This paper will discuss the necessity for social policy change in regards to the mental health system (or lack thereof) within the United States as well as internationally. The need for reform is tantamount in order for marginalized groups with mental disabilities to function well-beyond their capacities. An analysis of policy is needed to better understand the challenges that face current social workers and mental health professionals at this time. Therefore, this paper will discuss eight articles that pertain to the social work school of thought, and will be utilized to a great degree in making an argument for social reform.
The peer-reviewed, scholarly articles are presented and discussed to frame a basic foundation on what needs to be done, and if these changes are feasible in nature to our society. Since the topic is on Mental Health Policy, it is important to note any biases or hesitations that a social worker may have towards intellectual and mentally handicapped persons, and view this problem with an open mind free from negative beliefs.
Looking at this in the broad sense, this is not just a financial problem, nor a personal problem, but rather, this is a societal problem. There are many different ways in which mental health disorders can be attributed to. Crime, drug addiction, and many other factors are linked to some mental health issues. Depression, which affects millions worldwide can be treated through cognitive behavioral therapy. The best way to treat this problem would be prevention, and that is something that the United States, and the world has been lacking for quite some time. It is important to discuss this issue and provide long-term answers now, lest we face more financial burden and social burdens due to our own ineptitude.
The first article that will be discussed for this analysis is titled Mental Health and Poverty in the Inner City. This piece of literature examines the correlation between the rise in urbanization and mental health problems (Anakwenze & Zuberi, 148, 2013). It is a fact that the number of people who live in urban populations steadily increased within the millennium and is projected to go up in the next decade (Anakwenze & Zuberi, 148, 2013). This article provides evidence linking the rise of the urban population to the growing number of mental health disorders within it.
Living in a densely populated area can bring about many factors that can stimulate mental health problems. Noise, pollution, and lack of adequate green space are some of the problems that individuals face within cities (Anakwenze & Zuberi, 148, 2013). It is no wonder that mental health is of vital importance to the urban population, particularly the urban poor. Poverty is a strong characteristic of city life, and thus, it is necessary to see if there is causation between city-life and mental instabilities (Anakwenze & Zuberi, 148, 2013).
The article argues that the relationship between an urban environment and mental health problems can be described as cyclical and non-linear (Anakwenze & Zuberi, 148, 2013). The cycle is reinforced through poverty and this can nurture mental illness if not properly taken care of. The authors challenge current mental health policy and advocate for a system that specializes in prevention and treatment across all populations (Anakwenze & Zuberi, 148, 2013).
Crime, substance abuse, and other mechanisms that originate from urban environments can have a bi-directional relationship in regards to mental health and urbanization (Anakwenze & Zuberi, 148, 2013). They reinforce each other, causing a strong hold around the community. It is necessary for a new mental health policy to advocate for interventions within individuals and institutions in order to promote such an improvement in urban life. The many mechanisms that cause socio-economic disparities are outlined in great detail within the article; for example, dense and diverse populations, can cause great stress to the individual (Anakwenze & Zuberi, 149, 2013). It requires a person to be homogenous in their frame for social networking and diversification (Anakwenze & Zuberi, 149, 2013). The advocacy for a better social policy for urban environments cannot be valued enough. The second article, titled: Grand Challenges: Integrating Mental Health Services into Priority Health Care Platforms highlights the necessity for integrating mental health care into global programs designed for health.
This synthesizing of mental health policy into global health can have a significant impact in the lives of many individuals all across the globe (Patel et al.,1, 2013). The authors state that mental health problems are among the most frequent and disabling conditions within the planet. It is important to have everyone recognize the gravity of the situation and not take mental health lightly, because it is associated with chronic health problems that can worsen over time (Patel et al.,1, 2013). If left untreated, mental health disorders can have a significant impact on one’s self-care and can be linked to increase morbidity and mortality around the world (Patel et al.,1, 2013). Ineffective treatments can also increase the cost of healthcare and decrease productivity at work, requiring employers to cut costs and become ineffective themselves (Patel et al.,1, 2013). Knowing this, it is important to note that effective treatments for common mental health problems that plague the entire population can be utilized in order to help those in need (Patel et al.,1, 2013).
