The Policy Analysis Assignment Discussion

The Policy Analysis Assignment Discussion

https://www.congress.gov/bill/117th-congress/senate-resolution/518/text
S.Res.518 – A resolution expressing the sense of the Senate that in order to effectively address the high prevalence of individuals suffering from mental health conditions and substance use disorders, the United States needs to make historic financial investments into mental health and substance use disorder care and finally acknowledge such care as a priority in health care equal to physical health, and for other purposes. The Policy Analysis Assignment Discussion

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Healthcare policies are crucial in the United States healthcare system since it helps healthcare organizations protect and shape the population’s health and well-being. Policy revolves around issues fundamental to healthcare, like cost, access, privacy, and delivery methods. It also entails regulations and rules lawmakers set at national, state, and local levels. Hence, nurses and prospective nurses need to acknowledge the effectiveness of healthcare policies since they act as patient advocates. The paper will address the Bill dubbed “S.Res. 518. The main factors in evaluating will include problem identification, purpose statement, social determinants of health, impact, current legislation, policy recommendation, criteria for evaluation, PESTEL analysis, and recommendations and modifications The Policy Analysis Assignment Discussion

Problem Identification

The prevalence of persons with  mental health and substance use conditions in the United States is high. From the data obtained from the National Alliance of Mental Illness (NAMI), approximately 52.9 million US citizens had mental illness in 2020, which is 21 percent of the total population. In data representation, the statistics indicate that one has a mental illness in five Americans (National Alliance on Mental Illness, 2022)The Policy Analysis Assignment Discussion. Consequently, 5.6 percent of United States adults have a severe mental illness, about 14.2 million individuals, representing one in every 20 adults. Also, in the same year, 2020, American youths aged 6-17 years, at approximately 16.5 percent, had mental health disorders, amounting to 7.7 million people globally.

Regarding substance use disorder, approximately 6.7 percent of United States adults, about 17 million individuals, experience it co-occur with mental illness (National Alliance on Mental Illness, 2022). As a result, the country needs to find the most effective way to curb the situation. In supporting the data, the World Health Organization asserts that apart from the underdiagnosis of mental illness, there is also less identification of individuals that meet its diagnostic criteria. Such instances have been caused by misconceptions concerning mental illness and cultural beliefs that minimize the population’s need to seek mental health interventions. The Policy Analysis Assignment Discussion

Purpose Statement

Policymaking is essential in the healthcare realm since it involves a legislation team to pass Bills that are essential in the healthcare realm. However, it is also important to consider the social determinant of health since they help acknowledge the people who need healthcare help most and for what reasons. Therefore, the analysis will try to evaluate the best evidence-based approach that will help in reducing the increasing rates of substance use disorder and mental illness conditions. The Policy Analysis Assignment Discussion

Social Determinants of Health

Social determinants methodologies seek to comprehend how people’s living and working environments influence their healthcare outcomes. Numerous deep-rooted global health disparities, such as shorter life expectancy, relatively high infant mortality rates, and a significantly greater disease burden between many underserved groups, are believed to be caused by these social determinants (McKnight-Eily, 2021)The Policy Analysis Assignment Discussion. Social disparities in determinants are considered to arise from inequitable resource availability; thereby, they can be lowered through specific target economic and social policies and initiatives. Hence, the main social determinant of health factors, in conjunction with substance use disorder and mental health disorder, are stated below.

Healthcare Access and Quality

Access to medical care significantly impacts one’s overall health throughout all stages of life. When healthcare systems are used effectively, it allows for earlier detection and treatment of health issues, allowing them to be addressed and intervened more proactively. It further positively impacts chronic condition and life expectancy (Patel et al., 2018). Most healthcare systems across the globe stress lowering barriers to healthcare access for their citizens, but a slew of obstacles systematically complicate the said goal. A few remarkable barriers encompass insufficiently accessible, physically accessible, or relatively inexpensive services. Health policy is frequently revised to enhance access to healthcare. In the US, the enactment of Affordable Care Act (ACA) in 2010 was enacted to enhance access and quality of medical care for American citizens. Throughout the next decade, the ACA increased Medicaid eligibility to people earning approximately 138% of the federal poverty line, denoting the most significant coverage expansion to non-elderly adults in more than fifty years (Patel et al., 2018). Also, from  June 2021, approximately 38 United States states, inclusive of the District of Columbia, participated in either implementing or were already in the stages of implementing the expansion. Such factor also influences the patient’s ability to access quality care (Brown et al., 2021)The Policy Analysis Assignment Discussion.

