Introduction
The given article is structured in the form of a comparative analysis of the habits and behaviours related to smoking practices among the institutionalized psychiatric population. The evaluation of this article is being done from the sociological perspective. The assessment of the issue of smoking is specifically analyzed in two of the most important sites of Australia namely; South Australia and Queensland, where quitting of smoking habits among the population of the institutions of the public mental health services is the main problem (Lawn, 2004). The study of these locales has been conducted between the periods of 1999 to 2001.The main focus is on the systematic barriers, which make the prevention of smoking activities in such institutions, ineffective. Though, the government of Australia has made several efforts for the prevention of smoking in the work places, as well as, the public places; but even then, the problem is still at its zenith (Tobacco Policy, 1990).
Overall Evaluation
From the overall evaluation of the given article, it is clear that the two Australian places are facing a severe problem of barriers in the quitting the process of smoking by the Professionals, as well as, the Clients of the health service institutes. At both these Australian sites, a great human support and the auxiliary services are given to the areas of smoking. In the South Australian hospital, there is an enormous population of medical staff and clients. The health professionals have given several responses for not quitting smoking.
According to them, it is a means of reducing the work burden and stress. With such a practice of smoking, they are to establish a good relationship with their clients. The clients of the health service institutions of the South Australia use to start smoking at the beginning stage of the mental illness (McCreadie & Kelly, 2000). From the review of one of the article, it surveys that about more than 20% of the professionals and staff members of health institutions at the international level smoke and support smoking (Khan, Husain, Laeeq, Awais, Hussain & Khan, 2005).
At the other Australian location, which is Queensland, the health professionals are found addicted to the problem of smoking. In Queensland, the number of clients in the hospitals is very high, as the regional hospitals over there have really good facilities and services. But the problem of smoking is same here as is in the South Australia. Though, at both the places, the formal supply of free cigarettes is prohibited; but at the informal level, the supply of cigarette still continues.
At both the Australian locations, smoking is identified as the primary activity practiced by the clients. This has been analyzed through the data collection from such sites. The data related to these sites is collected through the participant observation method. Through this method, several points, which were hidden related to the medical professionals, came in the lime light. The participants related to whom, the data was collected, were the inpatients staff.
The smoking behaviours of the clients, as well as, the professionals were described as the means of interaction among the social groups and factors that also assisted in the handling the cerebral illness. This was also considered as the means of alleviating tiresome activities of the life. Moreover, it was also described as a means to feel relaxed. The staff members also stated that they only used smoking for their clinical purposes. As analyzed from the places, it was viewed that in both the Australian locations, the perspective of clients and nursing staff considered the activity of smoking as a means of reducing aggression.
As per the analysis of the entire healthcare institutions, it was evaluated that the individuals, who suffer from health problems like mental illness are found on priority, to incur smoking habits in comparison to the general public (Interventions for special groups, 2009). In a particular community, most of the ratio of the smokers is covered by the mentally ill people. From a survey, it was found that among the general public, only 18% of the people, of Australia smoke; while in the group of mentally ill people, about 30% or more people smoke (Smoking and Mental Illness, 2009). Regarding this issue, several studies were made in different countries of the world like the United States and Australia.
In the Australian survey, it was found that from the total group of smokers, about more than 35% of the group, was of those clients, who had any kind of mental disorders. In Australia, the study of smokers was mainly done among the individuals, who had any kind of psychotic disorder. From this study, it was found that from those, more than 70% males and more than 50% of females smoked about 20 cigarettes, per day. Among the mentally disabled people, most of the proportion was of those people, who were affected by prolonged sufferings or were having severe psychological disorders (Submission: Inquiry into mental health services 2008, 2008).
This is found as there are no legal restrictions in Australia for the prohibition of smoking. In the country, lots of people enjoy smoking in the public places and even in work places too (Right to Choose, 2009). In contrast to this, at some of the locations, such smoking activities are prohibited; but then also are followed, due to the no provision of legal interference. Most of the Australians enjoy such a freedom of smoking by using it even at workplaces.
This was found that mentally disabled people take this facility as voluntary activity. According to them, they will not acquire health facilities, if they are not allowed to practice smoking in the health service institutions. The mentally disabled people state that they have various kinds of stress, which can be easily removed through smoking practices. With such practices, they share their problems with the social groups.
