Essay on Asian Women in the Eyes of Americans - 2297 Words

Introduction The history of Asian women has many facets. I am about to touch on two key monumental points over a sixty year span that have shaped the views of Asian women in the eyes of Americans. As a brief overview, from as early as the 1940s, Asian women were recruited to serve their soldiers during World War II as sex slaves. Forty years later, the dawning of the 1980s brought about the desire of Asian women into American households and sparked the mail order bride phenomenon. The beginning of a new century has altered the lives of Asian women, in parts of Asia as well as in the United States of America. I will give you a glimpse into their every day lives in their home country and site observations to their strides†¦show more content†¦Afternoons would be reserved for middle-ranking officers and evening hours for higher-ranking officers. Commanders of a military unit, or the camp where â€Å"comfort stations† existed, monopolized the overnight stay privileges. When the war ended, most â€Å"comfort women† were simply abandoned. The â€Å"comfort women† have been hidden victims for over half a century. Having been victims of sexual violence, where a woman’s chastity is upheld as more important than life itself, many of these women have blamed themselves and kept their sufferings from family members and the community, fearing tainting of the family name. Stetz and Oh indicate although WWII has ended and is now a mass piece of history, the â€Å"comfort women† ordeal still exists today. They continue their isolated existence in poverty and poor health. They have not regained their honor nor had their pains eased. These women continue to endure insulting comments made by irresponsible Japanese officials and by neoconservative nationalists, who claim that many Asian women were merely sex workers for money during WWII. As of the end of January in 1998, the top aide to Japanese prime minister Hashimoto suggested that many women became â€Å"comfort women† for money and that the Japanese military’s use of these women was justified by the moves of the times. Within a month of the inauguration of South Korean president Kim Dae-jung, a lifelong fighter for democracyShow MoreRelatedBeauty Is Not Pain?1704 Words   |  7 Pagesself-esteem of many women spiral down, especially in Asia. Beauty standards in South Korea are now being define by many K-Pop idols. â€Å"In Seoul, 1 of every 5 women ages 19 to 49 has had some type of plastic surgery, according to a 2009 survey by Trend Monitor† (Chow, NPR). 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Essay about deployment flow chart - 1256 Words

â€Å"The clinical microsystem is the place where patients, families, and caregivers meet. It is the lotus of value creation in healthcare.†(Nelson, Batalden, et.al, 2011) Lilly Walden describes herself as an active, athletic, and healthy woman. In her mid-forties she continues to run 2–3 miles 5 days per week. Lilly is married with three children and is employed by the local school district as a speech therapist. Lilly describes herself as health-conscious. Her diet is balanced, and she is a nonsmoker and drinks wine on rare social occasions. Lilly has a history of asthma, triggered by environmental changes, and it typically requires antibiotic therapy for bronchial infections 2–3 times per year. This presentation will review the following:†¦show more content†¦There has to be shared decision making between the family members and educate them about treatment of the patient since they will be helping take care of the patient. 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Critically Examine the Trend and Size of Poverty in Hong Kong Free Essays

string(103) " special needs including school fees, school-related expenses, essential traveling expenses and so on\." No city in the world is as ironic and contradictory as Hong Kong. This city has not only the 6th highest per capita GDP, but also the highest Gini coefficient in the world (World Bank, 2011). Fortunately, the Hong Kong government isn’t turning a blind eye towards this dilemma but are instead actively looking for a trade-off between economic performance and social welfare. We will write a custom essay sample on Critically Examine the Trend and Size of Poverty in Hong Kong or any similar topic only for you Order Now One notable example is the re-establishment of the Commission on Poverty, it is hoped that a clearly-defined poverty line will shed a new light into the poverty situation in Hong Kong. Another important policy in recent years is the implementation of minimum wage law, which has been in effect for two years aiming to guarantee a basic wage for low-income workers, however its effect on overall employment level in Hong Kong is still to be determined. In this essay, I will first examine the overall trend and size of poverty in Hong Kong, then move on to assess the effectiveness of the present social security system, as well as the minimum wage in eradicating poverty in Hong Kong. Poverty, is an ambiguous term especially in Hong Kong. The United Nations places the benchmark for poverty as living under a