However, current policies do not allow easy access to such treatments, therefore, reform is needed to make sure that people have access to the treatments they deserve. The authors argue for a more cohesive network for doctors and patients to communicate about mental health (Patel et al.,1, 2013). For example, there are less psychiatrists in the continent of Africa, than there are in the state of Massachusetts (Patel et al.,1, 2013). Even in developed countries such as the United States, primary care facilities are the governing parties involved in the mental health care system (Patel et al.,1, 2013). This does not allow for adequate treatment and can exacerbate problems even further (Patel et al.,1, 2013). The article states that there needs to be integration in regards to primary care facilities and mental health professionals. The next article, Service development for intellectual disability mental health: a human rights approach talks about the population of people with intellectual disabilities (ID) in regards to mental health reform.
The authors state that people with intellectual disabilities suffer from major mental disabilities more frequently than their peers (Evans et al., 1098, 2012). Thus, it is imperative to review the current mental health policy and if necessary, change it to better suit the growing need for people with intellectual disabilities (Evans et al., 1098, 2012). The article uses the mental health policies in Australia as an example, appraising the standards set up by the United Nations on the rights of persons with disabilities. The article demonstrates the need for an in-depth analysis on mental health care on a global scale and must understand the paradigm in which mental health policies are shaped (Evans et al., 1098, 2012). They use the human-rights framework as the perspective in which to base all mental health problems accordingly. Public mental health services must be aware of the ever growing number of patients with intellectual disabilities and plan accordingly to suit the needs of this population (Evans et al., 1098, 2012).
In order to adequately perform these services, great amounts of funding is required to create a stable environment in which to get help for mental disorders (Evans et al., 1109, 2012). This is the problem the authors face and recognize. However, they urge to apply more funding into the mental health system because mental health should be higher on the priority for the population than most would realize (Evans et al., 1109, 2012). They see it as an investment into the well-being of the community. Considering the human-rights approach, it is necessary to improve specialist services and apply better social practice foundations to help these marginalized groups (Evans et al., 1109, 2012). Mental Health Parity: Moving Closer to an Effective National Policy states that mental illness is one of the most leading causes of disabilities in North American’s between the ages of 15-44 (Hebert, 28, 2009). Even with this wide and diverse population, the problem of mental illness still goes unrecognized in the eyes of the public (Hebert, 28, 2009). Thus, the cost of individuals and families, be it emotional, or financial, can skyrocket if left untreated (Hebert, 28, 2009).
As with all the articles, the author advocates for a stronger mental health system for children and adults. They discuss the growing inequity of coverage between mental and physical health, as well as the proportion of insurance coverage in regards to mental health (Hebert, 28, 2009). Therefore, it is important to utilize every resource available to combat mental illness, and the burden should not have to be on the sufferer alone. More resources and a better capacity for understanding mental disorders must be initialized and maintained for proper care of individuals in need (Hebert, 28, 2009). Individuals with dual diagnoses of mental illness and substance abuse disorders are rampant and left untreated by the public, increasing crime and social problems nationwide.
The article stresses that “mental illness is as frightening and debilitating as any major physical disorder” (Hebert, 28, 2009). Social workers and advocates for parity between the mental healthcare system and the physical healthcare system have made great strides within the last decade, however there is still much to be done (Hebert, 28, 2009). Research shows that mental health is directly related to physical health, and the equity between the two systems needs to be further enhanced in order to achieve considerable gains within the community (Hebert, 28, 2009).
The article, Cultural Access and Mental Health: An Exploratory Study, talks about the rising rates of depression and other mental illnesses in regards to public concerns. The authors focus on twenty Italian regions and the relationship between health expenditures and hospital discharge rates (Crociata et al., 219, 2013). They cite that mental health disorders are growing in an exponential rate and that proper care must be maintained and development of new programs must be issued in the future (Crociata et al., 219, 2013).
Well-being deprivation has been discussed in the article as one of the major causes of mental illnesses among the population (Crociata et al., 219, 2013). This increases the rates of depression and other psychological problems and can stem from factors such as poverty (Crociata et al., 219, 2013). In accordance with the title, the authors believe that culture-related programs can produce positive effects to combat these epidemics (Crociata et al., 219, 2013). Well-being deprivation, in particular, is a preventable problem that results from the lack of attention to oneself. It is important to recognize this as a growing problem and something that the public needs to be aware of in order to maximize prevention and minimize contracting other mental health problems (Crociata et al., 219, 2013).
