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From the above data we can see that the most affected generation is the youngest generation, 18 to 29 years old. The target population for this project is the younger population, male and female between the ages of 18-29 years. One reason may be that this age group is caretaking for children as well as aging adults. Caregiving, while often managing a career and other responsibilities, has been found to have quite an emotional and physical impact that in some cases causes mental and physical deterioration at an extremely accelerated rate. The older generation shows the least cases, these people have fewer responsibilities and if anything, they have already lived their lives.
Research shows less than half of adolescents with psychiatric disorders received any kind of treatment in the past year. A social stigma continues to surround mental health disorders, and mental health care is frequently difficult to access. In 2013, 10 percent of adolescents lacked insurance and,when they are covered, the amount of mental health services they can receive is often limited (United States Department of health and human service, 2016). 46% of the population has employer based health insurance alone, 11% has employer plus another type of insurance; 15% only has Medicare, just 6% has Medicare with another type, 9% has AHCCCS alone and finally 5% has AHCCCS plus another type of insurance. The reason why we have less number of insured people is because insurance premiums are expensive hence most households cannot afford them. Similarly, due to economic crisis, we have had people losing jobs. Another reason could be the fact that we have people who work on jobs that are not covered, especially the illegal immigrants. The Maricopa County government should try to come up with a strategy of seeing that the insurance companies get to lower their charges to affordable levels, by doing so, we will have more people, especially age group 18-29 year old being insured and thus accessing medical attention early enough before things get worse (Arizona Health Survey,2008).
On the other hand, there is need to have more hospitals across the county that offer mental health services, this will reduce overcrowding in hospitals, thus the quality of care provided will be high.
4)
A lot of resources need to be directed towards this sector, for instance, training more mental health nurses, doctors and personnel, and ensuring that they get better training on how to handle assess and treat patients. We have had cases where some patients don’t really know how to go about their situation and some of the explanations provided by the doctors and nurses often fail to describe patients’ experience. That said, more research needs to be carried out.
Among the involved agencies are the Arizona Health Care cost Containment system, which is a Medicaid agency that offers health care programs to serve Arizona residents. Secondly we have Mental Health America which is a community-based nonprofit organization which aims at promoting mental health as one of the major components of one’s wellness. Furthermore, we have other facilities such as Desert Vista Behavioral Health Center in Mesa and Behavioral Health Annex on the main Maricopa Integrated Health System campuswhich have qualified personnel such as a psychiatrist, social worker, registered nurse, recreational therapist, and chaplain and peer support counselor. Maricopa Integrated Health System has also made sure that we have medical nurse practitioners in behavioral health outpatient clinics across the county hence a patient is able to receive primary care and mental health services at the same location.
4a)
In my fieldwork, I came up with relevant questions meant to help in examining the mental health in the county. I narrowed down to an asset-based approach which entailed asking individual indicators far as mental health care access is concerned. I started by asking individuals whether they have ever been told that they have Bi-polar or depression, and this was based on race, age and gender. I went ahead to ask those with Bi-polar if they are taking medications for it or if they have visited a doctor in the past 12 months. From my research, I found out that younger age groups had showed higher prevalence of Bi-polar and a few were taking medication, compared to the older generation. It also came to my notice that quite a number of those who reported to have Bi-polar and depression had no insurance, a few of these uninsured individuals were taking medication and almost half reported as to not have visited a doctor about their disorder in the past 12 months. According to gender, females recorded a large number of individuals with Bi-polar as compared to their male counterparts.
Part of the questions I asked the patients were; how the diagnoses of depression and bipolar made them feel, how the impact of early diagnoses affected or helped them, the kind of experiences or situations that led, or may lead them to feeling hopeless, and where they can learn about community supports, different groups, and helpful ways to build a strong, positive life. Just to mention a few.
5)
There is still a lot to be done with regard to mental health; there should be education, awareness and campaigns meant to inform the public on the importance of visiting a professional in case they happen to feel like having mental disorder symptoms. It is also important to inform the public on how they can receive mental care and how they can avoid these mental disorders. By doing so we will have fewer cases of mental disorders in Maricopa County.
There is need for a service system that will not only be able to support the management but also care of individuals with complex mental health issues. Poverty, health disparity/inequality also needs to be addressed as it is also one of the factors affecting the access to mental health. Lastly, one crucial area that needs to be addressed is the issue of stigmatization of mental health patients. While conducting my field work interviews, I found out, many of the affected young individual self stigmatized themselves. They see the disease as a sign of weakness, shame, blame, social exclusion and “black sheep of the family”. This stigmatization needs to be addressed county wide.
C)
According to healthy people 2020, Mental health could be described as a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with challenges.
The desired outcome, per healthy people 2020 will be an Improvement of mental health through prevention and by ensuring access to appropriate, quality mental health services.