Education Access and Quality

Given the significant evidence linking social determinants to mental health outcomes, multidimensional initiatives have been directed toward eliminating multisystem social inequalities like access to educational opportunities. A lack of education is linked to decreased mental and physical health. Higher education quality and academic performance have been consistently and repeatedly linked to improved social outcomes, such as better social networks and lower criminal justice involvement likelihood. Patel et al. (2018) estimated the mortality rates in the US to be caused to six social aspects utilizing information from previous studies. In 2020, roughly 245,000 deaths were due to a lack of education. These mortality forecasts are significant compared to those from leading disease-related factors(McKnight-Eily, 2021). For example, the death rate attributed to low education levels was comparable to that attributed to an acute heart attack. As a result, insufficient educational attainment, particularly dropping out of school, must be perceived as a public health issue. Moreover, higher educational achievement forecasts reduced death rates and deaths that may occur later in life. The Policy Analysis Assignment Discussion

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Social and Community Context

Adolescents’ indirect and direct exposure to physical aggression has been linked to higher depressive and PTSD symptoms and anxiety. Furthermore, those living in the United States and are within areas with high incarceration rates could be at a greater risk of developing a generalized anxiety disorder and major depression. McKnight-Eily (2021) asserts that people of color who resided in a state where at least one such murder occurred within the previous three months reported increased occasions when their psychological health was at stake. That proves the need to assess community-related issues when finding interventions for substance use disorders and mental illnesses.

Socioeconomic Status

The World Health Organization, through a life-course approach, describes ways mental health manifestations at every life stage can have a cumulative and evolving effect on socioeconomic status and other social determinants. Early adulthood is a key phase in which numerous social determinants could collide and initiate behavioral mental conditions (McKnight-Eily, 2021)The Policy Analysis Assignment Discussion. Mental health manifestations may negatively influence how people explore social conventions and systems at this point in life, impacting school achievement, job capacity, and justice involvement. Such health conditions could then inhibit potential income, limit access to socioeconomic advancement, and increase the chance of developing a mental illness. Furthermore, young adults regularly lack access to or a long-term linkage to treatment programs, exacerbating social inequities.

 Neighborhood and Built Environment

Contemporary social determinant research has frequently focused on community character traits such as urbanicity or perceptions of safety. Rural residents have a higher incidence of illness than urban residents, and the density of the population appears to impact symptoms of depression in gay and bisexual men (Patel et al., 2018)The Policy Analysis Assignment Discussion. Neighborhood safety has emerged as a significant predictor of behavioral health outcomes, as evaluated by individual experience and perception. Fulfilment with the living situation and community identity was correlated with lower depression levels of depression among American urban residents, while neighborhood planning disputes with local authorities were associated with higher levels.

Impact

Mental illnesses and substance use abnormalities accounted for 20.4% of the worldwide burden of diseases in 2010 and constituted the primary cause of years lived with mental disorders across all different subgroups (McKnight-Eily, 2021). These repercussions impact society, particularly through financial consequences, and are limited to patient populations and their social environment. Precisely predicting such costs is complicated and challenging due to insufficient information. Furthermore, studies on economic impacts vary substantially because of errors in disorder interpretations, populations or samples researched, cost source materials and care delivery, methodological approach, and inadequate cost categories because of a shortage of information and interpretations (McKnight-Eily, 2021)The Policy Analysis Assignment Discussion. However, enhanced epidemiological and financial techniques and models, in addition to more comprehensive epidemiological data, have enabled comprehensive accumulation and reliable data, which provides ample information necessary for the economic impacts that mental disorders bring along. Therefore, the best way to understand the impact of mental and substance use disorders on healthcare is through cognitive-behavioral therapy that enables the affected individuals to change their destructive behaviors and thoughts, thus managing the patient population’s problems easily.

Current Legislation

And while 13 years after the  Paul Wellstone and Pete Domenici 2008 “Mental Health Parity and Addiction Equality Act” was passed, there remains a gap of compliance between many insurance companies and an inability to fund mental health and substance use disorder services adequately (Warnock, 2022). The other gap withstands in Medicaid, which is currently the single largest payer of substance abuse and mental health disorder services, there is still inadequate reimbursement. Also, it is necessary to incentivize insurers to fully cover mental health and addiction services in the exact way that almost all highly specialized services have been covered. The other gap entails 55 % of counties lacking a single therapist, counselor, or social worker, and only 10% of people with substance use disorder obtain specialty treatment (Warnock, 2022)The Policy Analysis Assignment Discussion.

Policy Recommendation

The policy recommendation to reduce the prevalence of substance use disorder and mental illness is S.RES.518. The Bill is sponsored by Senator Warnock Raphael and was introduced on February 17 2022 and is currently agreed to Senate (Warnock, 2022). The main aim of the Bill is to make sure that the Senate takes the initiative in addressing the prevalence of substance use disorder and mental illness through involving financial investments and prioritizing this care just like any other care in the healthcare realm. In that case, the federal government will have a role in creating a comprehensive approach that will improve overall healthcare services at local, state, and federal levels in integrating substance use disorders and mental health within the healthcare system, especially for early screening, interventions, and diagnosis while ensuring that all patient population can easily access the healthcare services. The Policy Analysis Assignment Discussion

https://www.congress.gov/bill/117th-congress/senate-resolution/518/text

Criteria for Evaluation

The evaluation criteria will include effectiveness, efficiency, and equity.