Cultural access allows for empowerment of the self (Crociata et al., 219, 2013). These can include going to concerts, or reading books, and strengthens involvement within the community or within the self. It provides a sense of who we are in this world and how we relate to others in a given timeframe (Crociata et al., 219, 2013). Being involved in these activities can stimulate the ability to take care of one’s physical, emotional, and mental well-being. Thus, advocacy is important in order to allow a greater number of people to be able to take care of themselves through cultural activities (Crociata et al., 219, 2013).
Outlining the Scope of Behavioral Health Practice in Integrated Primary Care: Dispelling the Myth of the One-Trick Mental Health Pony, is an article that addresses integrated primary care practices in conjunction with mental health treatments. The authors indicate that in order to adequately prepare for all aspects of health, primary care facilities must be equipped to handle mental health problems (Miller et al., 2013).
They conducted a literature review of several research articles to determine the service of behavioral health practices in regards to primary health care facilities. Depression was the most dominant screening and the most likely to be treated (Miller et al., 2013). However, many other illnesses are lacking in proper treatment by primary care facilities because they do not have the full range of services of other mental health care facilities (Miller et al., 2013). This fragmentation care between the two facilities is apparent in society, as mental health problems are still rampant and left untreated. Therefore, the best option is to have primary care facilities incorporate many of the practices of mental health care and in turn, will help those that need medical treatment (Miller et al., 2013).
Allowing a collaboration between healthcare practices is empirically supported to add to the continuity of the primary healthcare system. It will enhance and create opportunities for collaboration in order to improve the prognosis of many mental health patients. It is also seen to have a boosting effect on the economy of the primary healthcare system, as more patients will utilize these facilities more (Miller et al., 2013).
If left fragmented, it will lead to higher costs and poorer outcomes and will eventually exhaust those who are willing to help mental health patients and their families (Miller et al., 2013). The authors advocate for integration and de-fragmentation of services in order to help the public.
The next article, International and national policy challenges in mental health, discusses mental health in regards to the global health agenda. The global health agenda is a list of health problems that are being focused on in order to better humanity (Jenkins et al., 101, 2011). These goals are backed by several financial institutions and thus, are more likely to have better research and development against these problems (Jenkins et al., 101, 2011). However, mental health is not specified in the agenda, and therefore, are not fully funded and less likely to have results.
The authors talk about the World Health Organization (WHO), along with the World Bank, as key players in the financial and global resources that entail such research (Jenkins et al., 102, 2011). They insist that not much attention is given to mental health because physical ailments such as AIDS, or influenza, take a much more precedent over mental health concerns. It is not specified at all in the priorities of the WHO and the World Bank (Jenkins et al., 102, 2011).
The WHO and World Bank created Millennium Development Goals in order to have a structured itinerary on research and development against public health problems (Jenkins et al., 102, 2011). However, there are no goals specifically for the quality of mental healthcare, leaving the mental healthcare system to be on the backend of financial funding and backing by these major organizations (Jenkins et al., 102, 2011).
The lack of goals presented by the WHO presents many challenges to mental health, including invisibility and marginalization of people with mental disorders (Jenkins et al., 103, 2011). This is a travesty in its’ own right because many people suffer from these disorders with no help or no treatment available to them.
The final article that I will incorporate to support my argument for a better mental health policy is titled, What kind of evidence do we need for evidence-based mental health policy? The case of the Better Access initiative. This article discusses the Better Access scheme of Australia’s commonwealth on health and aging (Allen & Jackson, 696, 2011). While being very expensive, the authors state that the new mental health policy by Australia helps many of its’ citizens by becoming one of the most significant advances of mental health policy to date (Allen & Jackson, 696, 2011).
While not perfect by any means, this new policy has helped those with mental disorders attain better prognoses and a higher quality of living as opposed to the previous regime (Allen & Jackson, 696, 2011). The Better Access initiative has raised many positive evaluations from several governmental sources and while expensive, is projected to help even more in the future (Allen & Jackson, 696, 2011). The authors, who are both psychiatrists themselves and do not get money from the Better Access Initiative assess the risks and rewards of this system and weighs in on the future outcome of the new policy (Allen & Jackson, 696, 2011). In summary, they believe that this initiative is a step closer to achieving a better quality of healthcare for those with mentally disabling disorders (Allen & Jackson, 696, 2011).
It is important to note that this is a somewhat new system and that there are relatively many problems, however as with any new policy, it is a step in the right direction even with the humongous financial cost to the government.