monthly income less than or equal to half of the median household income of equal size households. This is the definition that the Commission on Poverty is likely to adopt. But before the launch of official poverty line people are considered poor only if they apply for Comprehensive Social Security Assistance (CSSA), which eligibility is largely determined by nominal income. As a result, the number of people applying for CSSA decreased after minimum wage law has been imposed. In this essay therefore, I will adopt the UN definition of poverty in examining its trend and size in Hong Kong. Poverty rate up to the year 2011 was the lowest since that of 2001. Before 2011, there had been an overall increasing trend in both the number of households living in poverty as well as the poverty rate. In this sense, 2011 can be seen as a watershed year; the poverty rate plummeted to 17. 1% when compared to 17. 9% in the previous year, which meant a reduction of 55000 people suffering from poverty. Additionally, the total number of poor households had been rising from 2001 to 2007, but this trend started to decline from then on. The total number of poor households in 2011 was 444,000, when compared with that of the years 2007 and 2010; there had been a reduction of 11,000 and 7000 households respectively. In spite of the declining poverty trend and size, income disparity in Hong Kong has been worsening. In the year 2001, the median monthly income of high-income group was $31,000 while that of low-income group was $10,000, which meant that the former was 3. 1 times that of the latter. However, this disparity continued to grow and in the year 2011, the median monthly income of the high-income group increased to $35,000, while that of the low-income group plunged to $9000, which meant that the high-income group had a monthly income 3. 5 times more than that of the low-income group. In brief, it is undeniable that the declining trend and size of poverty has been promising, but that was largely due to the thriving economy instead of governmental efforts, at the same time, the income gap has been widening despite the implementation of minimum wage law. These statistics all indicate that the current social policies are inadequate in eliminating the imminent threat of poverty. The social security system in Hong Kong is a three-tier system consisting of social assistance and social allowance in the form of Comprehensive Social Security Assistance and Old Age Allowance, mandated occupational pension in the form of Mandatory Provident Fund as well as private saving. In the remaining part of the essay, the effectiveness of the above social security policies in lifting poverty will be assessed one by one. The Comprehensive Social Security Assistance was renamed after the Public Assistance Scheme in 1993 has the sole purpose to provide â€Å"a safety net for those who cannot support themselves financially. It is designed to bring their income up to a prescribed level to meet their basic needs. † (Social Welfare Department, 2012) It is a non-contributory and means-tested scheme financed wholly by the government. CSSA payments can be broadly classified into three categories: standard rate, supplements and special grants. Standard Rates from 2012 is divided into 5 types: elderly person aged over 60 or above, ill health adult under 60, disabled child, able-bodied adult aged under 60 and able-bodied child. The amount of standard rates payable to each type differs, but they are under the same guiding principles; the standard rates for children and seniors are higher than those of the adults, rates for single individuals living alone are greater than those of family members, and rates will increase with levels of severity of disability. Tsoi, 2002) Additionally, there are five types of supplements. Long-term supplement is an annual payment to recipients who have been receiving assistance for at least 12 months for the replacement of household and durable goods. Single parent supplement is a monthly payment to single parent families with special difficulties in bringing up their families. Community living supplement is a monthly payment to old, disabled and certified ill-health CSSA recipients living in th e community instead of any institutions. Transport supplement aims to promote social integration and geographical mobility by providing monthly assistance to certified 100% disabled as well as population between 12 to 64 years of age. Last but not least, the intention of the residential care supplement is to relieve the accommodation burdens of old, disabled and certified ill-health CSSA applicants who are not living in subsidised housing estates. Besides, a range of special grants are also set up to meet applicants’ special needs including school fees, school-related expenses, essential traveling expenses and so on. You read "Critically Examine the Trend and Size of Poverty in Hong Kong" in category "Essay examples" Famous English philosopher Midgley once commented that redistributing wealth in the form of social assistance has the â€Å"most direct potential impact on the poverty problem. † She identified three necessary conditions in order