It is often said that prevention is better than cure, therefore, the county should focus more on education, and coming up with preventive measures, ensure that we increased coordination of services and collaboration of providers, and new programs or approaches aimed at better handling the overflow of people with serious mental illnesses into prison systems, hospital EDs, and homeless shelters.
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D)a
The first objective will be to collaborate with mental health practitioners by doing mental status screening for every patient visit to county clinic and hospitals. This will help detect early signs and symptoms of mental illness.
The second objective is nursing teaching/education of parents and psychiatric nurse.Parent education will focus on signs and symptoms to watch for while their children are at home.
Nurses’ education will focus on training them about mental status assessment tools that can aid in early detection of mental illness.
D)b
The first action plan will be for nursing administrators to be charged with responsibilities of
identifying, investigating and implementing a solid mental health screening tool that will be
Readily available in all high schools, and clinics throughout the county. This can be
achieved by reviewing the evidence base and current practices, then develop an operational
Policy with an approved mental health assessment tool. After approving this assessment
tools, each clinic supervisors will then assume the responsibility of training their staff on the approved tool.
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The second nursing action plan will be for nursing supervisors to encourage and train all nursing staff working on the Psychiatry Unit in current psychiatric nursing assessment of patient functioning, including mental status evaluation tis can be done by developing a training module, or power points that includes objectives and content, then develop a training schedule, and Initiate evaluation and cycle for skills maintenance.
2 & 3)
Nursing administrators, local government officials and clinicians should collaborate to organize and provide enhanced psychiatric training to primary care mid-level practitioners and nurses who provide coverage to psychiatric hospitals and medical clinics. The training will focus on education, easy access, quick mental health assessment and easy referral to clinical psychiatrist for full evaluation and follow up.
Without formulating any new policy or laws, Local nursing unions, nursing administrators and county health official should collaborate to mandate mental health assessment as part of admission at all clinics, middle schools, high schools and colleges all over the county, then encourage the lawmakers to formulate a policy that will ensure free evaluation by a clinical psychiatrist for every referral from all levels of education.
This should take about 6 months or less to implement. In addition, nurses needs to continue to encourage the county health official to set up more rehabilitation centers so as to reach as many people as possible. This will mean that more people will have access to these facilities and be able to access the necessary mental health care or services easily. Within a period of 12 months, there should a significant increase in access to mental health care county wide.
E)
An extensive survey would be used as a tool to gather information on the state of mental health and well-being of the residents. This would include gathering information on mental health status, barriers to mental health care access and if at all there are other new disorders that have come up. From this valuable data, the concerned parties will be able to look at the barriers, evaluate and proffer solutions that best fit each and every issue.
A measurable tool will be to collect a data that will identify how many individuals is currently receiving care, how many potential individual are still out there seeking for help; this too should show a decrease in the number of individuals still seeking help. The tool should also show an improvement in the quality live of the residents Maricopa county.
F)
Access to mental health and medical care is a good determinant of how well a community is doing when it comes to good quality of life. The field work gave me the insight and knowledge of how many of our population does not have access to care. One in four residents of our county have not seen a practitioner in the past year, while one in six delayed or did not get medical care they need because of access, and one in seven does not have health insurance. I found out in my field work that access to healthcare was the most important health problem in Maricopa county, and it the sixth most important factor affecting the quality of life of our community member. While doing my fieldwork and research,
It is now up to the important that stakeholders within Maricopa County to combine forces towards making the county a healthy county. Health care providers should offer services that are meant to Improve the healthcare, safety, and well-being of adolescents and young adults in the county.
References
Arizona Health Survey. (2008). Design and methodology of the Arizona Health Survey. Phoenix AZ: St. Luke’s Health Initiatives.
Blumberg, S. J., Ganesh, N., Luke, J. V., & Gonzales, G. (2013). Wireless substitution: state-level estimates from the National Health Interview Survey, 2012. National health statistics reports, (70).
Bobo, W. V., Wollan, P., Lewis, G., Bertram, S., Kurland, M. J., Vore, K., & Yawn, B. P. (2014, September). Depressive symptoms and access to mental health care in women screened for postpartum depression that lose health insurance coverage after delivery: findings from the Translating Research into Practice for Postpartum Depression (TRIPPD) effectiveness study. InMayo Clinic Proceedings (Vol. 89, No. 9, pp. 1220-1228). Elsevier.
United States Department of Health http://www.hhs.gov/ash/oah/adolescent-health-topics/mental-health/access-mental-health.html
White, C. (2015). Incarcerating Youth With Mental Health Problems A Focus on the Intersection of Race, Ethnicity, and Mental Illness. Youth Violence and Juvenile Justice, 1541204015609965.
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