Assigment 6 modules reflexion 2-3 pages.Apa seven . All instructions attached.

Module

5

Case Report 1: Module 5. Policy Innovations in Population Health

5A) Background

The population health assessment results suggested that policy changes would facilitate greater improvements in LGBTQI mental

health treatment in the health system. City C’s state has policies in place prohibiting health insurance discrimination based on sexual orientation or

gender identity, though access to inclusive and affirming care can still be problematic. The health system focused on system-specific changes that could

Foundations of Population Health

Module 5: Case Report | 3

be implemented broadly across their hospitals and clinics to enhance access to behavioral health for LGBTQI populations.

5B) Reflection Question

City C’s health system opted to take a ‘Health in All Policies’ (HiAP) approach to find ways to improve behavioral health for LGBTQI individuals in their hospitals and clinics. Use the key elements of HiAP practice to consider how the health system might provide inclusive and affirming care to LGBTQI individuals. Key elements include: 1) defining mutually beneficial goals, 2) cross-sector collaboration, 3) engaging stakeholders, 4) opportunity for policy change, and 5) promote health and equity.

5C) Considerations

The stakeholder advisory board played a major role in ensuring that the key elements of the HiAP approach were met. Consider the following ways in which the health system could remain true to the HiAP approach to enhance behavioral health for LGBTQI populations. This is not an exhaustive list.

Define mutually beneficial goals

· Policy goals are considered a “win” for the health system leadership, providers, staff and of course, patients.

· Policies that improve patient satisfaction and meet joint accreditation standards are important to health system leadership.

· Policies that improve the quality of patient care and satisfaction, while reducing costs assist providers with meeting performance standards.

Cross-sector collaboration

· The health system collaborated with community organizations and public health agencies with expertise in working with LGBTQI populations. Academics with expertise in policy formation specific to LGBTQI populations were consulted.

Engaging stakeholders

· Health system patients and community members who identify as LGBTQI were involved in policy formation to ensure that diverse voices were represented.

· The stakeholder advisory board prioritized the inclusion of patients and community members with intersecting identities (e.g., identify as a transgender male and Black) in the policy formation process.

Opportunity for policy change

· Health system administration communicated the need for policy changes to improve behavioral health for their LGBTQI patients to their employees.

· Leadership throughout the health system’s hospitals and clinics highlighted the administration’s communication and described the relevance of the policies to their specific departments.

· Policy changes were based on recommendations from the Joint Commission on how to provide culturally competent and patient- and family-centered care for the LGBTQI community (The Joint Commission, 2011). Some examples include:

· Modifying their non-discrimination policy to prohibit discrimination based on personal characteristics including sexual orientation and gender identity or expression.

· Developing disciplinary processes that address intimidating, disrespectful, or discriminatory behavior toward LGBTQI patients or staff.

Promote health and equity

· The stakeholder advisory board identified policies that would improve access to and the quality of behavioral health services for LGBTQI patients.

· They prioritized policies that would be sustainable.

· They identified evaluation strategies for ensuring that the policies had the desired impact on behavioral health and equity for LGBTQI patients.

Case Report References

American Psychiatric Association. (2013). Major depressive disorder. In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Appleby, L. (2021). What has been the effect of covid-19 on suicide rates? BMJ, 372, n834. https://doi.org/10.1136/bmj.n834

Azofeifa, A., Stroup, D.F., Lyerla, R., Largo T., Gabella B.A., Smith C.K., Truman M.D., Brewer, R.D., Brener, N.D. (2018). Evaluating Behavioral Health Surveillance Systems. Preventing Chronic Disease, 15. https://doi.org/10.5888/pcd15.170459

Centers for Disease Control and Prevention. (2021, August 5). Mental health conditions: Depression and anxiety. https:// www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html

The Commonwealth Fund. (2020, May 21). Mental Health Conditions and Substance Use: Comparing U.S. Needs and Treatment Capacity with Those in Other High-Income Countries. https://doi.org/10.26099/09ht-rj07

Ettman, C. K., Abdalla, S. M., Cohen, G. H., Sampson, L., Vivier, P. M., & Galea, S. (2020).

Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic. JAMA Network Open, 3(9), e2019686–e2019686. https://doi.org/10.1001/jamanetworkopen.2020.19686

Gay & Lesbian Medical Association (n.d.). Guidelines for care of lesbian, gay, bisexual, and transgender patients. http://www.glma.org/_data/n_0001/resources/live/Welcoming%20Environment.pdf

Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., Silverman, M.

M., Fisher, P. W., Hughes, T., Rosario, M., Russell, S. T., Malley, E., Reed, J., Litts, D. A., Haller, E., Sell, R. L., Remafedi, G., Bradford, J., Beautrais, A. L., … Clayton, P. J. (2011). Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations. Journal of Homosexuality, 58(1), 10–51. https://doi.org/10.1080/00918369.2011.534038

Human Rights Campaign Foundation (n.d.). Mental health and the LGBTQ community. https://www.nimh.nih.gov/health/statistics/major-depression

The Joint Commission (2011). Advancing effective communication, cultural competence, and patient- and family-centered care for the lesbian, gay, bisexual, and transgender (LGBT) community: A field guide. https:// www.nj.gov/humanservices/dmhas/home/councils/Multicultural/LGBT_Field_G uide.pdf

National Center for Health Statistics. (2021, April 14). Ambulatory Care Use and Physician Office Visits. Center for Disease Control and Prevention. https://www.cdc.gov/nchs/fastats/physician-visits.htm

National Institute of Mental Health . (n.d.-a). Major depression. https://www.nimh.nih.gov/health/statistics/major-depression

National Institute of Mental Health . (n.d.-b). Suicide. https://www.nimh.nih.gov/health/statistics/suicide

Office of Disease Prevention and Health Promotion. (n.d.-a). Increase the proportion of primary care visits where adolescents and adults are screened for depression — MHMD‑08.

Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental- health-and-mental-disorders/increase-proportion-primary-care-visits-where- adolescents-and-adults-are-screened-depression-mhmd-08

Office of Disease Prevention and Health Promotion. (n.d.-b). Reduce suicidal thoughts in lesbian, gay, or bisexual high school students—LGBT-06. Healthy People 2030. . U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/lgbt/reduce- suicidal-thoughts-lesbian-gay-or-bisexual-high-school-students-lgbt-06

Office of Disease Prevention and Health Promotion. (n.d.-c). Reduce the suicide rate – MHMD-

01. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental- health-and-mental-disorders/reduce-suicide-rate-mhmd-01

The Trevor Project. (n.d.). Facts About Suicide. https://www.thetrevorproject.org/resources/preventing-suicide/facts-about-suicide/

The Williams Institute. (2020, June). Sexual Orientation Change Efforts, Adverse Childhood Experiences, and Suicide Ideation and Attempt Among Sexual Minority Adults. UCLA School of Law. https://williamsinstitute.law.ucla.edu/publications/lgb-conversion- therapy-suicide/