US Mental Health Assistance
Mental health problems or mental illnesses are among the major public health issues in the United States given their prevalence. Mental health illnesses affected nearly all populations in the United States including children and adults. However, the prevalence of mental illnesses among adults is high in comparison to other populations. Mental health problems among adults in the U.S. incorporate many different conditions whose degree of severity varies from mild to moderate to severe (National Institute of Mental Health, 2019). One of the major contributing factors to the prevalence of mental illnesses among adults in America is the rapid growth of the aging population. Adults suffering from mental illness don’t always understand they are sick and are difficult to help. Our system puts them out on the street or locks them up. There is need for policy changes to address the prevalence of mental health illnesses among adults. An alternative care policy is the most suitable policy action for the government since it would help establish an assortment of mental health services and treatment for these patients.
Historical Context of the Problem
Mental illnesses have existed in the American healthcare system for a long period of time due to the challenges experienced by various patient populations across the country. Generally, millions of Americans across all age groups are affected by mental illnesses or mental health problems annually. Colpe et al. (2010) states that approximately 26% of Americans aged 18 years or more are affected by mental health conditions or reported to have a diagnosable mental illness in a given year. These diagnosable mental health conditions among adults vary in terms of lifetime prevalence. Recent surveys have shown that the estimated lifetime prevalence of mental health conditions among adults in the United States is high for anxiety disorders, impulse-control disorders, mood disorders and substance abuse disorders at 29%, 25%, 21%, and 15% respectively. As a result, adults in the United States are increasingly vulnerable to chronic mental health disorders.
Currently, the National Alliance on Mental Illness (2018) reports that nearly 1 in every 5 adults in the United States suffer from a diagnosable mental health condition. This implies that approximately 18.5% of the adult population in the U.S. i.e. 43.8 million adults experience a diagnosable mental illness in a given year. Additionally, 1 in every 25 adults in the U.S. experience a severe mental disorder in a given year. The severe mental illness experienced by these individuals significantly affects or limits at least one of their major life activities. Some of the most common mental health conditions experienced by adults in the United States include anxiety disorder, substance use disorder, schizophrenia, and bipolar disorder.
The prevalence of mental illnesses among adults in the United States has made it one of the major public health issues in the country. As a result, various initiatives have been developed and implemented in the U.S. healthcare system to help address mental health problems among adults and other patient populations. Colpe et al. (2010) contends that public health systems in the United States have relied on public health surveillance to develop health programs. In this case, public health system in the U.S. utilize mental health surveillance to collect data regarding mental health conditions and plan health programs. Additionally, various health programs and initiatives are used as a means for promoting the mental health and wellbeing of adults suffering from mental disorders. The National Institute of Mental Health (2019) reports that some of these initiatives include inpatient treatment or counseling and outpatient treatment or counseling. Such treatment or counseling approaches for adults are regarded as mental health services that sometimes incorporate the use of medication for emotional and psychological problems.
Despite the existence of mental health services in the U.S. healthcare system, mental health remains a major issue facing adult populations across the country. Prevalence of mental health issues among U.S. adults continue to increase due to various factors including seeming ineffectiveness of mental health services and factors relating to individual adult patients. Adults suffering from mental illness don’t always understand they are sick and are difficult to help. This continues to be a major problem regardless of measures and initiatives undertaken by the U.S. healthcare system to increase awareness on this issue and enhance treatment. The difficulties associated with helping adults suffering from mental health illnesses contributes to perceived ineffectiveness of some of the treatment alternatives provided in U.S. healthcare system.
In addition to individual factors, mental illnesses are public health issues because of the structure of the current U.S. healthcare system. The nature and structure of the American healthcare system currently puts mental health patients out on the street and locks them up. This further exacerbates their condition and interfere with their ability to receive timely and effective help. According to the National Alliance on Mental Illness (2018), approximately 26% of homeless adults staying in shelters suffer from severe mental health conditions. On the other hand, 20% of state prisoners and local jail prisoners have mental health problems. In addition, less than 50% of adults suffering from mental health conditions in the United States receive mental health services.
