Health Policy Issue Paper: S.1945 -- Mental Health Reform Act of 2015
Donielle Kinchen
Liberty University
NURS 501-B04
Dr. Kennedy
03/06/2016
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Abstract
Mental health reform is needed in the United States. It’s a topic that goes
untouched in both the households and in the field of medicine. With this Mental
Health Reform Act, those with mental illness can receive the proper care they need
so they can be equal to those living normal lives.
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Introduction of Problem/Issue and Related Bill
To understand mental health and the stigma it has upon the community is to
research and know what exactly it is. Mental health advocates have been working
with federal legislators in a conjunctive effort to protect the track of mental health
parity [Men99]. Definitions of mental illnesses have changed over the last half-
century. Mental illness refers to conditions that affect cognition, emotion, and
behavior[Evo]. According to the National Institute of Mental Health (NIMH),
mental health covers many disorders, Anxiety Disorder, Depression, Eating
Disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder (OCD),
Panic Disorder, Post-Traumatic Stress Disorder (PTSD), Schizophrenia, are a few;
and in which these disorders are often associated with children and adolescents,
older adults, men and women.
Mental illness affects many types of people especially soldiers who are post-
war. There are many instances that traumatize soldiers who are deployed into
horrific war situations that may cause them to experience PTSD. Some cases are
severe enough to destroy a person’s mental state and/or affect their families and
loved ones. Questions regarding situations like this may pose as “What can we do
to help him overcome this?”, “Who can (s)he see to get a p
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roper diagnosis and how to go about treatment?”. These questions often go
unnoticed and sometimes unasked because mental health isn’t a household topic.
Although the NIMH has research that supports the development of mental
health disorders, the senate proposes a bill, S. 1945 Mental Health Reform Act of
2015, that will bring proper care for mental health disorders.
The Mental Health Reform Act was created to make psychiatric, psychological,
and supportive services for individuals available as needed to individuals with
mental illness and families of those who suffer from mental illness., and for other
purposes.
Bill S. 1945 Mental Health Reform Act of 2015 is sponsored by Republican
Senator Bill Cassidy, Louisiana and introduced on August 5, 2015. There hasn’t
been much action put forth toward the bill since it’s introduction date in August of
2015. It has been read twice and referred to the Committee that is involved in
Health, Education, Labor and Pensions.
Background/Significance and Scope of the Problem
U.S. Senator Bill Cassidy (R-La.) & U.S. Senator Chris Murphy (D-Conn.),
who are both members of the U.S. Senate under the Health, Education, Labor and
Pensions Committee introduced The Mental Health Reform Act of 2015, which is a
bipartisan legislation that will make critical changes to address a plethora of issues
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that pertain to supportive services regarding mental health and develop meaningful
solutions to improve outcomes for families dealing with mental illness [Chr15].
According to Murphy, mental health has been neglected by the United States
and its leaders while those who suffered on the streets, in jails, or loiter without
treatment were ignored by the silent nation. Mental health is a subject that is rarely
touched and often goes ignored. Treatment may not be available or affordable to
those who suffer and because of that, many may not understand what’s going on,
how they can cope with it or how they can overcome it.
Health is defined as "a state of complete physical, mental, and social well-
being and not merely the absence of disease or infirmity" by the World Health
Organization in 1948[Evo]. Mental health and the comforting characteristics of this
definition have been discussed in U.S. health care and public health. The concepts
can be assimilated into the national health and healthcare reform initiatives, given
that this is Murphy and Cassidy’s main goal when bringing the Mental Health
Reform Act to the attention of lawmakers.
Health reform refers to efforts focused on health promotion and the
development of a positive welfare. Mental health reform refers to efforts focused
on illness and how we can forego on treatments of the disease and rehabilitation
efforts. People with mental illness may stem no benefit from the advances that
have been made in the understanding of and the treatments for mental illness
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because a considerable amount may have received inadequate treatment or no
treatment at all[Min071]. With no treatment, mental health and illness will
continue to go unnoticed and ignored and many people will succumb to the
dangers of themselves and their mental illness.
