time Scale Reduced Stress Reduce Boredom Reduce Frustration More Relaxed Enjoying Life Stop Self Harm Have calm work that he enjoys such as art with no hard deadlines. Find people of similar tastes and socialize Give recognition for his creative work and try to manufacture some success at what he does. Domestic Carer Self but Carer can help Friends and Relatives Permanently Permanently Periodically Case Study 2: Question 1 Factors Affecting Decisions to Self Medicate The main driving factor for individuals to self medicate in most of the world today is mostly due to budgetary constraints leading to the inability of these people to seek proper medical care. In the case however this is not the situation. However Jean Barlow, may self medicate here due to due to wholly different reasons. The reasons would probably be due to mental reasons rather than financial. As stated in the case she did develop anxiety after getting discharged from the hospital. Since the reason for getting admitted to the hospital were not really conventional physical problems that make people go to the hospital in the first place such anxiety and dip in confidence is very much expected. This is because being forgetful and lack of sleep is usually considered human traits and general minor life problems rather than something that requires medical attention. This social status about these disorders may have caused her to be embarrassed about seeking medical attention in the first place. Therefore in situations such as these one may easily be subject to self doubt and therefore lose self confidence. This factors will in turn cause her to self medicate instead of seeking further medical attention. Possible Risks of Self Medication The risk likely occur from self medication are widely spread. The most common form is addiction. This is because people who self medicate generally tend to do so by unconventional and sometimes illegal drugs such as cannabis and alcohol. Due to its availability alcohol is most commonly used by most self medicating patients especially when trying to alleviate anxiety. Not only alcohol is an abusive substance, what it does is worsen anxiety and cause depression among alcoholics in the long term. Although in the short term they tend to alleviate these symptoms. Such benefits encourages the person the consume alcohol over and over again causing addiction and worsening their base situation in general. Addiction in turn makes the person suffer from more symptoms and worsens the current situation. If such problems keep on persisting the person may eventually become a suicide risk. These above risks do very well apply to the case in question here. Other ways of self medication include over t he counter medicines and sometimes, if the law is not stringent where she lives, antibiotics and anti depressants. These medications also if not taken in correct doses does possess the risk of addiction along with dangerous side effects. Moreover the risk of misdiagnosis and over dosage are very common amongst self medicating individuals. Measures to Minimize Risks The best way to reduce this risk would to educate Jean Barlow about the risk and benefits of it. Although somebody suffering from low self confidence and high levels of anxiety is very much likely to make judgmental errors but proper knowledge of what she is dealing with will obviously help her regardless of her impaired judgmental abilities. There would be less risk of misdiagnosis. However excessive dosages and the risk of long term usage would tend to persist. To avoid such a situation continuous monitoring would be required. This risk can be reduced if individuals close to Jean Barlow are educated on these grounds or have access to primary care. The hospital could also reduce this risk by scheduling successive checkups in regular intervals so that she could be monitored. Advantage and Disadvantage of Self Medication The chief advantage that Jean would benefit from self medication would be the save in costs. Moreover it would save her time which she can dedicate to her other work. If more people like Jean could successfully self medicate them it would greatly reduce the pressure on the healthcare system in the society which would be able to focus its effort elsewhere to more major healthcare problems. Day to day healthcare problems such as acnes and common flu have routine and standard medications which can easily be self medicated although the risk of misdiagnosis does persist. However in Jean’s case, it is not so. Her problem is mainly due to self confidence along with forgetfulness and difficulty in sleeping. If she can successfully medicate her own problems, it is very well. The chief disadvantage in doing so however is the so many risks that have been discussed previously in detail. If gone wrong it could worsen the situation and even create new problems for Jean. Moreover the solutio n to the current problem without expert monitoring may cause problems such as addiction to sleeping pill for example which would be much harder to solve. Should Jean be Encouraged to Self Medicate? In my opinion Jean should not be encouraged to self medicate at this time cause she is suffering from low self confidence. Her initials problems may have been very standard and be self diagnosed but her low self confidence would impair her judgment and can cause her to take wrong decisions therefore increasing the chances of the risks. She should rather seek medical attention whenever she suffers her symptoms. However going to the doctor every time something minor happens may cause a further dent in her confidence leading to fear and frustration among everything she does. She may be encouraged under certain situations to self medicate. If self medication is done successfully it would help her increase in self confidence leading to an overall development in life for Jean. This can become a bit of a gamble but would bring positive for Jane if successful. Case Study 3: Question 2 Meeting Mr H’s Dietary Needs To