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  1. What is the Perspective on the Role of Government, and the Nature of Society, as it Pertains to the Policy?  

  2. What Dynamics and Patterns of U.S. Social Policy are Evident in the Policy (from class lectures/activities)?

Historical background

Mental health is a state of mind which affects an individual’s feeling, thinking and mood. This can in turn affect someone’s ability to perform necessary daily activities and logical and cognitive ability. Mental health is very difficult to treat every individual suffers different experience even if they are suffering from the same disease or have same diagnosis (Andrade et al., 2014). Still today there is a social stigma around mental health as admitting having mental problem sometime perceives as weak and feeble mentality. This does not help the current situation either and as a direct consequence mental health is emerging as a global prevalence now a day (Ramchand et al., 2015). Hence, there is a growing need of treating and prevention of this prevalence before it is too late.

The situation in United States in America is no different than the other countries. Almost one out of five American is suffering from mental illness as of right now. Current healthcare situation and policies are not helping this situation any better (Williams et al., 2015). Hence, a need of better policies and prevention tactics is needed from the government. Fortunately for the people of America, government have listened to the public outcry of the situation and passed a bill in the house named H.R. 34, the 21st Century Cures Act, Nov. 30, 2016. This bill includes two provisions regarding mental health. One of them is Helping Families in Mental Health Crisis Act of 2016 (H.R. 2646) and another is known as Mental Health Reform Act of 2016 (S. 2680). Therefore, in this article, historical background, reason behind the formation of this policy, description of this policy and social thought and ideology regarding this policy will be discussed thoroughly.

Senators Bill Cassidy (R-LA) and Chris Murphy (D-CT) had proposed the Mental Health Reform Act of 2016 (S. 2680) in the senate. The bill was placed on the Committee on Health, Education, Labor, and Pensions with a favourable report on 03/16/2016 with suggestion for amendment after read twice in front of the committee on the previous day. The amendment regarding this bill was reported by Senator Alexander which was substitute in nature. The bill then placed before the Senate Legislative Calendar on 04/26/2016 under general order with the calendar number 437. The progress and approval of the bill was actively supported, promoted and lobbied by the National Alliance on Mental Illness (NAMI), United States of America’s largest organisation for mental health working at the grass root level. NAMI have signed petition, collected signature, sent emails and thousands and thousands of tweet to the government to pass the bill. Fortunately, the bill was signed into law as part of H.R. 34, the 21st Century Cures Act, Nov. 30, 2016 on 13th December, 2016 by that time United States of America President Mr. Barrack Obama (Actions - S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

One out of five American is a victim of mental illness. Although, mental illness is curable, the prevalence of mental health is getting higher by the day. In the last few years, the suicide rate in America is highest amongst the last 30 years. Along with that, suicide also leading contributor of death count in America. Despite being a curable disease almost half American could not be able to avail the mental health care treatment. Furthermore, mental health care plan is restricted by the various health insurance plan provided by the private organisation. This is also one of the primary reason of the unavailability of mental health care treatment by majority of Americans. Hence, there was immediate and necessary action needed from the government. Fortuitously, government had listened to this emerging necessity and passed the act for the prevention, treatment and promotion of mental health.

Reason behind the policy

The Mental Health Reform Act of 2016 (S. 2680) is an important and necessary step towards strengthening United States of America’s mental health system. The primary objective of this policy is to strengthening and advancing of mental health in United States of America with the federal help. This will authorize program with the aim of early screening and intervention system specially to keep the children in school. This policy will also take part in promotion for evidence based initiative to acknowledge and address the mental health before it is declined to advanced stage. This policy also encourages the family involvement and provisional support while strictly and stringently maintaining the privacy of the individuals while prioritizing and planning of community based services to reduce the rate of homelessness and incarceration. Additionally, this policy aims to support and provide parity guidance while also funding for the mental health services. Furthermore, this policy aims to hire more workforce related to behavioural health and people who had live experience in this regard. They will be the vital and necessary part of support and care team whose objective will be to provide recovery to the needed individuals (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

