Sai Kagithala
Dr. Aaron Martin
March 29, 2017
Policy Paper
Mental Health: Make America Brighter Again
Unmet mental health needs among adolescents are alarmingly high, as more than 1 in 5 individuals aged 13-18 experience a severe mental disorder at some point during their life. According to the Congressional Research Service Report, an estimated 26.2% of Americans aged 18 and older suffer from a diagnosable mental illness in a given year. Even though mental illnesses are widespread in the population, the main burden of illness is concentrated in a much smaller proportion—about 6%, or 1 in 17—who suffer from a serious mental illness. These numbers provide the basis of our research where we established that the lack of resources in disadvantaged socioeconomic areas, as well as the lack of social workers hinders many from seeking the help they need when it comes to mental health, thus creating a stigma around a mundane issue. Historically, mental illness has not been as well understood as other physical illness, which has led to disparities in the treatment and financing of mental illness. The mental health care system currently faces a number of structural and functional issues since it is integrally separate from normal healthcare. The bipartisan Mental Health Reform Act of 2016, which was passed under the Obama Administration, strengthens federal coordination of mental health resources, increases reporting on mental health parity, supports the mental health workforce, and increases access to mental health services; this Act has been an integral part in helping solve the issue around Mental Health.
Mental Illness is defined as anything that alters one’s mood or thinking, that includes disorders such as depression, anxiety, bipolar disorder, autism, borderline personality disorders, eating disorders etc. Two of the most common mental illnesses are anxiety and mood disorders in the United States; however, particular cultures such as those in Asian countries, mental illnesses are often stigmatized and seen as a source of shame, because in these cultures, success is often assessed as the combination of emotional control and self control. For example, one study comparing Indian and American attitudes toward mental illness surveyed students at a University in the Himalayan region of Northern India and at a university in the Rocky Mountain region of the United States. The Indian students were likely to view depression as arising from personally controllable causes, such as failure to achieve an award. The students then proposed that social interactions as well as self-reflections are intended to help fight depression. However, the large absence of social workers should be taken into account for mental illness in order to maximize the effectiveness of mental health care delivery programs. The stigma attached to mental illness is a byproduct of bias, stereotyping and avoidance. It is a structural barrier that discourages people from seeking treatment, especially in rural areas. According to the Surgeon General’s report, “in order to address the issue of stigma, there needs to be a change in society’s perception of mental illness through greater availability of effective treatment options.”
The Mental Health Reform Act of 2016 aims to expand The Substance Abuse and Mental Health Services Administration(SAMHSA) to develop and to tackle the issue of making sure that the stigma around Mental health mitigates. This Act calls on SAMHSA to train and recruit more social workers that are dedicated to addressing Mental and Substance use disorders. This led SAMHSA to unite with Federal and other partners to help augment the number of trained professionals to address the nations mental health problem. The United States Bureau of Labor estimates that by 2020 there will be a 36.3 percent increase in the workforce. This increase will help facilitate stigma around mental health in socioeconomic areas, as well as those areas that are culturally different. Culture is a major structural barrier that could be addressed by the increase of social workers that are able to help these communities, by mediating the efforts of different groups involved. The Act goes on to aid those that are homeless suffering from a substance or mental health disorder, who have no means of getting help. This allows counselors and doctors to target individuals from impoverished areas, who make up majority of those that have a mental health issue. Garfinkel points out why it has taken so long for the government to take action because of the “[decentralized] U.S. political system explains why the U.S. provides less cash assistance to those in need.”
Talking to my Representative, Mr. Martin Howrylak, we concluded that the state level has a decentralized system, where “many welfare state scholars don't believe it works”,while reforms have been made years ago to battle the problem of mental health but there are different ways to tackle the problem. The Mental Health Reform Act of 2016, a federal bill, focuses on extending support to primary and behavioral health care. This further allows the two parties to collaborate and work to solve a national problem. However, we also have to keep in mind the differences in physical and mental health, where we have to ensure the health care equalization of workers since different workers are paid and viewed differently in the two fields. Although a federal law mandates that social workers must be paid equally, the loopholes in the system allow primary health care workers to earn more than their health care counterparts. One reason for this inequality is for insurance purposes that Representative Howrylak speculates. This is an important aspect because, this makes the mental health care system less appealing for the monetary value it has on their lives. Graham notes that as with any organization, internal politics plays a huge role in governmental bodies (Pg. 143). However, with this bill, there is more pressure on SAMHSA to deliver results such that their workforce is being treated fairly, and making a difference in the lives that matter. Representative Howrylak points that at the state level “we could say that changes have been made, but perhaps the pendulum has swung to one side, and we need to rectify it again in order to better suit those in need of attention.” This act provides the opportunity for those individuals in need, by opening gates that they never had access to before, such as hospitals needing to treat the homeless individuals. Another structural barrier that the bill is overcoming is that 100 million people are in need of attention, but there are shortages of units such as social workers. According to the Occupational Outlook Handbook, as of 2016 there are only 682,100 social workers, that is a 5% increase in the social labor force, within a year, the same year the Health Reform Act of 2016 passed. This proves the extent to which the Reform Act is working, and the number of future social workers that could potentially arise from this bill. Representative Howrylak offered a Medicaid expansion, which currently accepts those that are financially unstable and gives them affordable options for the costs. This method parallels Reform Act, such that affordable options are given to anyone that is financially unstable. He also was fixated on destigmatization of mental health with an educational standpoint. He plans on using the institutions we created to target the next generation, those that are easier to teach about mental health. The bill also expands SAMHSA's authority to develop educational materials and intervention strategies which will help the cause through the civics sphere. We should create a mandate for a mental health parity, which the Senator from New Mexico is currently working on.
Representative Howrylak is a strong advocate for this issue and feels that with bills such as the Health Reform Act of 2016, tackling mental health issues should be a “piece of cake.” Infrastructure is in place in some locations and we need to make sure that the existing ones are in check as well as make sure that they are reaching out to people. Keeping in mind that the state and local levels have decentralized funding which creates a lot of inefficiencies, the Federal Government has stepped in to provide the help that individuals need. We must also keep in mind that in the past, it was the states and local governments job to take care of mental health, however after noticing the inefficiencies the federal Government was able to make changes to the Mental health Care system with lasting impacts. “The integration of health and mental health is not only possible, it is essential to the success of health reform.” Integration is crucial to moving away from stigma to prevention, wellness, and primary care. Leaving mental health out of health care produces greater suffering for both health and mental health conditions, greater burden to families and communities.
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