This particular legislation has been endorsed by a few health associations such
as the National Alliance on Mental Illness, American Psychological Association,
and the Clinical Social Work Association [Cap13]. This legislation is listed
important step forward in bringing greater accountability to our public mental
health system. This legislation will also bring to light how the U.S. turns a sour eye
towards those with mental health issues. It also brings forward the ethics in
practice and care inside and outside the health care industry. Ethics is described as
a “person’s moral principles”. It is also stated as an integral part of the foundation
of nursing [Ame152]. Although there may be a shortage of psychiatrist and
psychologist, this legislation would support the proper training for all health care
professionals (nurses, physicians, surgeons, etc.) giving them a fuller knowledge
and proper precautions on how to handle a mentally ill individual. That way, the
code of ethics goes unbroken because of proper knowledge and care tactics.
This Mental Health Reform is planned out to do the following:
Integrate Physical and Mental Health
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By integrating the two, this encourages states to identify barrier to integration
by breaking down the walls between the two systems. In doing so, states could
become eligible for grants for five years of up to $2 million. This could also
help treat low-income individuals who have persistent and serious mental
illness.
Designate an Assistant Secretary for Mental Health and Substance Use
By doing this, this brings the issue higher up by establishing an Assistant
Secretary for Mental Health and Substance Use disorder with the USDHHS,
who will oversee grants and promoting practices that are best for early
diagnosis, treatment and rehabilitation.
Establish New Grant Programs for Early Intervention
Establishing a new grant program will bring more awareness and more funds to
the research. Grant programs would be focused on rigorous early involvement
for children who may demonstrate risk factors that could be recognized as
mental illness as young as 3 years old to adolescence and adulthood.
Establish Interagency Serious Mental Illness Coordinating Committee
Setting a committee under the Assistant Secretary can ensure the promotion of
research and treatment related to Serious Mental Illness and process evaluations
for efficiency.
Establish New National Mental Health Policy Laboratory
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Innovation grants that classify new and effective models of care can be funded
along with demonstration grants to bring effective models to scale for adults
and children.
Reauthorize Successful Research and Grant Programs
Key programs such as the Community Mental Health Block Grants become
reauthorized to increase funding for critical biomedical research on mental
health.
Strengthen Transparency and Enforcement of Mental Health Parity
In order to strengthen transparency and the enforcement of mental health parity,
this requires the U.S. Department of Labor, USDHHS and the U.S. Department
of Treasury’s aide to conduct audits on the Mental Health Parity
implementation. This will also offer guidance on how comparability toward
mental health services and physical health services are determined.
Improve Mental Health Services within Medicare/Medicaid
This will allow patients to use mental health and primary care services on the
same day at the same location. In turn this will repeal the current Medicaid
exclusion on inpatient care for people between 22-64.
‘
Proponent and Opponent Arguments
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The Mental Health Reform Act of 2015 has gained about 15 cosponsors, 8
democrats and 7 republicans with the original cosponsor being Sen. Christopher S.
Murphy (D-CT), ranging from states such as Connecticut, Louisiana and New
Hampshire. A cosponsor is the first member of House or Senate to be named
among the potentially numerous lawmakers who introduce a bill for consideration.
Another group who may be for this reform bill are people who are struggling
with or family and friends of those struggling with mental illness. Individuals who
are struggling with mental illness and cannot afford proper care.
For example, a family of 4, a mother, father, daughter and son, with their son
being diagnosed with Bipolar Disorder. Bipolar Disorder, which can also be known
as a manic-depressive illness, is a brain disorder that causes strange shifts in
energy, mood, activity levels and causes rifts in day-to-day activity and is also
broken down into four different types:
Bipolar I Disorder – manic or mixed episodes that may last seven days at the
least. Some may be manic symptom that are severe enough for immediate
hospitalization.
