psychiatric and mental healthcare

Reply separately to two of my peer’s posts (See attached peer’s posts, post#1 and post#2).

INSTRUCTIONS:

Your responses should be in a well-developed paragraph (300-350 words) to each peer, and they should include evidence-based research to support your statements using proper citations and APA format!

Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add NEW informative content regarding to their topic that is validated via citations.

  • Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.
  • Minimum of 300 words per peer reply.

Background: I am a Registered Nurse, I work in a Psychiatric Hospital (Crisis & Stabilization).

There are several policies that related to barriers to accessing psychiatric and mental healthcare. One particular policy issue is Medicaid coverage policy. Currently, Florida has approximately 600,000 uninsured individuals with mental health issues and is ranked 50th in the nation in its per capita mental health support in 2014 (Florida Policy Institute, 2017). Improvement in this coverage gap is critical in addressing not just Florida but also the national behavioral health crisis. Improved coverage access has been shown to reduce financial barriers to care and increase the number of well needed psychiatric providers (Florida Policy Institute, 2017). This will help expand access and help close gap coverage.  Although there is a shortage of mental health providers, it is still important to act as patient advocates and work towards reducing disparities. Some of the burden of mental health provider shortage falls on the clinic primary care providers leading to lack of care for the mentally ill. Nurse practitioners (NPs) can become policy-aware by serving on state, local and federal commissions, take the lead on public health, and propose solutions to promote change (Russell, 2020). NPs can also become a part of mentoring programs, joining professional nursing organizations, and educating other nurses and physicians. Political activism can produce change especially when done collectively.  Please see the attached white paper from Mind to support my statement.

References Florida Policy Institute. (2017). Florida must increase its support for mental health services. Center on budget and policy priorities.  https://www.floridapolicy.org/posts/florida-must-increase-its-support-for-mental-health-services Russell N. (2020). America Needs Nurse Practitioners to Advocate for Social Justice. The journal for nurse practitioners: JNP, 16(9), 710–711.  https://doi.org/10.1016/j.nurpra.2020.06.024

Icon Description automatically generated White paper.pdf

Question: Identify one policy issue related to barriers to accessing psychiatric and mental healthcare that is currently being addressed by your national professional organization.

  Individuals with different psychiatric diagnoses (PD) including behavioral health disorders face challenges when accessing mental health care especially in hospital emergency departments (EDs). Behavioral health disorders include both mental illness and substance use disorders. Although bills like H.2083 or S.675 were in place to help improve access to Mental Health care, the covid-19 pandemic contributed negatively to accessing mental health care as resources were diverted to combating the pandemic in Massachusetts (MAMH, 2021). Government policies that involve a reduction in total state spending on public mental health services, reduction in reimbursement for psychiatric admissions, and closure of state and private psychiatric hospitals contributed to making accessing mental health treatment difficult. Individuals with psychiatric diagnosis are seen in the EDs continually, and they often present to the ED for crisis care in which care services may not be sufficient. Although EDs are adept at stabilizing and managing medical illnesses, there has not been a great advancement in behavioral health stabilization of this population. Individuals with PD require specialized care to address their complex psychological, medical, and social needs. In ideal situations, individuals with PD must be assessed and managed in a safe, quiet, and calm environment, unlike many emergency care environments (Lambert & Fischer-Sanchez, 2020). Many EDs may not be equipped with sufficient facilities, staff, transfer options, or specific resources available for Individuals with PD. Many emergency providers have limited clinical skills to manage the complexities of these patients, which can include the need for emergent interventions of diagnosis, sedation, restraint, and care for comorbid medical conditions (Lambert & Fischer-Sanchez, 2020).  Although EDs are not required to meet the same standards as inpatient psychiatric facilities, they are required to provide a safe environment and comply with the standard of care. Many hospitals must execute creative strategies to provide care and use newer models of care deliveries like tele behavioral health. These strategies are only effective when there are insufficient providers and services available. Early treatment and treatment response is an important consideration for individuals with PD who present to EDs as the majority of behavioral emergencies can be resolved within twenty-four hours without inpatient hospitalization (Lambert & Fischer-Sanchez, 2020). The American Psychiatric Nurses association (APNA) represents all levels of psychiatric-mental health nursing, and they advocate for improved access to mental health care irrespective of the health setting. APNA made the following recommendations:

·  All providers must use mental health and substance use screenings tools to promote prevention, early identification, brief intervention, and referral to treatment.

·  National, state, and local policies and regulations must ensure universal access to affordable services that promote mental health, prevent mental illness and substance use disorders, and offer care or treatment provided by qualified health care professionals (APNA, 2021).

Mental health care must start at the initial point of contact and be comprehensively intertwined throughout services delivery within the health care system in the United States of America (APNA, 2021). Question: Discuss how NPs can become policy-aware, as well as act as patient advocates. Nurse practitioners (NPs) can become policy-aware and act as patient advocates by actively being involved in the political process that will change policies that affect access to mental health care. NPs actively participating in state or national NP organizations involves actively writing letters, meeting with their three representatives, and keeping abreast of regulations affecting advanced practice NPs This can be achieved by developing coalitions among other healthcare providers and utilizing social media outlets to create successful campaigns. (Ryan & Rosenberg, 2015). For instance, government officials review community assessments to establish public health policies. NPs’ active participation in community assessments ensures officials collect relevant and accurate information cyclically to maintain continual community well-being. NPs can actively participate in joint commissions and special interest groups that promote public health and assist in developing an environment that responds to citizens’ needs and manages current health issues (Ryan & Rosenberg, 2015). Active political involvement is important as it is the most effective method to create changes to mental healthcare, the essence of professionalism, improves patient advocacy, and overall health of the population.

References

 

Galea, S., Merchant, R. M., & Lurie, N. (2020). The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention. JAMA Internal Medicine180(6), 817–818. https://doi.org/10.1001/jamainternmed.2020.1562

Lambert, K., & Fischer-Sanchez, D. (2020). ASHRM/AHA behavioral health white paper series behavioral health care in the emergency department setting.  https://www.ashrm.org/system/files/media/file/2020/07/Behavioral-Health-White-Paper-PART2_FINAL.pdf

Ryan, S.F., & Rosenberg, S. (2015). Nurse practitioners and political engagement: Findings from a nurse practitioner advanced practice focus group & national online survey.  http://anp-foundation.org/wp-content/uploads/2015/04/Nurse_Practitioners_and_Political_Engagement_Report.pdf The American Psychiatric Nurses Association (APNA). (2021). Whole health begins with mental health.  https://www.apna.org/news/mental-health-policy/ The Massachusetts Association for Mental Health Inc. (MAMH). (2021). Take Action!  https://www.mamh.org/advocacy/take-action

Please this is link to the APNA white paper:  https://www.apna.org/news/mental-health-policy/

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