Effectiveness

The S.RES.518 Bill is effective, considering that it focuses on ensuring that proper mechanisms in the healthcare realm are set aside to cater to the need of individuals with mental illness and substance use disorders. According to McKnight-Eily (2021), an appropriate healthcare bill tend to focus more on increasing the overall well-being of the patient population. In that case, S.RES. 518 focuses on providing patient-focused care and ensuring equality in treating patients, especially those with mental health and substance use disorders. Also, through the Bill, the healthcare setting will reduce the stigma and discrimination these individuals face. The Policy Analysis Assignment Discussion

Efficiency

The main strategy incorporated in the Bill is that the federal government will create a comprehensive approach to improve local, state, and federal healthcare services. Such an approach is effective since the federal governments are superior to the local and state governments and can easily fund bills without much struggle (Patel et al., 2018). In that case, since the Bill calls for financial enhancement in funding healthcare to curb the increase in substance use and mental health disorders, the federal government will be better positioned to fund the incentives due to its funding capacity.

Equity

The Bill aims to address equity in accessing healthcare services for substance use and mental health disorders at a federal level. That way, it will be easier to address health disparities concerning accessibility, quality, and availability, especially for minority communities. That is because there is a high prevalence of ethnic and racial stigma for the minority, including the disabled. According to (McKnight-Eily, 2021), compared to the 48 percent of Caucasians receiving mental health interventions, Asians and African Americans stand at 22 and 31 percent, consecutively. Also, queer, transgender, bisexual, gay, and lesbians face a great threat of substance use and mental health conditions (Warnock, 2022)The Policy Analysis Assignment Discussion. Hence, the Bill will try to formulate an effective way to provide quality and accessible care.

PESTEL Analysis

Pestle Factors	Influence
Political	·         government stability and type in funding Bill’s recommendations. ·         Changes in the political environment, especially during power transitions.
Economic	·         Interests and Inflation rates especially like now when the world is experiencing an economic crisis due to the Russia-Ukraine war. ·         The technological advancement that requires more training for the nursing professionals
Social	·         The main cultural values and perception towards mental and substance use disorder interventions ·         There will be a need to create awareness of mental illness and substance use disorder.
Technology	·         How will the emerging technologies impact screening, diagnosing, and treating mental health and substance use disorders like telemedicine? ·         Impact of social media platforms in creating awareness.
Legislation	·         How will other laws affect the current Bill upon senate approval? ·         How the healthcare system will implement  the discrimination law in preventing stigmatization of the target patients
Environment	·         Increasing nursing training and workshops on handling mental and substance use patients. ·         There is a need to engage patient-centered and individualized care by incorporating evidence-based research.

 

Recommendation and Modifications

From the selected Bill, it is evident that the main aim is to ensure the need to treat mental health conditions and substance use disorders like other physical health needs. That is because there has been a notable disparity of care for these patients, especially those from underserved areas and minorities (Warnock, 2022)The Policy Analysis Assignment Discussion. However, it will be important to ensure that healthcare providers are included in the bill debate to help the policymakers understand why the Bill is important to the target population and America as a country. The reason behind that is that healthcare providers associate with the patients daily and thus can impact making the bill patient-focused. In that regard, the areas that need modification concern providing ample ways that insurance companies like Medicaid should steer through the support for mental health and substance use disorder diagnosis and treatment. That way, it will be easier to distinguish the role of the insurance companies and healthcare providers in providing care for these target patient populations.

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References

Brown, E. A., White, B. M., Jones, W. J., Gebregziabher, M., & Simpson, K. N. (2021). Measuring the impact of the Affordable Care Act Medicaid expansion on access to primary care using an interrupted time series approach. Health Research Policy and Systems, 19(1). https://doi.org/10.1186/s12961-021-00730-0

McKnight-Eily, L. R. (2021). Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic — United States, April and May 2020. MMWR. Morbidity and Mortality Weekly Report, 70(5). https://doi.org/10.15585/mmwr.mm7005a3

National Alliance on Mental Illness. (2022, June). Mental health By the Numbers. Nami.org; National Alliance on Mental Illness. https://www.nami.org/mhstats

Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., Chisholm, D., Collins, P. Y., Cooper, J. L., Eaton, J., Herrman, H., Herzallah, M. M., Huang, Y., Jordans, M. J. D., Kleinman, A., Medina-Mora, M. E., Morgan, E., Niaz, U., Omigbodun, O., & Prince, M. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598. https://doi.org/10.1016/s0140-6736(18)31612-x The Policy Analysis Assignment Discussion

Warnock, R. G. (2022, February 17). Text – S.Res.518 – 117th Congress (2021-2022): A resolution expressing the sense of the Senate that in order to effectively address the high prevalence of individuals suffering from mental health conditions and substance use disorders, the United States needs to make historic financial investments into mental health and substance use disorder care and finally acknowledge such care as a priority in health care equal to physical health, and for other purposes. Www.congress.gov. https://www.congress.gov/bill/117th-congress/senate-resolution/518/text The Policy Analysis Assignment Discussion