Bipolar II Disorder – a form of depressive and hypomanic episodes but not
necessarily full-blown manic/mixed episodes.
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Bipolar Disorder Not Other Specified (BP-NOS) – when the symptoms of
bipolar disorder exist inside the patient, but does not meet the investigative
standards for both bipolar I/II.
Cyclothymic Disorder/Cyclothymia – individuals with this form of bipolar
disorder have hypomania episodes along with mild depression for at least 2
years. These symptoms do not meet the investigative standards for any other
form of bipolar disorder.
Doctors who diagnose bipolar disorder follow the Diagnostic and Statistical
Manual of Mental Disorder [Nat15]. The son is ultimately diagnosed with Bipolar I
Disorder. The mother noticed strange behavior from her son. She noticed that one
moment he was extremely happy, over zealous, and the next moment he was a little
irritable. His teachers would notice that he would be easily distracted or having a
difficult time concentrating, drawing pictures or zoning out during a teaching
lesson. The teacher recommended that he see a specialist or physician.
The mother took him to visit a physician who then diagnosed him with Bipolar
I Disorder and recommend he see a specialist for his behavior. Unfortunately, there
was no one in their community that specializes in mental illness. Therefore, the
Mental Health Reform Act would aide in the early stages of his disorder and
intervene in the process of it progressing. It would also help educate all medical
physicians on how to properly diagnose mental illness, giving an accurate
prognosis and be able to properly treat the illness (medication, therapy, etc.)
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It’s been realized that in the twenty-first century, mental health problems/illness
are cured differently than other illnesses. The system for curing psychiatric illness
is known to be a bit confusing.[Haz11]. This family would strongly support the
Mental Health Reform Act because it was written for them. Parents who may be
unaccustomed with how the mental health system work and who are trying to find
help for their child may feel that they’ve entered a new city for the first and do not
know where to go [Haz11].
Nursing’s OR Human Services Perspective
Psychiatry is a branch of medicine that is focused on the diagnosis, treatment
and prevention of mental, emotional and behavioral disorders. It’s named as the
dominant discourse for mental illness [Rog14]. Psychiatry and psychiatrist have
given help those with mental illness a way to express themselves and overcome
their illness by either helping them cope with it or by prescribing medicines
[Ame16].
Psychiatrist are trained and educated to perform a range of medical laboratory
and psychological test which help provide a picture of a patient’s mental and
physical health. With proper education and clinical training, psychiatrist are
equipped to understand the different relationship between emotional and other
medical illnesses. Their relationship toward a patient is to be able to understand the
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patient and be able to tell what’s wrong. Their outlook on this reform bill will help
improve their diagnosis, give better funding for research. This reform bill will also
train and educate nurses and physicians on how to spot mental illness and what to
do in the case they encounter a patient with a mental illness.
Policy/Bill Recommendations
I believe mental health is a serious issue that needs to be addressed in America
and not be ignored. There are plenty of people in this nation with mental illness
who go untreated but they’re not treated properly by doctors or because they can’t
afford it and do not have insurance. Mental health is a stigma that runs in our
nation. It can be labeled for various reasons through different people. Psychiatry
has been the dominant discourse when coping and curing mental health issues are
involved [Rog14]. The illness framework is the dominant framework mental health
services because psychiatry is the dominant profession within those services
[Rog14].
The Mental Health Reform Act of 2015 should be considered for passing. Our
nation needs to realized that if we should follow under the saying “All Men Are
Created Equal”, then we should provide proper healthcare for those who are
mentally ill; as a nation we should make those with mental illness feel as though
they are normal, as if nothing is wrong. The recommendations this bill should take
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is to create a full detailed budget of cost of training and education materials needed
to put the bill into full effect. There’s always a cost when creating a bill. This bill
has the potential to be greater than what it is. with a few revision and adding a
detailed budget, we can make a change in the mental health/illness community that
can affect the way people are treated, physically, mentally and emotionally.
