Analyzing Policy Issue Analysis Essay

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¶ … healthcare policy, using a Congressional bill introduced into the American parliament in its present legislative session. Introduction/Problem Description

Paul Raeburn was faced with hardly any good alternatives when he required immediate assistance with his suicidal teenaged son, who threatened to lie in wait for a train on the nearby railway tracks. Despite Raeburn, one of the top science and health writers in the American society, being more capable of locating the best mental health professionals and therapy options in the country for aiding his son compared to most other people, only one option came to mind when hit by this crisis -- seeking the police's help and risking the imprisonment, rather than hospitalization, of his son (Szalavitz, 2012). Though it is unclear whether mental ailments (alone or combined with any developmental disorder) had any part to play in the shocking Newtown shooting incident, the tragedy has sparked an important discussion concerning how psychiatric patients are cared for. This debate has harshly criticized the disorganized nature of the U.S. mental health care system, which leaves innumerable young adults and kids (such as Raeburn's child), without requisite resources. Hence, this paper will examine today's mental healthcare structure for kids, and how it affects their families.

Background Information

The current state of America's mental healthcare delivery is inadequate in meeting kids' and youngsters' needs. Mental health care is inaccessible to individuals direly needing them (Stagman and Cooper, 2010):

1. Substance abuse and mental health issues are common in today's youth, beginning from a very young age.

1. Twenty percent of individuals aged below 18 years suffer diagnosable mental problems.

1. Ten percent of youngsters suffer from severe mental ailments, impairing their functioning at school, home, and in society.

1. Major mental ailments can begin anywhere between 7 and 11 years of age.

1. About 50% of lifetime mental ailments begin in mid-teenage.

Social Factors

Stakeholders are kids and families (i.e. they are impacted most). Of the roughly 7.4 million American children (11.3%) diagnosed with behavioral, developmental, or emotional conditions, a disproportionately large number have no mental health service access due to being underinsured, as per a recent Health Resources and Services Administration report. The report also found that: 65.7% of these mentally ill kids are boys; 51.1% are aged from 12-17 years; 24.8% are poor (income less than federal poverty line); about 33% suffer from chronic physical problems as well; 29.4% insured kids have insurance, which usually doesn't cover their needs; and 40.3% have two or more behavioral, developmental, or emotional conditions (45.8% of these have learning disabilities as well, as against 2.7% of kids without any behavioral, developmental, or emotional problems) (Many children not receiving needed mental health services, study finds, 2010).

Economic Factors

Mental health for kids is inadequately financed. Though no recent estimates exist of total national expenditure, federal agencies invested about 6 billion dollars in preventive health services in the year 2007 (Stagman and Cooper, 2010). In spite of this financial backing, and largely because of a deficit in flexible financial aid for service customers and the system, care quality is poor and several kids and youngsters don't receive necessary services.

Finance policies guide kids'/youngsters' mental health service quality and capacity.

Restrictive financing streams hinder system leaders' ability of offering services, depending on children's and their families' unique needs, within their community setting.

Flexible financing strategies enhance service innovation, whilst also increasing the system's capacity of providing required services.

Capacity overflow results in high usage of emergency rooms and other expensive forms of patient care.

Ethical Factors

In diagnosing childhood psychiatric problems, values play a key role. As human behavior and emotional expression occurs along a continuum, classifying them as abnormal or normal inescapably entails value judgments. On the basis of assessments dysfunction or harmful impairment and symptom observation, clinicians must ascertain if a patient's suffering warrants therapy (Parens and Johnston, n.d). It is suggested by some commentators that increasing diagnoses in countries like America indicates access to improved mental health services, i.e., an increasing number of children receive early diagnosis, owing to improved, early recognition of their ailments. Furthermore, it has been rightly indicated that values contribute to diagnoses in all medical fields, and that it is unsurprising that diagnoses in psychiatry involve the following value judgment: that a particular degree of suffering must be considered bad.

Political and Legal Factors

The 2014 Presidential Budget covers a crucial 205-million-dollar funding of programs aimed at early identification of mental health issues, improving mental healthcare access, and supporting safer schools. Thirty million dollars are allocated to research and tools for enhanced understanding of prevention of gun violence, including major mental health problems. The budget backs initiatives for aiding adults (particularly teachers)...

...

Further, the budget intends to aid 8,000 schools in implementing evidence-based behaviors for cultivating positive student behavioral outcomes and school atmospheres. Investments will be made to train over 5,000 master's level psychologists and social workers, as well as other mental healthcare providers. These individuals, together with family practitioners, doctorate psychiatrists and other professionals in the healthcare field, contribute very significantly to serving mentally-ill youngsters. Moreover, the budget allots funds to public health studies on prevention of gun violence, and expanding public health information on suicides and homicides, for helping inform prevention tactics.
Policy Option/Alternative