Policy Options to Resolve the Problem
Mental health policies are critical toward promoting access to mental health services among adults suffering from mental illnesses in the United States. Rather than putting mental health patients on the streets or locking them up, the U.S. healthcare system could significantly benefit from enacting policies that seek to deal with the issue. Mental health policies are essential in this process since they define a vision for the future. The vision provides standards for prevention, treatment and rehabilitation of those suffering from mental disorders. Moreover, the standards help in health promotion of mental health in the community. Therefore, health policies are critical in addressing the problem of mental illnesses among U.S. adults through coordinating programs and services that seek to accomplish specific objectives regarding mental health promotion and well-being. The United States healthcare system could benefit from various policy alternatives that target promotion of mental health and wellbeing among adults. Some of the policy options the U.S. government may adopt to resolve the issue include
Parity in Health Insurance
As shown in the previous discussion, many adults suffering from mental health issues are forced out of the current healthcare system by being put in streets or being locked up. This complicates the situations facing these patients as they seemingly do not understand they are sick and are difficult to help. One of the major reasons for the inability of the current healthcare system to cater for adults with mental illnesses is lack of suitable healthcare coverage for their conditions. Despite the enactment of the Affordable Care Act in 2010 to improve accessibility and affordability of care to patients, adults with mental illnesses still struggle to access and afford mental health services. There is lack of parity in private and state/federal health insurance coverage for mental health patients.
Goldman & Grob (2006) state that parity in health insurance coverage for these patients would help integrate and equalize mental health coverage in mainstream private health insurance. Current measures to enhance parity in private health insurance for mental disorders have been characterized by concerns regarding costs. These concerns are centered on the controversy on whether spending on mental health services is worthwhile. Due to these concerns, achieving parity or equal mental health coverage has become a major challenge. The lack of parity in health insurance for mental health services in the private sector has made it increasingly difficult for adults with mental illnesses to access and afford treatment for their conditions. As a result, Goldman & Grob (2006) argue that there is need for parity in private insurance markets, state legislation, and federal benefit programs. Parity would lead to equality in coverage, which in turn enhances the ability of adults with mental illnesses to access and afford mental health services. This would in turn deal with the current issue in which adults suffering from mental illnesses are put on the streets or locked up instead of being incorporated in the current healthcare system.
General Social Policy
The second policy option for the government to resolve the issue is the enactment of general social policy that targets mental health conditions in adults. Jenkins (2003) argues that the government should adopt mental health policies that are integrated into the public health policy and general social policy. The integration of mental health into general social policy is essential because mental illnesses cause heavy burdens for societies, limits the development of health and growth targets, and because mental health is integral to physical health. The lack of a general social policy that incorporates mental health contributes to social exclusion of adults suffering from mental illnesses. In the current U.S. healthcare system, adults with mental health conditions are socially excluded from the system as they are put out on the streets or locked up due to lack of a general social policy that integrates mental health policies. This enhances stigmatization of these patients, which exacerbates their conditions.
A general social policy that integrate mental health conditions help to improve the plight of adults with mental disorders through lessening the extent and severity associated with these conditions. This is achieved as the policy promotes the development of mental health services for these individuals while lessening stigmatization and promoting their human rights and dignity. Moreover, a general social policy that integrates mental health helps to promote psychological aspects of general healthcare and lessens mortality associated with mental disorders. The U.S. healthcare system would benefit from such a policy since it fosters concerted efforts between different stakeholders toward promoting the health and wellbeing of mental health patients.
Alternative Care Policy
Alternative care policy could also be used by the government to resolve the issue given role alternative care plays in promoting the health and wellbeing of patients suffering from mental health illnesses. Alternative care policy should focus on expanding the reach of mainstream psychiatry and development of alternative care approaches for mental health patients. For example, an alternative mental healthcare approach that is anti-mainstream has emerged and proven essential in addressing the needs of such patients. Alternative care approaches for mental health illnesses under this policy should focus on promoting holistic recovery. This would entail establishment of an assortment of in-home services, residential centers, and awareness groups or organizations (Carey, 2016).