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Bibliography
American Nursing Association. (2015). American Nurses Association code of
Ethics for Nurses with Interpretive Statements . Distant Production Home
University .
American Psychiatric Association. (2016). What is Psychiatry. Retrieved from
American Psychiatric Association: http://www.psychiatry.org/patients-
families/what-is-psychiatry
Caplan, G. (2013). An approach to community mental health (Vol. III). Routledge.
Hazen, E. P. (2011). Mental Health Disorders in Adolescents: A Guide for Parents,
Teachers, and Professionals. Rutgers University Press.
Manderscheid, R. W.-E. (2009). Evolving Definitions of Mental Illness and
Wellness. US National Library of Medicine.
Minas, H., & Cohen, A. (2007). Why Focus on Mental Health Systems. Retrieved
from BioMed Central:
http://ijmhs.biomedcentral.com/articles/10.1186/1752-4458-1-1
Murphy, C. (2015). U.S. Senate. Retrieved from Chris Murphy United States
Senator for Connecticut: https://www.murphy.senate.gov/newsroom/press-
releases/cassidy-murphy-introduce-comprehensive-overhaul-of-mental-
health-system
National Institute of Mental Health. (2015). Bipolar Disorder. Retrieved from
National Institute of Mental Health:
https://www.nimh.nih.gov/health/topics/bipolar-
disorder/index.shtml#part_145405
Rogers, A., & Pilgrim, D. (2014). A Sociology of Mental Health and Illness. New
York, New York: McGraw-Hil Education.
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U.S. Department of Health and Human Services. (1999). Mental Health: A Report
of the Surgeon General. National Institute of Mental Health, U.S.
Department of Health and Human Services (USDHHS), Rockville.
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Criteria
Problem/issue
is
briefly
discussed.
Related
legislation/bill
is
identified.
Name
and
number
of
bi
who
introduced
is
noted.
Current
status
of
given
(i.
included.
is
provided.
Individual
in
committee,
passed
by
house,
etc.).
Main headings
History
of
bill,
initial
development
and
impetus
for
introduction
of
bill,
etc.,
are
discussed.
Pertinent
literature
review
relevant
to
the
issue/problem
is
included
(i.e.
related
to
the
issue
of
HIV
or teen
pregnancy,
present
literature
that
validates
this
problem.
Social,
economic,
political,
and
ethical
considerations/impact
related
to
issue
are
discussed.
Proponents
(interest
groups/individual)
of
bill
are
listed
and
position
is
discussed.
Opponents
(interest
groups/individual)
of
bill
are
listed
and
position
is
discussed.
“Nursing”
OR
“human
services”
perspective
on
the
issue
and
related
bill
is
presented.
Internet,
journal
sources
used
(Le.,
see
role
of
Advanced
Practice
Nurses
(Hamric));
ANA
position
statements,
human
services
oriented
institutions,
organizations;
Virginia
Nurse
Practice
Act;
Code
of
Ethics
for
Nursing,
etc.).
Personal
views
about
issue/proposed
legislation
are
given.
Expanded
on
comments
about
the
given
in
the
introduction
(may
include
actual
bill
document
retrieved
from
Internet
as
an
appendix.
Student
recommendations
if
bill
should
be
passed
in
current
form
discussed
(why/why
not)
and
student
recommendations
for
revision
of
elimination
are
given.
Current
APA
formatting.
Correct
spelling,
grammar,
and
sentence
structure
used.
Flow
of
ideas
are
well
organized,
coherent,
and
thorough.
Points
Possible
0
to
30
points
0
to
50
points
0
to
40
points
0
to
50
points
0
to
50
points
0
to
30
points
HEALTH POLICY ISSUE PAPER GRADING RUBRIC
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