to fully realize this potential, first, social assistance must be financial by progressive taxation, second, the level of benefit provided must be sufficient to raise recipients out of poverty and third, needy people must have easy access to social assistance schemes and that these schemes would not deter them from applying for help. Tsoi, 2002). With applies the above mentioned three principles to Hong Kong, it is worthy to highlight that Hong Kong only fulfilled the first condition out of the three. In the following paragraphs, the low effectiveness of the CSSA will be discussed with respect to its level of benefits, process of application as well as incentives for its recipients to reintegrate into the job market. The level of benefits by the stand ard rates of the CSSA cannot reflect the actual needs of its recipients, but are in fact set arbitrarily. At the oment, the standard rates of CSSA recipients are reviewed and adjusted annually by the Legislative Council to reflect the changes in Price Level by the Census and Statistics Department. The Consumption Price Index however, is a reference to the household expenditure of the 25% of the population with the lowest income. It is highly dubious as to whether the household expenditures of the poor households would be an authentic indicator and correspond to what they actually need to support their daily living. In addition, some CSSA recipients described the process of application as humiliating and intimidating. According to a joint project by the Department of Applied Social Sciences in Polytechnic University and Oxfam Hong Kong on Perception and Utilization of the CSSA in 2007, it was found that some recipients felt that their applications were always delayed and mishandled. Some applicants even accused the social security officers as having bad manners and lack empathy. These findings were found out after in-depth interviews and group discussion, although it is questionable as to the representativeness of the sample size, the critique to the â€Å"humiliating† application procedures must point to some bearing of truth that the CSSA recipients feel. Besides, some social workers in the study also complained that â€Å"some officers tend to insult and threaten the applicants by making unreasonable requests†. Going back to Midgley’s third condition in order to eradicate poverty which concerns the access to social security must not deter the needy from applying; the Social Services Department could clearly do a better job. Furthermore, there is always an unspoken concern that receiving CSSA would encourage a â€Å"dependency culture†, especially when the CSSA mechanisms do not encourage able-bodied recipients to attain economic independence. Contrary to common misconception that only able-bodied lazy people and new immigrants would apply for CSSA, most CSSA applicants, amounting to 60% (Oxfam, 2007) treat social security as the last resort to alleviate their dire financial circumstances. However, due to a lack of support services, only 8%-10% of able-bodied CSSA recipients are able to re-enter the competitive job market (Ming Pao Daily News, 2000) through the Special Job Attachment Programme. In addition, the additional cost for attempting to re-enter the job market may ut an extra toll on the families receiving CSSA, let alone some single parent’s families with insufficient child-care facilities may choose to keep on receiving welfare instead of working. In short, CSSA do not provide sufficient incentive for its recipients to re-join the work force, which is the only way to escape poverty. Another aspect of the social security system in Hong Kong is mandated occupational pension, which is in the form of Mandatory Provident Fund in Hong Kong. It is a compulsory, occupation-related scheme with defined monthly contribution by both employers and employees. The Mandatory Provident Fund Schemes Ordinance was passed in 2000 with the hope of strengthening the safety net and retirement protection. Contribution to the MPF is mandated to be 10% of the employee’s income with which 5% is contributed by his/her employer. Besides, the mandatory contribution is adjusted with relevance to employees’ income. After the implementation of minimum wage, the monthly relevant income is readjusted, for employees with monthly income less than $6500, only their employers are mandated to contribute 5% of relevant income, this becomes the minimum contribution. On the other hand, for employees with income higher than $25000, both employers and employees are required to contribute $1250, this becomes the maximum contribution. All MPF contributions will be injected into registered MPF trustee in the market chosen by the employers, but now, employees will be able to choose new MPF scheme annually based on their performance. In the following paragraphs, the limitations of the MPF scheme will be discussed including its limited coverage as well as inadequate retirement protection which undoubtedly hamper its effectiveness. As aforementioned, MPF is an employment-related protection scheme, which means that only people with long-term employment contract will receive retirement protection. The