support Mr. H’s dietary needs we need to make sure, there are enough omega-3 fats in his diet. This means there should be lots of fish in his diet. This not only deals with the attention span problem but also with his problem of mood swings by keeping it at a minimum level. A low-GL diet should also be maintained. This means that there should be very low glucose in the diet as well as a minimum of any types of stimulants such as tea, coffee and alcohol. Magnesium and potassium also has displayed abilities to calm the brain and reduce mood swings as well as increase concentration. So to support Mr. H’s dietary needs, we have to give him lots of fish, sources of magnesium and potassium such as pumpkin seeds and bananas while at the same time try to avoid stimulants such as alcohol and caffeine. Managing the Tension to Help Mr H Cook Safely Mr. H is not independent. His mood swings and short attention span can cause a variety of accidents while cooking such a meal. Therefore to enable Mr. H to cook safely without any disruptions I first need to make sure that he is continuously monitored throughout the process. He should not be left alone or ignored at any point in time during the whole event. I also need to study and remember his entire recipe for cooking such a meal. Care has to be taken that the room temperature is comfortable and not too hot as an uncomfortable temperature may unsettle him. Moreover I need to make sure that there is a fire extinguisher somewhere very nearby preferably in the room in case of any kind of cooking emergency. I would also need to keep him engaged in the cooking process and help him if he tends to forget any steps in a manner which does not offend him or unsettle him in any other way. In case of emergency I would also need somebody nearby in case there is an apparent need for any relating reason to force him to retire his task. Continuous monitoring would probably stop any unprecedented event from taking place and therefore there would not be much tension if done right and Mr. H would be able to cook his favourite meal. Question 3 Effectiveness of Organizational Risk Assessment Policies and Procedures The organizational risk assessment policies is essential to finding out all the risk the organization possesses. These include risks to the staff, users and anyone else that is involved with the organization. The organization tries to promote a dynamic method in identification of risk management by working closely with users and other agencies in order to find the triggers of these risk and find risk histories. The objective is to preempt these ricks before they occur. This assessment procedure considers every stakeholder of the organization in question and tries to avoid all manners of risks. After risks are identified the organization decides on the management technique of these risks in order to avoid them from happening in the near future. They also tend to try to consider if any of their risk management plans give rise to any further risks or harassment for the users. When all of this is done, the organization trains its entire staff, usually annually on the various risk managem ent procedures within the organization. They also take steps within the infrastructural work of the organization in order to avoid any risk. For example, setting up a grill in the room of a user who maybe prone to jumping out of the window. These benefit the organization in many ways. The users mostly get their rights as they are free from any sort of harm. Moreover the organization is saved from a lot of accidents which might have affected both financially and operationally. Being saved from these costs are therefore highly beneficial to the organization. Question 4 Current Legislation, Codes of Practice and Policies of Medical Administration Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) is responsible for covering the administration and management in care homes of medicines. The act is passed by an act of parliament and it states that: â€Å"The registered person must protect service users against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording, handling, using, safe keeping, dispensing, safe administration and disposal of medicines used for the purposes of the regulated activity.† While in accordance to the above â€Å"the registered person must have regard to any guidance issued by the Secretary of State or an appropriate expert body in relation to the safe handling and use of medicines† The objective of the regulation is that the users of the service: will get their medicines at the correct times and in a manner which is safe will have information about the medicines which have been prescribed to them and are available to them or the people acting on their behalf The Care Quality Commission is responsible for monitoring compliance with the regulations for all registered services. The Misuse of Drugs Acts Regulations also under various circumstances regulates controlled drugs handling. Other code of practices and procedures relating to this matter is provided by the Nurse and Midwifery Council and the Royal Pharmaceutical Society of Britain. The Royal Pharmaceutical Society of Great Britain in its Guidance called The Handling of Medicine in Social Care, calls upon 8 principles that should be in place for safely administering drugs in residential homes. Organization Medication Policy The organizations medicine administration policy is basically in line with the 8 principles of Royal Pharmaceutical Society. The first principle gives the user the choice and independence to choose the pharmaceutical provider for his/her medicines including dispensed medicines. These give individuals a lot of independence and makes sure everything is done with their consent and not against their will. However under certain circumstances this principle can be bent, when there is no choice. For example, the person is having extreme breathing difficulty and not in a position to communicate but needs emergency medication. By