Around half people who are suffering from mental health in United States in America does not get the treatment required because of lack of mental health workforce. As mentioned in the above paragraph, The Mental Health Reform Act of 2016 (S. 2680) will increases the trained medical professionals to help the situation. Along with that it will also forms a minority fellowship program with the objective of to increase the number of qualified and culturally competent mental health professionals. This policy also increase grant amount for the training of mental health professionals. Incidentally, people living in remote area could not able avail the services provided by mental healthcare system because of their location. Along with that there are people who are unable to consult with technical professional due to working hour as they just do not have the time to travel. To address this issues, The Mental Health Reform Act of 2016 (S. 2680) will also dedicate grant for the tele- health where this individual can have access to the modern and updated mental health care system (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

Mental health care were denied or restricted at higher rate than any other health sector despite being the presence of federal parity law. The Mental Health Reform Act of 2016 (S. 2680) will enhance and strengthen the enforcement of the ‘Mental Health Parity Law’. This will force the health plan providers to be held accountable for the coverage they have paid for the services. This policy will audit and report the any plan with more than five parity violation to the congress. This policy will ensure the interagency action plan to enforce and enhance parity and a GAO parity study will be investigated (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

Description of the policy

Amongst the mental health sufferer, almost half the people shows symptoms or illness by the age of 14. This calls for an early intervention plan to proper and justly tackle the situation. The Mental Health Reform Act of 2016 (S. 2680) will invest heavily on the early intervention, so that individual have the access to the proper mental health care treatment plan before it is too late for them. This policy will allocate five per cent of total mental health fund which will then support the evidence based initiatives ( like FEP or First Episode Psychosis programs) addressing the early intervention for the mental illness. Additionally, it will also allocate grant for the early intervention plan and programs for children (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

Furthermore, the Mental Health Reform Act of 2016 (S. 2680) policy will help in integration of mental health care system with total health. This will provide a holistic treatment to an individual not just the treatment of a single condition. To achieve this objective, the policy will support the training of medical professionals and social volunteers to provide integrated services in the underserved area for mental health care. The policy will also responsible for the creation of fund to support integrated health care services like behavioural and primary health (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

Moreover, the Mental Health Reform Act of 2016 (S. 2680) help to strengthen the community crisis system, so that individual with mental illness can avail the mental healthcare treatment sooner before their situation deteriorates further. To accomplish this objective the policy will allocate grant to augment the community crisis response service for the people with need and to maintain and develop the databases related to the mental health and mental health providing facilities for crisis stabilization (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

Along with that, the Mental Health Reform Act of 2016 (S. 2680) help the liaison between organisation and institution in the related field. This policy requires that an independent process to be created by the Secretary of Health and Human Services for complaints and grievance against Protection and Advocacy for Individuals with Mental Illness Program (PAIMI). This policy has also removed the restriction placed on the PAIMI. This policy also permits the payment for the individual aged between 22 to 64 years old receiving treatment at Medicaid managed care organizations (MCOs). But their stay in the institution has to short term which is no more than fifteen days per month (S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016, 2018).

With respect to the National Mental Policy Laboratory (NMHPL), Mental Health Reform Act of 2016 (S. 2680) has no particular and differentiable comparison. However, the duties and responsibilities mentioned in this policy were influenced by the NMHPL. This policy has acknowledged many problems that need to be acknowledged to fix the United States of America’s mental health system. Interestingly, this policy aims to authorize funding for many new provisions but the funding must be appropriated by Congress in their annual budget. This means the Congress have just authorized the funding but have not provided the funds just yet. Additionally, this bill have not addressed the issues how the poor will receive the treatment for their mental illness. Hence, this policy is right step towards the addressing of the issues of mental health but still needs few tweaks and tunings to be work better.