MPF only have limited coverage and do not have universal protection as people excluded from the workforce including the sick, the disabled, housewives, hawkers, domestic employees and so on are unprotected, this amount to quite a sizable portion in the population. Besides, the employers might try to evade from the mandated contributions by altering the terms of employment contract. Employers are legally bound to contribute to MPF for their employees if they are employed for more than 60 days, therefore, some employers may deliberately change the employment contract to 59 days or terminate the contract and re-employ the employees. In brief, the MPF scheme does not provided for universal protection in the sense that a significant portion of the population is left unprotected, let alone some canny employers attempt to alter the employment contract in order to avoid contributing to their employees’ retirement protection scheme. Furthermore, the predicament of the MPF Scheme is that despite its objective is to provide retirement protection and reinforce the safety net, the protection is in fact far from sufficient. MPF is a define-contribution scheme but it is not a defined-benefits scheme, which meant that employees’ contribution is contingent upon many factors including the duration of contribution, returns from investments by the trustees after deducing the high administrative and transaction costs incurred, as well as the amount of contribution. This led to the inevitable unpredictability of benefits which is neither guaranteed by the trustees nor protected by the government. Besides, the scheme was introduced only in 2000, which meant that people around retirement age at that time would receive either little or no protection at all due to the short contribution period. At the moment, elderly poverty was one of the severest forms of poverty in Hong Kong. In short, contrary to its initial intention, the MPF does not guarantee retirement protection, instead only added more uncertainties and unpredictability to lives after retirement. The statutory minimum wage was passed in 2010 and fully implemented Labour Day of 2011. It aims at â€Å"striking an appropriate balance between forestalling excessively low wages and minimising the loss of low-paid jobs while sustaining Hong Kong’s economic growth and competitiveness (Labour Department, 2011). The initial minimum wage rate was set at $28, but the commission set up by the government to review the minimum wage rate biannually has agreed to increase to $30 an hour. From a theoretical standpoint, setting up a wage floor would upset the balance of the labour market by forcing some low skill workers to be laid off. Nevertheless, the government estimated that 273800 grassroot workers would benefit from the law and could sustain a basic level of living by avoiding from being underpaid. After about two years since the law has passed, however, it seems that reports about employers trying to cut the fringe benefits of employees were not uncommon and the actual effect and repercussion of minimum wage on the labour market is yet to be unravelled. In the following essay, I will examine the implementation of minimum wage law with regard to its effectiveness in eradicating poverty in Hong Kong. In order to assess the effectiveness of minimum wage, the first indicator is changes in monthly income of the lower income groups when compared with higher income groups in the lower half year of 2011. If we divide the whole population equally into ten decile groups with the first decile group being the poorest 10% of the people and the tenth decile group being the wealthiest 10%, it was found that in the first three decile groups all experience increase in monthly income ranging from 6. 9% to 9. 3%, while the last three decile groups experience either no change or negative growth in their monthly income (HKCSS, 2011). However, looking at income alone would not be a comprehensive assessment of the effect of minimum wage law given that the economic began to boom around the time minimum wage was implemented. Therefore, a much more reliable assessment would be to compare the living standards of low income households before and after the minimum wage came into force. A study commissioned by Oxfam Hong Kong adopted a two-stage stratified surveys that interview impoverished households with at least one family member receiving minimum wage and compare their livelihood from March 2011 to January 2012. In the following paragraphs, findings from this study will be further analysed. In terms of monthly income, the minimum wage law has indeed increase the nominal household income. About 70% of interviewees, representing 131125 families reported an increase in household income after the introduction of minimum wage. Moreover, 72. 6% of them also reported a rise in individual workers’ income. In spite of an increase in monthly income and in fact, hourly income as well, working hours of workers decreased. The average hourly wage of respondents who stayed in the same job before and after implementation of minimum wage increased, 56. 