This is analyzed that through the ban on smoking; there would be a negative consequence, which will create an atmosphere of tension among the clients of the health care institutions, as well as, the professionals and also the nursing staff. The nursing staffs; which deal with such kinds of clients, also favoured smoking, as in their perspective, they could treat the clients better in a tension free mood, which can be gained through smoking, as according to them this is a means of releasing the stress.
The issue of smoking is considered as the systemic issue in the given article. In different wards of both the places, there is a great dedication for the smoking activities. The staff members of both the locales have considered the intake tobacco as a great feeling. According to the clients, through smoking, they attain a control on the affright of illness and do not feel frail too (Lawn, 2001). The staff members exchange the food items and drugs from the cigarettes. Some of the staff members of both the sites accepted the use of cigarette only on some special occasions such as during sexual relations and as a reward by staff. Whereas, in South Australia; the clients who smoke, are charged with a lower rate, in comparison to the non-smoking clients. For boarding and other facilities, the non-smoker clients have to give higher charges.
In Queensland, a very effective strategy has been formed regarding such an issue of smoking. The strategy is named as National Tobacco Strategy. There are several important key features of this national strategy. Some of the key features of this strategy are the prevention of the smoking in both indoor and outdoor sites of the workplaces; especially, in the health care institutions (National Tobacco Strategy 2004-2009: Implementation – Queensland, (2008). This strategy is focusing on the advertising of the message, for giving up smoking in the workplaces.
In Queensland, several policies were also framed to highlight the disadvantages of smoking to the general public, as well as, the clients of the health service institutions. Some of the health care Professionals had ethical dilemmas in their dealing with the clients, in the management of the cerebral infirmity and use of smoking in such workplaces. They stated that the smoking had become a strong routine activity in the wards.
One of the most important barriers, in the activities related to the prevention of smoking habits in Australia is the deficiency of the responsiveness of the psychiatric population, towards the treatments of ceasing the habit of smoking (Mikhailovich & Morrison, 2008). There are several other obstructions such as the problem of obesity among the patients. One of the barriers is the interdependence of the clients and nursing staff, on each other. The lack of continuous evaluation of the work environment, of the mentally disabled service centres, is also a great hurdle, as this is found risky by the evaluator (Disabled people smoke the most, 2007).
In contrast to this, several clients of both the places are intending to quit smoking. Several clients have even made several efforts to release themselves from such a habit of smoking and to gain freedom from the mental illness, as well. In the article, the culture of smoking has been made more comprehensible by the “Ecological Model” which has been provided by the theoretical aspects, given by Bronfenbrenner. The model given by him was based on the mental health perspectives. All the components, which are the integral part, of the system such as the clients, the staff members and their inter-relationship is analyzed in this model.
This relationship is considered as the micro system in which, all the relationships among the components of the system, with each other exist. In such a micro system, all kinds of activities related to smoking take place. In such a structure, it is analyzed that the social groups have great apprehension for mental illness, which they remove, through such activities. There are two other concepts, which have been linked with the given model. One is “Dynamic Conservatism” and the other is “Social Exchange Theory”. Dynamic conservatism is an aspect analyzed by Schon, to describe the way through which, the individuals struggle to maintain the situation as it is. This is given in concern that the clients and staff members of both the locales have all the skills, to preserve the habit of smoking (Gilmore, Hirschhorn & Kelly, 1999).
The Social Exchange Theory is based on the exchange of goods among the individuals. This is a kind of barter system. According to such a theory, individuals exchange rewards and resources for their benefits, as well as, to maintain a good relationship with each other. The smoking systems followed by the members and clients of the mental health service institutions also help them to have superior relationship among themselves (Social Exchange Theory – Major Contemporary Concepts, 2009).
Group dynamics is also another important factor related to such a system of smoking. This is a kind of adjustment made between the staff members and the clients of the mental health services. In the group dynamics system, the people of different groups share their experiences with each other to relax from the boring work schedule; moreover, they believe in cooperating with the group members of a particular community or a group (Group Dynamics, Processes & Development, 2001).
Conclusion
From the overall evaluation of the given article, it is concluded that individuals of the mental health services practice smoking activities. This specifically, exists in the mental health service institutions of Australia. The two main destinations of Australia, which have been analyzed, in relation with such issue, are the South Australia and Queensland. The clients and the staff of these institutes are the main obstacles, which make it difficult, to quit from such a harmful habit of smoking. Some theoretical aspects are also analyzed in the article, to verify that such practices are favoured by these people, to have a good relationship with each other and to develop a stress-free environment.
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