The 2015 Helping Families in Mental Health Crisis Act (H.R.2646) has created the Assistant Secretary for Mental Health and Substance Use Disorders post, to whom the Administrator of the Substance Abuse and Mental Health Services Administration's (SAMHSA) responsibilities will be delegated. Mental health initiatives are extended, with mental health training expanded. SAMHSA has to institute the Interagency Serious Mental Illness Coordinating Committee and the National Mental Health Policy Laboratory. The bill modifies the 1944 Public Health Service Act, and requires translation of top scientific and evidence-based practices into care systems by NIMH (National Institute of Mental Health) (Helping Families in Mental Health Crisis Act of 2015, n.d). Liability protection is offered to specific mental health professional volunteers. Subspecialists in pediatric mental healthcare are qualified for National Health Service Corps initiatives. An underserved group of kids or a child psychiatry training site may be identified as an area with shortage of health professionals. Protected health data of those who suffer severe mental ailment might be released under specific conditions to caregivers. The bill also amends Social Security Act (SSA) Title XIX (i.e., Medicaid) for conditional mental health coverage expansion. SSA Title XVIII's (i.e., Medicare) Part D (Voluntary Prescription Drug Benefit Program) has also been amended, requiring antipsychotic and antidepressant coverage (Helping Families in Mental Health Crisis Act of 2015, n.d). Provided it doesn't increase Medicare expenses, the 190-day inpatient psychiatric hospitalization lifetime limit will be eliminated. Health IT incentives and activities are expanded, covering certain substance abuse and mental health facilities and professionals. The bill restricts counseling and lobbying activities of advocacy and protection systems for mentally-ill persons. These systems should concentrate on ensuring that mentally-ill people's rights aren't abused or neglected.

Evaluation of Bill

The Helping Families in Mental Health Crisis Act of 2015

H.R. 2646

Evaluation Criteria-Pro/Con:

Effective- Pro: Creation of a countrywide strategy for increasing mental health staff. Focus is on professional recruitment, and improved services access to underserved populations, kids and adolescents (Jacques, 2015).

Con: This bill would eliminate a large portion of the crucial work carried out by the PAIMI program (Protection and Advocacy (P&A) for Individuals with Mental Illness). P&A organizations are accredited with the significant mental healthcare improvements witnessed across America (The Helping Families in Mental Health Crisis Act of 2015a-u Represents Wrong Policy Direction, n.d).

Efficient- Pro: Increased resource access to behavioral healthcare professionals, for implementing technology services such as electronic health records (Jacques, 2015).

Con: This bill will make discriminatory alterations to HIPAA (Health Insurance Portability and Accountability Act), decreasing mentally-ill individuals' privacy rights, thereby dissuading them from approaching mental health clinics and hospitals (The Helping Families in Mental Health Crisis Act of 2015a-u Represents Wrong Policy Direction, n.d).

Equitable- Pro: Covers grants of 20 million dollars for assisted outpatient treatment (AOT) initiatives in communities and states through the year 2020. Eighty percent of these funds are reserved for novel AOT programs, incentive creation, and infrastructure and resource provision for establishing AOT programs in place where they aren't available as yet (Jacques, 2015).

Con- The bill would drastically cut or completely eliminate several million dollars from key SAMHSA-run programs (The Helping Families in Mental Health Crisis Act of 2015a-u Represents Wrong Policy Direction, n.d).

Results of Analysis/Summary

In light of all the data showcased in the paper, I would definitely recommend the bill, as it earmarks grants amounting to 20 million dollars for AOT initiatives in communities and states through the year 2020, of which 80% are allocated to novel AOT programs. Furthermore, the bill supports creation of a countrywide strategy for increasing mental healthcare workers (Writer Thoughts, n.d). Hence, the bill will improve social, ethical, legal/political, and economic factors. In terms of efficiency,…

Sources Used in Documents:

References

(n.d.). Congress.gov -- Library of Congress. H.R.2646-114th Congress (2015-2016): Helping Families in Mental Health Crisis Act of 2015 -- Congress.gov -- Library of Congress. Retrieved February 19, 2016, from http://www.congress.gov/bill/114th-congress/house-bill/2646

(2010, October 18). HRSA. Many children not receiving needed mental health services, study finds. Retrieved February 18, 2016, from http://www.hrsa.gov/about/news/pressreleases/2010/101018childmentalhealth

Jacques, M. (2015, June 30). World's Largest Professional Network -- LinkedIn. PRA Statement. Retrieved February 19, 2016, from http://www.linkedin.com/pulse/pra-statement-helping-families-mental-health-crisis-act-marc-jacques

Parens, & Johnston. (n.d.). The Hastings Center - Bioethics and Public Policy. Mental Health in Children and Adolescents - The Hastings Center. Retrieved February 18, 2016, from http://www.thehastingscenter.org/Publications/BriefingBook/Detail.aspx?id=2188
Sebelius, K. (2013). The White House -- whitehouse.gov. Increasing Access to Mental Health Services -- whitehouse.gov. Retrieved February 18, 2016, from http://www.whitehouse.gov/blog/2013/04/10/increasing-access-mental-health-services
Stagman, S and Cooper. (2010). NCCP -- Home. NCCP -- Children's Mental Health. Retrieved February 18, 2016, from http://www.nccp.org/publications/pub_929.html
Szalavitz, M. (2012, December 20). Health - TIME. America's Failing Mental Health System: Families Struggle to Find Quality Care -- TIME.com. Retrieved February 18, 2016, from http://healthland.time.com/2012/12/20/americas-failing-mental-health-system-families-struggle-to-find-quality-care/
(n.d.). The Bazelon Center for Mental Health Law. The Helping Families in Mental Health Crisis Act of 2015a-u Represents Wrong Policy Direction. Retrieved February 19, 2016, from http://www.bazelon.org/News-Publications/H.R.-2646-Press-Release.aspx


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