NURSING

Answer

Barriers to Long-Term Mental Health Care

Employees with mental health conditions tend to fear workplace reprisals associated with utilization of employer-provided insurance.  One of the major reprisals is employment termination on the claim of absenteeism or lost productivity in order to avoid burden of care associated with long-term mental healthcare services. There is need for policy changes to protect employees from unfair dismissal after being diagnosed with a mental health condition or psychosocial issues (Thomas et al., 2017). In addition, there is need to ensure that employer-sponsored insurance are offered in accordance to  the Affordable Care Act and the Mental Health and Substance Use Parity so as to guarantee employee benefits and rights (American Foundation for Suicide Prevention, 2020).  Stigmatization and discrimination are two major issues facing mental health patients that need be addressed to improve access and outcomes of mental health care services.

Nurse can be involved in getting more people to access or seek mental health care. Nurses should address stigma and discrimination that is the main cause of low utilization of mental health services. Besides, stigma and discrimination may cause mental health patients to pull away from care. Stigmatization has far reaching impacts apart from low utilization of mental health care services. Being stigmatized depletes social, economic, and instrumental resources, leading to many negative outcomes, including disparities in quantity and quality of education (Smith & Applegate, 2018). Nurses should lead public education campaigns and education programs to address misunderstandings of society about mental health and improve mental health awareness (Smith & Applegate, 2018). Nurses should also implement anti-stigma and recovery-based approaches into mental health care services (Murney et al., 2020). Another approach for improving access and utilization of mental health care services is through implantation and use of E-mental health. E-mental health has ability to address treatment gaps (Lal, 2019).

Once mental health patients are discharged, Advanced Practice Registered Nurses (APRNs) can be fundamental in ensuring continuity of care to patients and families. Patients and families may have various needs and issues associated with the mental health or psychological problems that need to be identified and addressed. In accordance with Standard 1 of the American Nurses Association (2015), APRNs should conduct thorough assessments to improve patient and family outcomes.  This particularly, important given that patients may be discharged unsafely from long-term mental health care institution. For example, in the provided 60 Minutes report a patient was discharged in unsafe manner before full recovery; thus, mental healthcare services and care need to be provided at home or in community setting (Pelley, 2015). In addition, APRNs should collaborate with community workers and other providers to improve health care and well-being of mental health patients after discharge through follow-up and promotion of life-long continuity of care (Kaakinen et al., 2015).

In conclusion, mental health patients who seek employer-sponsored insurance may risk workplace repercussions such as unfair dismissal; perhaps, due to stigmatization and discrimination. Nurses should address stigmatization and discrimination experienced by mental health patients to improve utilization of mental health services and promote realization of better outcomes. These can be address through involvement of nurses in public education and campaign to address misunderstandings and improve awareness of mental health or psychosocial issues. Lastly, but not the least, APRNs should be involved in follow-up of patients once mental health patients are discharged from mental health facilities.

References

American Foundation for Suicide Prevention. (2020). Mental health and substance use parity and your employer-sponsored insurance. https://www.thenationalcouncil.org/wp-content/uploads/2013/02/20140909-MH-Parity-and-ESI.pdf?daf=375ateTbd56

American Nurses Association. (2015). Nursing: scope and standards of practice (3^rd ed.). Silver Spring, MD: ANA. https://www.iupuc.edu/health-sciences/files/Nursing-ScopeStandards-3E.pdf 

Kaakinen, J. R., Coehlo, D. P., Steele, R., Tobacco, A., & Hanson, S. M. H. (2015). Family health care nursing: Theory, practice, and research (5^th ed.). Philadelphia: F.A. Davis. Company

Lal, S. (2019). E-mental health: Promising advancements in policy, research, and practice. Healthcare Management Forum, 32(2), 56-62. https://doi.org/10.1177%2F0840470418818583

Murney, M. A., Sapag, J. C., Bobbili, S. J., & Khenti, A. (2020). Stigma and discrimination related to mental health and substance use issues in primary health care in Toronto, Canada: a qualitative study. International Journal of Qualitative Studies on Health and Well-being, 15(1). https://doi.org/10.1080/17482631.2020.1744926

Pelley, S. (Aug 02, 2015). Denied. https://www.cbsnews.com/news/mental-illness-health-care-insurance-60-minutes-2/

Smith, P. A., & Applegate, A. (2018). Mental health stigma and communication and their intersections with education. Communication Education, 67(3), 382-393. https://doi.org/10.1080/03634523.2018.1465988

Thomas, K. C., Shartzer, A., Kurth, N. K., & Hall, J. P. (2017). Impact of ACA health reforms for people with mental health conditions. Psychiatry Services. https://doi.org/10.1176/appi.ps.201700044This question has been answered