Preston Hunter
Professor Miner
English 2010
Proposal
Proposal to Mental Health Treatment
Introduction
The world today is experiencing serious issues relating to mental health. Many of these
issues have not been realized or are simply being ignored. Many of these problems may be
acknowledged, but there is not a solution that is feasible or cost effective. One major issue is the
treatment that an individual suffering from a mental illness is receiving, or the lack of treatment.
According to the Substance Abuse and Mental Health Services Administration, in a 2014
National Survey, only 41% of adults in the U.S. with a mental health condition received mental
health services in the past year. Among adults with a serious mental illness, 62.9% received
mental health services in the past year (Hedden, Kennet and Lipari). With 60% of adults who
arent receiving services, there is work to be done. This is only data reported on the services
received, it doesnt state whether the services were successful or not. Not only is there a large
number of people not getting the treatment they need, but mental health is costing unnecessary
amounts of money that can be cut down. T.R. Insel reports in the American Journal of Psychiatry
that serious mental illness costs America $193.2 billion in lost earnings per year (Insel).
Change needs to be made in how mental health treatment is handled.
Plan of Action
A plan, similar to one already in place by Intermountain Healthcare, with mandatory
implementation in all clinics or hospitals across the United States would offer the opportunity to:
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5.
Increase the number of people who receive treatment.
Increase the effectiveness of the treatment.
Decrease the cost of treatment for the patient as well as the provider.
Give physicians empowerment.
Make the treatment more personalized to the patient.
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2.
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In order to meet these expectations, the plan and recommendations would:
Integrate the mental health treatment into the primary care physician care.
Allow the individual to go to their primary care instead of the E.R.
Provide a mental health coordinator to the patient as a resource and provider.
Assess the needs of the patient and meet these needs personally where appropriate.
Require the system be implemented in all clinics or hospitals nationwide.
Implementation
The first step to this process is to transition to going to a primary care physician when
dealing with mental health related issues instead of the emergency room. A primary care
physician would be the individuals normal doctor ranging from a pediatrician to an internal
medicine doctor. Approximately 73% of patients seeking primary care have a psychological or
behavioral health component connected to their chief complaint (American Academy of
Nursing). By going to a primary care doctor, patients will be able to treat both their health and
mental health needs at the same time. There are multiple reasons for this that will benefit
everyone. Typically, the E.R. doctor is not specialized in mental health and doesnt know how to
treat the problem as well as the patients
personal primary care physician. Not only
can they treat the problem more
effectively, but the primary care physician
costs much less than a visit to the
emergency room.
Treating mental health is a process. It takes a long time and doesnt just happen overnight.
The next step is for the physician to refer the patient to a mental health coordinator who is
already in that physicians office. The patient just steps into another room with the coordinator.
The patient will no longer have to wait weeks for an appointment with another specialist. The
mental health coordinator is already in the office and is able to provide treatment for common
conditions and other issues. They are able to work together as a team to help consult and do their
part to offer the best treatment to the patient (Intermountain Healthcare). This new mental health
coordinator can be a nurse or social worker who is trained in mental health and has a background
with this treatment. This also minimizes the amount of people admitted into psych wards or
specialty hospitals that dont always have successful results. The coordinator will then sit down
with the patient and figure out what the issues are. They will be able to ask and successfully
answer questions such as does the patient have the right medicine? Are they getting the best
possible care for their illness? Do they need further counseling? Are they experiencing suicidal
thoughts and need a mentor or help? Is the problem intense enough for them to see a
psychiatrist? These are all questions that need to be answered correctly. Having one simple
question diagnosed incorrectly can have drastic impacts on the patient.
Once the foundation has been laid for the patient, they now have an available resource to
help them further their treatment. Their personal coordinator will be able to be reached by phone
to help with any concerns. They will be calling the patient a few days after the initial visit and
follow up to make sure everything is okay. They are then there to answer questions as well. The
coordinator can take care of issues over the phone that would not require an actual physician
visit. Once again, time and money are saved.
The new mental health coordinator will not only save money, but a lot of the burden is then
lifted off of the primary care physician. The coordinator will now function as a linkage to the
physician and provide therapy and support that the doctor cant always provide. It is all about
keeping it team oriented and in a primary care office. It gives the patient and the doctor resources
to offer help to achieve the best possible care.
Now, the primary care physicians
would need some additional training in
mental health treatment, but that would be
arranged. The physicians will receive
additional training as well as refreshers
from medical school and residency. The
idea has results. A similar plan that has been implemented by Intermountain Healthcare and a
few other health care providers has been quite successful. According to the American Academy
of Nursing, Patients with depression who are treated in MHI clinics are 54% less likely to have
emergency room visits than depressed patients in non-MHI clinics. And in 2010, patients with
depression who were involved with an MHI clinic saw their health insurance claims decrease by
$667 in the year following their diagnosis (American Academy of Nursing).
Continuous feedback will then be needed and given to improve this system. It will not be
perfect the first time it is put into place, nor will it stay perfect. There will be changes that can be
made to continue to improve the life of the patient while saving money. To continue to progress,
one cannot stick to the status quo. This MHI system will be adaptable and subject to change
based on feedback, both from doctors and patients, as well to the location of each clinic to deal
with specified problems. It will be reevaluated on a yearly basis.
Conclusion
This system has seen results that need to be seen across the country. If this plan would be
implemented in all clinics then mental health issues would decrease drastically. It wouldnt be
totally gone, but the improvement is possible and it has been proven. The lives of those living
with mental health conditions must, and can, be improved. This issue needs to be realized and
then addressed. Issues will be minimalized. Money will be saved. People will be happier.
Works Cited
American Academy of Nursing. Rais the Voice. 2014. Article. March 2016.
Hedden, Sara L., et al. Behavioral Health Trends in the United States: Results from the 2014
National Survey on Drug Use and Health. Survey Results. Rockville: Substance Abuse
and Mental Health Services, 2015. Publication.
Insel, T.R. "Assessing the Economic Costs of Serious Mental Illness." The American Journal of
Psychiatry (n.d.): 663-665. Journal Article.
Intermountain Healthcare. A Team-Based Approach to Mental Health Integration in Primary
Care. 16 July 2014. Article. March 2016.
