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Policy Issues in Mental Health and Impact
Mental healthcare is an area of care that has been neglected by policy makers and by the medical community at some point in its history. Examining how the mentally ill have been treated throughout history demonstrates that opinions have changed and people treatment has followed how the general public viewed mental health. At times reformers would make conditions better, but these always seemed to be followed by periods when the mentally ill were treated like criminals. This roller coaster ride of options and opinions seems to be changing currently, and the idea that mental health is as much of a disease as other forms of chronic illness is beginning to take hold with the general public.
Some of the credit for this can be laid at the feet of a greater awareness of how PTSD affects soldiers and other victims of extreme trauma, but, in part, it is also due to the greater awareness and education fostered by local and national organizations. Because of the efforts of organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institutes of Mental Health (NIMH), the National Alliance on Mental Illness (NAMI), and more local efforts such as The Carter Center, the message and education has started to take root. This paper looks at these organizations, how they affect a particular practicum site, and how they have personally affected the author.
The goal of SAMHSA, as stated by the Leading Change document, is to reduce "the impact of substance abuse and mental illness on American communities" (SMAHSA, 2011) which actually does not explain the true mission very well. The goal could be better stated as trying to provide programs and alternatives for families that will lessen the financial and care-related stress that they experience due to mental illness and substance abuse. The organization has attempted to accomplish this by first outlining the issues faced by the organization and then decide how it can "best use its limited resources" to positively impact as many lives as possible (SAMHSA, 2011). Many times throughout the document the purpose of putting people first is emphasized.
The primary impact is emotional, and this applies to both the person with the disease and the family who cares for them, but financial responsibility is also a problem. SAMHSA realizes, especially since the advent of the fiscal crisis, that people are not giving as much money to charity and that the government's funds are being spent in areas that are thought to contain greater need. But, SAMHSA has outlined why substance abuse and mental illness is such a large issue. The action plan states that;
"The annual total estimated societal cost of substance abuse in the United States is $510.8 billion; By 2020, behavioral health disorders will surpass all physical diseases as a major cause of disability worldwide; In 2008, an estimated 9.8 million adults aged 18 and older in the United States had a serious mental illness; " (SAMHSA, 2011)
And there are other statistics that outline the need also. The final goal is to increase understanding of the associated issues throughout the U.S.
The primary purpose of the National Institutes of Mental Health (NIMH) is to conduct and support research that provides insight into the various mental and behavioral health disorders (NIMH, 2008). The reason that they consider this such a vital mission is that mental illness affects more than 13 million people every year, and, according to the site, it accounts for 25% of the hours lost to illness in the United States and Canada (NIMH, 2008). The research done by NIMH is not meant to help control mental health disorders as much as it is meant to understand and manage them.
Simply, the institute has four guiding principles which help researchers design appropriate studies. These four -- promote discovery in the brain and behavioral sciences, chart mental illness trajectories, develop new and better interventions, strengthen the public health impact of the research -- are meant to provide a continuum that can lead to better support from the government and public, and can also lead to possible cures and definitely better management (NIMH, 2008). The organization realizes that professionals use the DSM series to make diagnoses, but another goal, a corollary to the first principle, is to "Redefine mental disorders into dimensions or components of observable behaviors that are more closely aligned with the biology of the brain" (NIMH, 2008). This effort should allow scientists to better understand exactly what causes and can hopefully cure specific mental illness.
The bulk of the paper explains, in some detail, how each of the four principles will be accomplished in the coming years. NIMH is constantly narrowing its research and seeking to educate the public on its findings. This organization may ultimately be the most important with regard to controlling mental illness in the future.
This site offers a better view of what mental illness actually is than any of the others so far. The reason it seems so is that the language is geared toward people seeking help rather than researchers or policy makers. The definition of recovery is interesting because they are not saying that a person is ever cured, but that they can mitigate the symptoms to such a degree that they can lead normal lives (NAMI, 2012). Possibly the most important message the site has regarding recovery is that it is a process not an event (NAMI, 2012), and that it is acquired through "medical and clinical values, community, and successful living" (NAMI, 2012). It seems that this information could be extremely helpful for someone seeking a positive message in the midst of the struggle of mental illness.
The site has a variety of ways that people, those with mental illnesses and other concerned individuals, can get involved. Advocacy is an important tool because people with mental illness are very often silent regarding their issues. The unfortunate fact is that there is still a stigma attached to mental illness and many times those afflicted do not want others to know their problems. Thus, it is important that there are those who are willing to advocate for those who prefer to remain silent. The site also lists a variety of events that are occurring around the country to honor those who have made some contribution to the fight against mental illness. The organization has a convention every year that highlights a different aspect of mental illness. Caregivers, consumers and professionals attend the conferences (NAMI, 2012). Besides these features there are many more interactive methods -- discussion groups, assistance through the STAR center, helpful news and a store which supports the efforts of NAMI -- that people can become involved through.
The Carter Center
Jimmy Carter and his wife Rosalyn have worked tirelessly to improve the lives of people around the world. Though some would say that the efforts are to shore up the legacy of a largely failed presidency, the reasons for the help they provide do not matter. The site states that "the Carter Center's Mental Health Program works to promote awareness about mental health issues, inform public policy, achieve equity for mental health care comparable to other health care, and reduce stigma and discrimination against those with mental illnesses" (The Carter Center, 2012). The last two seem to be the most important goals that any advocacy group could help to achieve in the short-term.
One way that Rosalynn Carter has impacted these two important goals is to provide awards in responsible mental health journalism for journalists around the world (The Carter Center, 2012). These fellowships are to ensure that the media covers mental health issues in a fair and informed manner. This speaks to both the anti-stigma and equity messages. Several of the sites have mentioned the fact that mental illness is often not considered in the same vein as other chronic illnesses such as diabetes, but The Carter Center, along with NAMI and the NIMH, are trying to change professional and public attitudes regarding this important belief.
The site also lists international and local efforts that Rosalyn Carter has included in the initiatives the foundation promotes. In Liberia, for example, the Center has partnered with the government and health departments to promote the same goals for mental illness that they have in the United States. Since the Carter's are from Georgia, they have also partnered with that state "to help bring forward solutions to help the government address Georgia's crumbling public mental health care systems" (The Carter Center, 2012). Through their efforts, the Carter's and other people involved with them hope to positively impact the state of mental illness around the world.
Impact on Agency
The goal of an mental health counseling center should fall in line with those presented by the four organizations listed. Of course, they may be smaller in scope because most do not have the international reach that these organizations do. However, every community…[continue]
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