The social situation, ideology and thought have been given to this policy are includes parity, equality and holistic approach of treatment. The term parity can be defined as a state where every individual are equally treated despite their economic, financial and cultural status (Peled, 2015). Social parity is important in any particular society so that every individual can have equal shot at the treatment. In this case, the Mental Health Reform Act of 2016 (S. 2680) will act upon and strengthen the ‘Mental Health Parity Law’ which will monitor the service provided by the insurance provider against the coverage amount paid by the individual. This will help lessen the burden on the economically troubled family and not just rich people will have the luxury of the treatment for mental health. Another aspect that this policy addressed that the holistic approach to an individual’s health. The holistic approach to health can be defined as the approach by which treatment aims to cure all the aspects related to individual’s health including physical and mental health and not just treating a singular symptoms or disease. The Mental Health Reform Act of 2016 (S. 2680) targets to integrate mental health treatment with the physical health treatment which aims to providing holistic treatment for an individual’s health. . By doing this, this policy will help the individuals suffering from mental with total care for both mental and physical health and not just the mental health. The Mental Health Reform Act of 2016 (S. 2680) also aims to bring equality amongst the social populace. Equality can be defined as equal access to the all the privilege provided the government despite an individual’s economic, financial and cultural status (Peled, 2015). This objective will help poor American to receive mental health care support and treatment as half of mentally ill people in America belongs in economically challenged environment.

Conclusion

Henceforth, from the above discussion, it can be inferred that mental health is a global problem in today’s situation. United States of America is also suffering from the same fate as almost one out of five people in America suffering from mental illness. Half of them are unable to access to the mental health care system despite being treatment and cure available for a particular illness due to their socio- economic status. This needed a government intervention to handle the situation and with this in mind United States Government have introduced the Mental Health Reform Act of 2016 (S. 2680). This policy have aim to reduce the disparity, inequality in the society receiving mental health treatment. Furthermore, this will also work to intervene and promote the mental health problem. However, this policy is not perfect and foolproof as it has some drawbacks. Most major drawback of this policy is that it has just mentioned the objective and not the procedure. This policy does not mentioned how the poor American will receive treatment for mental health. Therefore, to conclude, it can be said that the jury is still out about the usefulness of this policy but it is definitely needed few more tuning and tweaks and it is a right step forward towards the handling the situation of mental health in United States of America.

 Medicaid managed care organisations (MCOs):

Organisation managed by state Medicaid agency which accepts a set payment.

Mental health/illness:

Disease which causes thought and behavioural inability to handle daily activities.

Senate:

Upper chamber of United States Congress

Legislative calendar:

Calendar used to plan the daily business of legislative session

Holistic approach:

Total treatment approach including physical and mental

Equality:

Equal access to healthcare system irrespective of creed, culture, gender or belief.

Parity:

Equal treatment irrespective of creed, culture, gender or belief.

Prevalence:

Occurrence rate in a particular area or a certain period of time.

GAO:

United States Government Accountability Office

Evidence based approach:

Medical treatment approach which are backed by scientific research evidence.

Intervention:

Action engaged to mend a medical disorder.

Behavioural health:

Well- being related to emotions and behaviours of an individual.

References

Actions - S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016. (2018). Retrieved from https://www.congress.gov/bill/114th-congress/senate-bill/2680/actions

Andrade, L. H., Alonso, J., Mneimneh, Z., Wells, J. E., Al-Hamzawi, A., Borges, G., ... & Florescu, S. (2014). Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological medicine, 44(6), 1303-1317.

Peled, Y. (2015). Parity in the plural: Language and complex equality. Language Problems and Language Planning, 39(3), 282-297.

Ramchand, R., Rudavsky, R., Grant, S., Tanielian, T., & Jaycox, L. (2015). Prevalence of, risk factors for, and consequences of posttraumatic stress disorder and other mental health problems in military populations deployed to Iraq and Afghanistan. Current psychiatry reports, 17(5), 37.

S.2680 - 114th Congress (2015-2016): Mental Health Reform Act of 2016. (2018). Retrieved from https://www.congress.gov/bill/114th-congress/senate-bill/2680/text

Williams, E. P., Mesidor, M., Winters, K., Dubbert, P. M., & Wyatt, S. B. (2015). Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Current obesity reports, 4(3), 363-370.

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