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Public Policy Presentation

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Michele Pearce

on 5 December 2013

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Transcript of Public Policy Presentation

Improve mental health through prevention and by ensuring access to appropriate, quality mental health services.
on the Problem
Statistics

Public Policy Presentation
Worldwide
NURS 370 - 03 Professor Lynn Blanchette,
Michelle Cheesbro, Anna Hammond, LaToya Lange- Smith, Amanda Amirault, Michele Pearce,
Keri Howell, Vanessa Branco, Jenn Mann


TWO WORLDS COLLIDE


Identify the lack of mental health care as a widespread problem
Recognize the consequences of this problem in relation to society
Examine current policies and legislation and gaps they may possess
Discover evidence based public health interventions
Describe the impact on nursing responsibilities and health care practices



PRESENTATION OBJECTIVES
Mental health disorders are going untreated due to lack of screening in the primary care setting
Lack of accessible mental health care within all primary care settings
Knowledge deficit of basic mental health first aid

Health Problem


Increased risk of untreated mental illness across the
lifespan in the state of Rhode Island related to lack
of access to secondary and tertiary mental health care as demonstrated by:
low recognition rates [of mental illness]
limited access and support
lack of basic mental health first aid
a broken referral system
1:4 RI Residents have a mental illness


Community Diagnosis

How does Rhode Island Compare to the Nation?


In 2000, 62% of primary care facilities provided
mental health care. Goal for 2020 is to increase to 87%.

In 2001, 59.6% of children ages 4-17 received treatment for mental health problems. Goal for 2020 is to increase to 75.8%.

In 2008, 58.7% of adults (>18 years of age) received
treatment for serious mental illness. Goal for 2020 is to increase to 64%.



(Healthy People 2020, 2013 )

People with a mental disorder have a higher rate of disability and mortality
Perspectives on the problem

In Rhode Island (RI) 38,000 adults and 11,000 children have a diagnosed serious mental illness that impairs their daily functioning.
Did you know
The current health care system in RI provides services to about 19% of adults
with mental illness.
(National Alliance on Mental Illness)
(Health People 2020, 2013)
RELATED GOAL:
Detailed Goals
Is this about health or is it about money?



The current system makes access to treatment difficult for those needing mental health services.
Chaz Gross
Executive Director,
National Alliance on Mental Illness, RI
People with undiagnosed/untreated mental illness die 25 years sooner than the average American related to their lack of appropriate mental health care.
Currently we control mental illness when
our goal should be for recovery.
We are all on the same team and our goal
should be holistic care.
Sylvia Weber
Rhode Island
State Nurses Association
Susan Jacobsen
Executive Director,
The Rhode Island Mental Health Alliance
Everyone will benefit from the integration of primary and mental health care, as long as it is accessible.
Integration will make nursing practice
easier because patients will be more successful.
The integration would contribute to upstream care which will reduce emergency room visits and health
care costs.
Societal Consequences of undiagnosed/untreated mental illness
Untreated Mental Illnesses Often Result in Tragedy
15.8% of parents accused of killing their child had a history
of untreated mental illness.
12.3% of spouses accused of killing their spouse had a history of untreated mental illness.

25.1% of children accused of killing their parents had history of untreated mental illness.
17.3% of siblings accused of killing their sibling had a history of untreated mental illness.
(Treatment Advocacy Center)
(Treatment Advocacy Center)
(Treatment Advocacy Center)
(Treatment Advocacy Center)
Related Legislation
Existing
Evidence Based Interventions
Who will benefit?
Concerns with Integration
Impacts of Integration on Nursing
How will the proposed policy affect health care?
Support from a Nursing Organization
Goals for primary
health care
Develop skills and competencies related to mental health disorders
Increase resources for patient referrals
Ensure follow up with specialized mental health services
Redirect financial and human resources from tertiary care towards primary care
(Agency for Healthcare Research and Quality, 2012)
(World Health Organization, 2013)
Single location for care

Holistic approach

Improved continuity of care

Outpatient treatment within the community

Decreased institutionalization
Evaluation
Easily accessible
Acceptable to the population
Recognizes co-morbidities
Approaches care holistically
Efficient use of human resources
Reduces overall health care costs
Patient and families avoid multiple co-pays
Integrated Care is Patient Centered
Integrated Care is Community Oriented
Preserves dignity and human rights
Decreases institutionalization
Keeps families together
Potential diversion of scarce mental health resources and personnel
Insufficient reimbursement
Increased need for
training and education
(World Health Organization, 2013)

(Agency for Healthcare Research and Quality , 2012)
(World Health Organization, 2013)


(Agency for Healthcare Research and Quality, 2012)
(World Health Organization, 2013)
(Agency for Healthcare Research and Quality, 2012)
(World Health Organization, 2013)
Requires education and training
Expands the registered nurse's role in primary healthcare settings
Promotes a safer work environment
Provides a stronger foundation for advocacy
Gaps in Current Policies
35-50% of people in high income countries receive no mental health treatment for their disorder
Less than $2 USD per person is spent annually on mental health care in high income countries.
(World Health Organization, 2013)
Expansion of early childhood
screenings into primary care
across the lifespan.
(National Alliance on Mental Illness
Rhode Island, 2013)


Was signed by the Governor on July 16, 2013

Approved the formation of a 23 member special joint commission to investigate the integration of primary care and mental health services in Rhode Island.

Senate House Resolution #834
(C. Gross, verbal communication,
Nov. 7, 2013)
(Sylvia Weber, verbal communication,
November 14, 2013)
(Susan Jacobsen, verbal communication,
November 7, 2013)
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ADAM LANZA
JAMES HOLMES
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(State of Rhode Island General Assembly, 2013)
Improve access to mental health resources
Decrease emergency medical care
Enhance continuity of care and care management
Promote successful patient outcomes


REFERENCES
Rhode Island Chronic Care Sustainability Initiative
UTAH
Whole Health Initiative Project
Rhode Island
1.6%
98.4%
A Success Story
(Resource Center to Promote Acceptance, Dignity, and
Social Inclusion Associated with Mental Health)
Integration =
High cost
Lower satisfaction
Poor outcomes
Payment reimbursement
Adequate Training
LACK OF
TWO WORLDS COLLIDE
Primary Health Care
Mental Health
Care
Proposed Solution
Deanne
(American Academy of Family Physicians)
(Suicide Prevention Resource Center)
(Agency for Health Care Research and Quality)

Yvette Mendez
External Evaluator,
The Rhode Island Foundation
"Quality, affordable primary care is one of our priorities. By encouraging delivery in new, creative ways, we make it easier for people to access the care they need. We're confident that combining primary and behavioral health care will make a significant difference in the lives of patients."
(Yvette Mendez, personal electronic mail
communication, November 21, 2013)
(Substance Abuse and Mental Health Administration)
(National Alliance on Mental Illness, RI, 2013)
Google Images 2013
(American Psychiatric Nurses Assocation, 2013)
(National Institute of Health, 2013)
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Full transcript