Comparison of Policy Options
Each of these policy options for the government have varying impacts on the care of mental health patients. The three policy options discussed in the previous segment differ in terms of their approaches toward resolving the issue facing adults with mental illnesses. Parity in health insurance policy would help resolve this problem through expanding care and treatment for mental health conditions. This policy alternative would help expand care and treatment by improving the ability of adults with mental health illnesses to easily access and afford mental health services instead of being put on the streets or locked up. Parity in health insurance policy would address the problem by providing the premise for establishment of managed care arrangements for mental health. Such arrangements in turn widen the scope of insurance in relation to defining covered conditions and services that can be reimbursed. However, the establishment of such a policy would be characterized by concerns regarding definition of covered conditions. Previous measures toward parity in health insurance have limited the scope of coverage to specific conditions in order to ensure that resources are spent on severe mental health cases (Goldman & Grob, 2006). These limitations lessen the overall effectiveness of this policy alternative in resolving the current problem.
A general social policy that integrates mental health would address the problem through addressing social exclusion of adults suffering from mental health illnesses. As previously indicated, the major problem in the current healthcare system with regards to adults suffering with mental illnesses is social exclusion through putting them on the streets or locking them up. This policy alternative would help resolve the problem by promoting concerted efforts between various stakeholders through which adults with mental illnesses will not be excluded or discriminated against with regards to access to healthcare services. However, the policy could place heavy burdens on mental health providers through increased patients demands and needs.
Alternative care policy would address the problem by ensuring that adults with mental illnesses have alternative care settings for their conditions. In this regard, these patients would benefit from an assortment of in-home services, residential centers, and awareness groups or organizations (Carey, 2016). This helps to improve their conditions since they receive convenient, relevant and effective mental health services rather than being put out on the streets or being locked up. However, this policy could generate issues due to the fact that it is seemingly anti-mainstream.
Recommendation of Policy Action
The most suitable alternative out of the three policy options for the government to resolve this issue is alternative care policy. The current healthcare system is already facing heavy burdens in relation to providing general health and mental health services. These burdens come at a time when the system faces acute nursing shortage. Therefore, a suitable policy action for the government is one that does not exert further pressures and burdens on the current healthcare system and healthcare workforce. Given these factors, alternative care policy is the most suitable policy action since it would provide a good premise for addressing the needs of mental health patients without generating additional burdens and regardless of the severity of the condition. Existing evidence has demonstrated that alternative care under such a policy is effective in providing timely and effective mental health treatment and services. Through this policy, adults with mental illnesses will no longer grapple with neglect or social exclusion and will access mental health services regardless of the severity of their conditions (Carey, 2016).
In conclusion, mental health conditions are among the major public health issues facing the current healthcare system in the United States. The prevalence of mental health issues among adults in the country continues to increase due to various factors including increase in the aging population. However, adults with mental health problems don’t always understand they are sick and are difficult to help while the current system puts them on the streets or locks them up. As a result, there is need for enactment of suitable policy initiatives to resolve this problem. Some of the policy alternatives that the government can adopt to resolve the problem include parity in health insurance policy, a general social policy that incorporates mental health, and an alternative care policy. An alternative care policy is the most suitable policy action for the government since it would establish an assortment of mental health services and treatment for these patients.
References
Carey, B. (2016, August 8). An Alternative Form of Mental Health Care Gains a Foothold. The New York Times. Retrieved April 19, 2019, from https://www.nytimes.com/2016/08/09/health/psychiatrist-holistic-mental-health.html
Colpe, L.J., Freeman, E.J., Strine, T.W., Dhingra, S., McGuire, L.C., Elam-Evans, L.D. & Perry, G.S. (2010, January). Public Health Surveillance for Mental Health. Preventing Chronic Disease, 7(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811512/
Goldman, H.H. & Grob, G.N. (2006, May/June). Defining Mental Illness in Mental Health Policy. Health Affairs, 25(3). Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.3.737
Jenkins, R. (2003, February). Supporting Governments to Adopt Mental Health Problems. World Psychiatry, 2(1), 14-19.
National Alliance on Mental Illness. (2018). Mental Health by the Numbers. Retrieved April 19, 2019, from https://www.nami.org/learn-more/mental-health-by-the-numbers
National Institute of Mental Health. (2019, February). Mental Illness. Retrieved from National Institutes of Health website: https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
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