8% of them even receive an hourly wage that exceeded $28. However, the same group of people who remain in the same job also experience an average cut of about 13. 9 working hours. This reduction of working hour is more often than not, at the expense of the workers’ benefit such as cancelling paid lunch hour or meal break and no overtime payment and so on. 46. % of respondents complained that the previously paid rest days were cancelled since the enforcement of minimum wage law. Taking into account of the loss of paid rest days as well as other fringe benefits, coupled with the reduction in working hours, over half of the respondents, 55. 8% of them experienced a drop in individual income despite the apparent increase in nominal monthly income. In the paragraph above concerning CSSA recipients, it was briefly mentioned that they treat social assistanc e as their last resort to mitigate their financial situation. In fact, most of them felt â€Å"perceivable prejudice† against them. The introduction of minimum wage has a wide application, but it affects most significantly low-income jobs that CSSA recipients crave. About half of the respondents receiving CSSA in the Oxfam study affirm the effectiveness of wage floor as an impetus to quit receiving social assistance. This in brief, could address the need of CSSA recipients to self-reliance and eliminate the stigmatization or label that they feel attached to them by re-entering the job market. Nonetheless, increase in income to a certain extent does not mean or signify poverty alleviation. The most pivotal finding in the Oxfam study is that it reveals 40. 5% of households still live in deprivation despite the minimum wage law. This is because they define â€Å"deprivation† as the inabilities to afford at least three items that are dubbed essential by most Hong Kong residents including dental check-ups, leisure activities, afford to go to private clinics when sick and tea house and so on. According to Townsend (1979), â€Å"a person is considered to be in poverty if he or she does not have enough resources to enable him or her to participate in normal activities commonly engaged by ordinary members in the community and therefore cannot become fully integrated into the mainstream of society. † Therefore, when 40. 5% of respondents, representing 531354 households are still deprived of a chance to engage in social activities simply due to the fact that they still could not afford the items they need highlighted just how ineffective minimum wage legislation has been in eradicating poverty. In conclusion, lifting people out of poverty is a difficult problem that could not be solved by any social policy alone, let alone the many flaws and limitations that are embedded in social policies. However, it is only through identifying the imperfection in social welfare policies could we make improvement on them and hopefully attain the final goal of eradicating poverty at the end. Reference list: Hong Kong Council of Social Service, The Statistic review of the Low Income Household in Hong Kong, 2011. w. hkcss. org. hk/index_e. asp Labour Department (2011). Statutory Minimum Wage: Reference Guidelines for Employers and Employees. Legislative Council (2012). Before and After the Statutory Minimum Wage Ordinance in Hong Kong: Survey of Low-income workers and their Families. Oxfam Hong Kong and Centre for Social Policy Studies, Department of Applied Social Sciences, Hong Kong Polytechnic University (2007). Perception and Utilization of CSSA: a Study on the Views of the Public and th e Lower Income people. Social Welfare Department (2012), Comprehensive Social Assistance Scheme, retrieved from: http://www. swd. gov. hk/en/index/site_pubsvc/page_socsecu/sub_comprehens/ Tsoi Kcon-wah , â€Å"Poverty Eradication and Social Security in Hong kong†, in Advances in Social welfare in Hong Kong, ed. ,) by D. T. L. Shek, 2002, Chapter 9. World Bank (2011), Gini Index, retrieved from: http://data. worldbank. org/indicator/SI. POV. GINI How to cite Critically Examine the Trend and Size of Poverty in Hong Kong, Essay examples

1834 Poor Law free essay sample

National Service Framework 1998, 2009: set national standards and guidelines and targets for developing services †¢recovery approach represents shift from medical focus on cure to individual capacity, regardless of diagnosis and symptoms †¢measures to protect rights of people with mental illness in Mental Capacity Act 2005 and Mental Health Act 2007 PERSONALISATION: mental health service users’ limited access to direct payments the result of professional paternalism and fears about risk †¢personal budget studies showed most positive outcomes for mental health service users in terms of overall wellbeing and quality of life †¢Pathways to Personalisation, Putting Us First and New Horizons designed to increase access e. g. through risk management strategies. How many, what and why An estimated one in four people experience some form of mental illness during their lives which makes it one of the most common causes of disability. Common mental disorders are more likely to affect women than men, and the rates amongst women aged 45-64 have risen by about a fifth over the past fifteen years. People aged 75 and