Mental Health Services Delivery in the United States

Mental Health Services Delivery in the United States

1. Statement and Significance of the Policy

In many societies, both in America and the world at large, mental health is a rarely addressed issue, evident with the gaps in the current policies in practice. Mental illnesses have a high prevalence in the United States, both temporary and permanent, and many scholars believe the current healthcare models fail to address the condition adequately (Lake & Turner, 2017). The status of mental health care is further suppressed by the implications of constant changes in other policy issues such as the Affordable Care Act and health insurance policies (Rowan et al., 2013). Strategic changes have occurred in the public management and governance of mental healthcare approaches. According to Grob’s (2014) time series analysis of mental health policy in modern America, one major reform was the transfer of mental health from mental institutionalism into a community-based mental health care policy.

Since the end of World War II, several changes have occurred to the national mental health policy, approaches, and general public perceptions. According to Grob (2014), the changes in the system happened from the experiences of many psychiatrists in World War II who steered significant changes in modern America. The future generations of policymakers and health professionals built on the founding principles, but years later, no approaches have addressed significant issues of concern. Many attest this factor to the influence of policy changes, lack of minimum standards on treatment, and weak social frameworks such as cultural competence. According to the NIMH, 46.6 million adults in 2017 lived with mental illnesses, an indicator of a prevalence rate of one in every five U.S adults. Such statistics indicate the need for a systematic policy that is both inclusive and extensive to ensure access, quality care, and an integrated system of mental health issues.

1. Related Issues and Consequences

Currently, mental health policy is widely dispersed with the SAMHSA mandated towards the integration of the policies with the States and other stakeholders. The policy exists across six national legislation Acts such as the Mental Health Services for Students Act, RISE From Trauma Act, and Lower Healthcare Costs Act. It, however, fails to address underlying issues such as community-based approaches in sensitizing the public on means to prevent mental illnesses. The policies have also alienated mental health issues from the mainstream healthcare system, which many scholars believe can aid the treatment and prevention of the problem.

There’s a high need for the mental health policies to be integrated with the central health system to enable necessary prioritization (Patel et al., 2013), equal planning and approaches in research, policy, and practice (Ngo et al., 2013; Collins et al., 2013) and inclusion in existing health programs such as maternal and child health care (Rahman et al., 2013). The integration of all the acts and policies into a single framework would establish an origin for addressing the gaps in the system. The mental health issue is a very complex issue that requires an equally complex system to integrate its diversified nature of the occurrence. Across many mental health empirical studies, the complex systems approach has been primarily employed in an attempt to establish an integrated approach within the context of the study.

III. Proposal for Addressing the Issue

A practical model for mental health issues needs to address the specific problems in society, such as causes, challenges, early detection, and ways of preventing the future prevalence of the issues. According to Langellier et al. (2018), the issue of mental health involves multiple levels that interact with each other but fail to align. The starting point is, however, to identify the challenges and then establish the means to integrate the policies to address them equally and amicably. If the systems develop a minimum standard for mental health issues, veterans, young children, maternal mothers, and people across all income and social levels can have access to quality mental health care. The existent of different insurance policies for people with mental health conditions fail to align with other policies providing for quality mental health care. There’s also a need for the minimum health standards to adopt a framework for mental health treatment as it is the case for other non-communicable diseases (Patel et al., 2013) as a form for classifying the type of mental illness and the standard form of treatment.

Prevention approaches also need to adopt a sensitization approach to address diversity and different environmental issues that may lead to mental health illnesses. Cultural competence is established as one of the significant challenges in addressing mental health issues. The current standard approach for prevention and early detection falls under the RISE and Mental Health Services Acts. These programs are primarily practiced within the school system and fail to include the entire society and communities. The approach would foster cultural competence across different forms of mental issues, genetic and environmental, to enable people to relate their mental health needs with their individual backgrounds. An integrated Mental Health policy would advocate for a community-based approach to mental health and succeed in prevention, early diagnosis, research funding, and an aligned approach across federal, state, and local authority levels.

References

Collins, P. Y., Insel, T. R., Chockalingam, A., Daar, A., & Maddox, Y. T. (2013). Grand challenges in global mental health: integration in research, policy, and practice. PLoS medicine, 10(4).

Grob, G. N. (2014). From asylum to community: Mental health policy in modern America. Princeton University Press.

Lake, J., & Turner, M. S. (2017). Urgent need for improved mental health care and a more collaborative model of care. The Permanente Journal, 21.

Langellier, B. A., Yang, Y., Purtle, J., Nelson, K. L., Stankov, I., & Roux, A. V. D. (2019). Complex systems approaches to understand drivers of mental health and inform mental health policy: A systematic review. Administration and Policy in Mental Health and Mental Health Services Research, 46(2), 128-144.

Ngo, V. K., Rubinstein, A., Ganju, V., Kanellis, P., Loza, N., Rabadan-Diehl, C., & Daar, A. S. (2013). Grand challenges: integrating mental health care into the non-communicable disease agenda. PLoS medicine, 10(5).

Patel, V., Belkin, G. S., Chockalingam, A., Cooper, J., Saxena, S., & Unützer, J. (2013). Grand challenges: integrating mental health services into priority health care platforms. PloS medicine, 10(5).

Rahman, A., Surkan, P. J., Cayetano, C. E., Rwagatare, P., & Dickson, K. E. (2013). Grand challenges: integrating maternal mental health into maternal and child health programmes. PLoS medicine, 10(5).

Rowan, K., McAlpine, D. D., & Blewett, L. A. (2013). Access and cost barriers to mental health care, by insurance status, 1999–2010. Health Affairs, 32(10), 1723-1730.