I chose the topic of mental health because there are a lack of policies towards such a large problem that affects millions of Americans. I thought that there is no substitution for quality care in regards to mental disorders and disabilities and this is indeed a heavy burden that we place upon ourselves. I am diagnosed with severe major depressive disorder and it took a long time for me to realize what I was doing was out of the norm in society. Therefore, I have taken great care to advocate for those with mental disorders in order to ensure that they get quality care, myself included, and that we get a chance for a quality of life equitable to those without mental disorders.
While major depressive disorder is common among Americans, it is important to note that cognitive behavioral therapy is only available to those who have insurance, and they need a referral to see a specialist in the matter. I know this from experience, and I am deeply saddened to know that not many people are as lucky as me when it comes to medical expenses. I am a United States Veteran, and I am subject to free healthcare services provided by the Department of Veterans Affairs. However, if it were not for this, I would not be among those who will be receiving help due to lack of monetary and financial backing. I can only imagine those people who do not receive treatment for their disorders. It is truly sad that we live in a world where families can be torn apart due to lack of healthcare and prevention, and we need to focus on this problem now rather than later.
I believe that the new Affordable Care Act within the United States is a step in the right direction, however, we must be sure to maintain a strong foothold in regards to mental health. I agree with many of the articles that call for an integration between primary care and mental health facilities in order to accommodate those with mental health needs. In order to do this, a policy would need to be enacted that would combine both healthcare systems into one, with the backing of the American Medical Association among other groups. Many groups may be opposed to this scenario, as this will place a great amount of financial burden among insurance companies. However, in order to do what is right, I believe that we must make great financial sacrifices to help those in need. We need to make the changes now, rather than later to see results.
I may not know much about the entire healthcare system, however, I do know that it we are morally obligated as a society to take care of those who are in need of help. Perhaps the materialistic nature of capitalism has led us astray, but I have to believe that people are generally good. If we start to implement some of these problems as goals worldwide, we can increase the financial backing and research into solving these mental health disorders. Doing this will increase functionality of humanity as a whole, and we will be better able to tackle problems of other natures.
When we look at what is at stake, it is easy to gather than many of our problems in society can be attributed to some sort of mental health problem. Crime, drug addiction, and many other factors can be controlled easily with the right treatment plan. I am not saying that this will be the cure for everything, but I do believe that if we take better care of our citizens, then we will gain greater rewards as well.
Financially this will come at a great cost, but I believe the cost can be negated by the potential rewards that a new policy will bring. It is up to us to make sure that this happens, because the problem of mental health disorders will not go away if we ignore it. In fact, it will become widespread and until we can find a way to prevent or contain it, then we are only digging ourselves deeper and we will have to involve more financial backing as opposed to taking care of it in the first place. I see it as an investment to the future, because in reality, people are the future, and whether we like it or not, the more functional a person can be, the greater amount of good that she or he can give to the world.
Allen, N., & Jackson, H. (n.d.). What kind of evidence do we need for evidence-based mental health policy? The case of the Better Access initiative. Australian and New Zealand Journal of Psychiatry, 696-699. Anakwenze, U., & Zuberi, D. (2013). Mental Health and Poverty in the Inner City. Health & Social Work, 147-157. Crociata, A., Agovino, M., & Sacco, P. (2013). Cultural Access and Mental Health: An Exploratory Study. Soc Indic Res, (118), 219-233. Evans, E., Howlett, S., Kremser, T., Simpson, J., Kayess, R., & Trollor, J. (n.d.). Service development for intellectual disability mental health: A human rights approach. Journal of Intellectual Disability Research, 1098-1109. Hebert, A. (2009). Mental Health Parity: Moving Closer to an Effective National Policy. Journal of Financial Service
Professionals, 63(2), 28-31. Jenkins, R., Baingana, F., Ahmad, R., McDaid, D., & Atun, R. (2011). International and national policy challenges in mental health. Mental Health in Family Medicine, 8(2), 101-114. Miller, B., Levey, S., Payne-Murphy, J., & Kwan, B. (2014). Outlining the Scope of Behavioral Health Practice in Integrated Primary Care: Dispelling the Myth of the One-Trick Mental Health Pony. Families, Systems, and Health, 32(3), 338-343. Patel, V., Belkin, G., Chockalingam, A., Cooper, J., Saxena, S., & Unützer, J. (n.d.). Grand Challenges: Integrating Mental Health Services into Priority Health Care Platforms. PLoS Medicine, E1001448-E1001448.
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