over are least likely to have a common mental disorder. More than half with a common mental disorder present with a mixed anxiety and depressive disorder. Whilst serious mental illnesses such as psychotic disorders (e. . schizophrenia), anti-social personality disorder and borderline personality disorders receive considerable publicity they each affect one percent or less of the adult population. There are slightly higher rates of psychotic disorder amongst women than men but little difference in relation to personality disorders. The highest prevalence rates are amongst the 35-44 age group, with a significantly higher diagnosis of psychotic disorder amongst black men than men from other ethnic groups. Psychosis is also more prevalent amongst adults in the lowest income groups. A relatively high percentage of adult psychiatric patients, particularly amongst urban populations, have a co-diagnosis of substance misuse. The mental health disorders discussed so far may be transient, recurrent or chronic but degenerative brain disorders, commonly collectively known as dementia, are permanent and terminal. Because they affect one in twenty people over the age of 65, and one in five over the age of 80, an ageing population means that its prevalence will continue to increase. Need for social care The stigma attached to mental illness continues to affect service users, their families and carers. Although there are some encouraging signs of a shift in public attitudes, surveys show that a high proportion still believe that people with a mental illness should be kept in a psychiatric hospital. Stigma affects the lives of people with mental disorders in a number of dimensions, such as relationships, paid employment, housing and quality of life. This makes mental illness an issue for social care as well as health policy, whilst the growing prevalence of dementia will place increasing demands on both health and social care providers. 2. From institutionalisation to community care Institutionalisation In the 18C and 19C, as discussed in previous sessions, people regarded as dangerous were commonly confined to institutions under harsh and degrading conditions – initially in private madhouses and later in publicly-funded asylums. Successive Lunacy Acts passed during the 19C increased the number of medically-run asylums reflecting an increasing recognition that mental illness was a disease and the mind a function of the brain. Doctors played a central role in these institutions, certifying lunatics, diagnosing and treating them, running the asylums, and inspecting and supervising private madhouses. Nevertheless, only a minority of people with a mental disorder were confined to a specialist institution; the majority were looked after by their families or confined to workhouses or prisons. Welfare state and community care The asylums were absorbed into the National Health Service when it was formed in 1948, representing over half of all in-patient beds. From the 1950s onwards, however, there was a policy of closing these hospitals down, a policy shift underpinned by a number of key factors including the discovery of medications to treat the symptoms of psychosis which made custodial care less necessary for risk management. A powerful medical lobby pressed for doctors to be allowed to practise ‘real’, that is acute, medicine in hospitals rather than using them for chronic care. In terms of grassroots pressure, the anti-psychiatry/mental health survivor movement emerged in the early 1970s alongside the disability movement. Academics gave rise to the idea that mental illness was a social construct rather than medical fact (e. g. such as Szasz, Laing, Foucault) as well as critiquing the inhumane treatment of patients in long-stay hospitals (e. . Goffman). Arguments supporting hospital closure were developed against a backdrop of wider civil rights movements across Western society, exploited by pressure groups such as MIND in the UK. In Italy, radical psychiatrists successfully campaigned for the passing of Law 180 in 1978 which prevented new admissions to existing mental hospitals. As discussed previously, though, in the UK, deinstitutionalisation was also influenced by the belief that communi ty-based care would be cheaper. The 1959 Mental Health Act was a significant landmark in the development of care in the community, that is, the provision of a network of state-run, professionally-delivered services outside hospital, such as hostels, day care, social work support and sheltered employment schemes. The 1975 White Paper Better Services for the Mentally Ill re-emphasised the need to provide a comprehensive range of community services, followed by the 1976 White Paper Priorities for Health and Personal Social Services which encouraged health and local authorities to prioritise chronic care. Joint planning and joint finance arrangements introduced over the 1970s were designed to improve co-ordination between health and local authorities in the development of community-based services. Some NHS responsibilities were transferred to local authorities, such as psychiatric social work; and multidisciplinary community mental health