complying to the second principle, the organization’s staff keeps a detailed record what medicines are currently available within the organizations stores and all the records of each user’s medicine intake and therefore be able to refill stocks whenever required to make sure that there is never a shortage at key moments. The third principle also applies to the organization as the care workers when joining take part in a short training period where they learn to administer each type of medicine for people who are unable to do it by themselves. They learn how to feed tablets, capsules, eye drops, nasal drops etc. Compliance with the fourth principle ensures that the organization gives users exactly the medication prescribed for them and at the right time in the right way. The 5th principle states that unnecessary or unwanted medication is disposed of safely and the correct medicines are available whenever required. The organization stores all the medicines safely and out of reach of people who are not supposed to take the medicine. There is also a pharmacist who regularly advices the residential home on medication related issues. Lastly medications are only used to prevent diseases or relieve symptoms, not to punish people or encourage certain behaviors. Question 5 Promoting Maximizing Rights of Service through Effective Communication Effective communication is when the sender of a communication message sends a message that is completely understood by the receiver exactly as intended by the sender. When there is effective communication efficiency tends to rise regardless of the task at hand. This is no different for the health and social care service. The whole service depends on the user getting his rights maximized. When there is effective communication the user would know exactly what his rights are, what he will be getting out of the service and what he will be not. This will help him manage his expectations from the service and plan accordingly. Moreover the service provider’s work would also increase in efficiency if there is highly effective communications. The service would be able to provide for the user to his requirements, therefore maximizing his rights. If there is effective communication the service will unlikely to be unable to provide for the user anything that his rights cover. This is two- way communication is therefore extremely vital in health and social care aspects. Effective communication will always help the user to maximize his rights in this way. Question 6 Factors Contributing to Loss of Independence, Non Participation Social Exclusion Stigma is one of the most important factors that cause these problems for service users. Social stigma is especially for people with mental health problems affect people of all ages, at all levels of job and education levels. Society tends to have a negative impression about this problem unlike cancer or any other physical diseases. Therefore how other people judge them becomes a great barrier to the users. Not Just Sticks Stones’(Jim Read Sue Baker November 1996), a survey of the people with mental health problems in the matters of discrimination, taboo and stigma found out that: For the fear of unfair treatment, a large majority was put off for applying for jobs. Being treated unfairly by general health care services was something half the respondent felt. Harassment and abuse in public and sometimes even physical abuse was face by many Most people believed that discrimination has increased in the last 5 years but some thought it decreased as well. Due to these various problems the fear of stigma and discrimination sometimes makes the users stop talking about their mental distress with others therefore there is a communication gap and they fail to avail their full rights of the service. These factors therefore directly contribute to their social exclusion and non participation in service. Most people tend to stay at home and take small local jobs depending on their level of independence in fear of abuse from the uneducated society. The social stigma and the media terming most of them as ‘lunatics’ and ‘psychos,’ create a very bad impression in a lot of people’s minds therefore making lots of luxuries of life unable to these people causing a huge loss of independence for them. Conclusion Finally we can say that the various laws and legislations that the UK Government has put into place in order to maximize the rights of users are very well enforced and maintained. The way service in current times is designed is based on the objective of maximizing the rights of the users. Participation is on the rise leading to greater independence for users. Excellent management of risks and commendable practices of drug administration has led to much fewer service accidents and has ensured the rights of the users. Bibliography CM Hughes, J. M. (2001). Benefits and Risks of Self Medication. Drug Safety , 1027-37. Cowley, D. S. (1992). Alcohol abuse, substance abuse, and panic disorder. The American Journal of Medicine , 41S-48S. Galliot, B. (November 2007). The Physiology of Willpower: Linking Blood Glucose to Self-Control. Personality and Social Psychology Review, Vol 11 , 303-27. Kasten, B. P. (1999). Self-Medication With Alcohol and Drugs by Persons With Severe Mental Illness. Journal of the American Psychiatric Nurses Association , 80-87. Khantzian, E. (2003). The self-medication hypothesis of drug use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry , 231-244. Royal Pharmaceutical Society of Great Britain. Handling of Medicine in Social Care. Sinn, N. (October 2008). Nutritional and dietary influences on attention deficit hyperactivity disorder. Nutrition Reviews, Vol. 66 , 558-68. The Bamford Review of Mental Health and Learning Disability. (December 2006). Promoting the Social Inclusion of People With a Mental Health Problem and Learning Disability. World Health Organization. (2000). The Benefits and Risk of Self Medication. WHO Drug Information Vol. 14, No. 1 , 2-3.