teams were formed, comprising community psychiatric nurses, social workers, occupational therapists, psychologists and psychiatrists. Despite these measures, economic crisis and public spending cuts over the 1970s slowed the growth of community-based provision . Care v control Risk and control Beginning in the late 1980s, a series of high profile violent episodes involving mental health service users recreated fears about the safety of community care. Criticism about the lack of co-ordinated support for discharged mental health patients resulted in the Care Programme Approach (CPA), implemented in 1991, which required health authorities to collaborat e with social services departments and family carers, a care co-ordinator for each patient and regular care planning review. A further homicide led to an inquiry to conclude that CPA was ineffective. In 1994 the government required people considered most at risk of harming themselves or others to be placed on supervision registers to ensure they remained under the control of mental health services. The 1995 Mental Health (Patients in the Community) Act then extended the scope of healthcare providers’ authority over people discharged from hospital. The process of reforming the 1983 Mental Health Act once again gave prominence to the debate about public safety versus patient rights. A draft Bill contained controls such as compulsory medication and the detention of people with severe personality disorders even if they had not committed a crime. The Royal College of Psychiatrists formed an alliance with mental health user/survivor groups to oppose this use of psychiatry as a means of social control. Despite government concessions, the Bill was defeated and a second met with opposition. Thus the 2007 Mental Health Act left the 1983 Act largely intact, but introduced Supervised Community Treatment including Community Treatment Orders. This new power replaced supervised discharge with the power to return a patient to hospital where, if the individual had not taken prescribed medication, s/he could be forcibly medicated. The 2007 Act also replaced the specialist Approved Social Worker role with that of the Approved Mental Health Professional, whilst broadening the scope of the latter to permit treatment without patient consent. Care and rights There was also an emphasis on improving care and rights during this period. The 1998 National Service Framework established guidelines for developing and vidence-based national standards for services as well as time-limited targets for their achievement. This was updated in 2009 by the policy document New Horizons which had the twin aims of improving the mental health and wellbeing of the general population and improving the quality and accessibility of services for people with poor mental health. Greater recognition of stigmatising attitudes towards mental illness, amongst pu blic and professionals alike, can be linked to the recovery approach to mental illness. Alongside clinical treatment, the recovery approach focuses on each individual’s capacity to build a meaningful life, find and maintain hope, re-establish a positive identity and take responsibility and control, regardless of diagnosis or symptoms. Rather like the social model of disability, curing the illness is less the emphasis than social inclusion, individual choice and control. In terms of rights, the 2005 Mental Capacity Act gave expression to the principle that people were capable of making a decision unless a systematic assessment proved that their mental functioning was too impaired. The Act also contained safeguards to ensure that all practicable steps were taken to support vulnerable people to make decisions in their best interests with the least restrictive outcome. The 2007 also contained some protective measures. It replaced the treatability test with criteria for involuntary commitment based on a requirement that someone couldn’t be detained unless appropriate treatment was available. It also introduced the Mental Health Review Tribunal to improve patient safeguards and independent mental health advocates. Personalisation can be linked to the recovery approach but, historically, mental health service users have had limited access to direct payments and individual budgets. The evaluation of pilot studies indicated that only a low proportion of mental health service users relative to other service user groups received an individual budget. Those who did, however, reported the most positive outcomes in terms of overall wellbeing and a significantly higher quality of life. They benefited from the flexibility of individual budgets which gave them access to a wider range of support other than standard services. Guidance, such as Pathways to Personalisation and Putting Us First, attempted to address the reasons for low access by addressing the issue of risk and providing good practice guidance on risk management strategies, such as advance directives and crisis management plans to cope with fluctuations in mental health. Pathways to Personalisation is linked to the recommendations of New Horizons, the cross-governmental mental health strategy cited earlier.