Mental Health Disparities in Rural America Mental healthcare has a long and murky past in the United States. In the early 1900s, patients could live in institutions for many years. The treatments and conditions were, at times, inhumane. Legislation in the 1980s and 1990s created programs to protect this vulnerable population from abuse and discrimination. In the last 20 years, mental health advocacy groups and legislators have made gains in bringing attention to the disparity between physical and mental health programs. However, diagnosis and treatment of mental illnesses continues to be less than optimal. Mental health disparities continue to exist in all areas of the world. The Centers for Disease Control and Prevention (CDC) reports that 25% of people suffer from a mental illness and that 50% of people will develop one during their life ("Surveillance Report," 2011). Mental illness is also associated with “chronic diseases such as cardiovascular disease, arthritis, asthma, and diabetes” (Pederson et al., 2013, p. 695). Rural communities have higher rates of chronic illnesses, mental health issues and fewer providers thus making this population vulnerable to health disparities. The purpose of this paper is to explore mental illness in the rural community, ways to improve accessibility to care, and improve outcomes through the role of a rural nurse educator. Definitions Rural What is rural? On the Health Resources and Services Administration of the U.S. Department of Health and Human Services website the U.S. Census Bureau defines the word "rural" to mean “whatever is not urban” ("Defining the Rural Population," n.d, p. 1). The Census Bureau describes urban centers as populations of 50,000 or more and urban clusters ... ... middle of paper ... ...ducation material for patients, families, and educators of school age children. The information from this website is appropriate for school presentations. Both websites include a location finder for providers. All of these resources are helpful for educators, patients and families. Conclusion Mental health disparities in rural America will not magically disappear overnight, or even over a decade. The process will be slow and deliberate as long as there are advocates willing to keep pushing for change. Nurse educators can be advocates of decreasing stigma and discrimination of mental illness through educating their communities, families and patients. Additionally, nurse educators can be a driving force to institute technology driven mental health care services by collaborating with local health care organizations and other stakeholders (Smalley et al., 2010).
As a result of the lack of regulation in state mental institutions, most patients were not just abused and harassed, but also did not experience the treatment they came to these places for. While the maltreatment of patients did end with the downsizing and closing of these institutions in the 1970’s, the mental health care system in America merely shifted from patients being locked up in mental institutions to patients being locked up in actual prisons. The funds that were supposed to be saved from closing these mental institutions was never really pumped back into treating the mentally ill community. As a result, many mentally ill people were rushed out of mental institutions and exposed back into the real world with no help where they ended up either homeless, dead, or in trouble with the law. Judges even today are still forced to sentence those in the latter category to prison since there are few better options for mentally ill individuals to receive the treatment they need. The fact that America, even today, has not found a proper answer to treat the mentally ill really speaks about the flaws in our
The fight for improved health care for those with mental illness has been an ongoing and important struggle for advocates in the United States who are aware of the difficulties faced by the mentally ill and those who take care of them. People unfortunate enough to be inflicted with the burden of having a severe mental illness experience dramatic changes in their behavior and go through psychotic episodes severe enough to the point where they are a burden to not only themselves but also to people in their society. Mental institutions are equipped to provide specialized treatment and rehabilitative services to severely mentally ill patients, with the help of these institutions the mentally ill are able to get the care needed for them to control their illness and be rehabilitated to the point where they can become a functional part of our society. Deinstitutionalization has led to the closing down and reduction of mental institutions, which means the thousands of patients who relied on these mental institutions have now been thrown out into society on their own without any support system to help them treat their mental illness. Years after the beginning of deinstitutionalization and after observing the numerous effects of deinstitutionalization it has become very obvious as to why our nation needs to be re-institutionalized.
Small towns, quaint and charming, ideally picturesque for a small family to grow up in with a white picket fence paired up with the mother, father and the 2.5 children. What happens when that serene local town, exuberantly bustling with business, progressively loses the aspects that kept it alive? The youth, boisterous and effervescent, grew up surrounded by the local businesses, schools and practices, but as the years wear on, living in that small town years down the road slowly grew to be less appealing. In The Heartland and the Rural Youth Exodus by Patrick J. Carr and Maria Kefalas equally argue that “small towns play an unwitting part in their own decline (Carr and Kefalas 33) when they forget to remember the “untapped resource of the
The west is known for its real Cowboys, wide open spaces, and the poor approach for those with mental illnesses. All over the region, people suffering from these diseases are pressured into silence by the majority’s mentality about being a true westerner. Within groups of adults, acceptance, both self and social, is hard to come by. The results are often devastating to those who are troubled. Because the mountain west internalizes being Cowboy tough, people need to learn more about mental illness, and the afflicted too often rely on self-sufficiency and experience the difficulty of going against culture.
Mental illness is more common than one would like to believe. In reality, one in five Americans will suffer from a mental disorder in any given year. Though that ratio is about equivalent to more than fifty-four million people, mental illness still remains a shameful and stigmatized topic (National Institute of Mental Health, n.d.). The taboo of mental illness has an extensive and exhausting history, dating back to the beginning of American colonization. It has not been an easy road, to say the least.
If the United States had unlimited funds, the appropriate response to such a high number of mentally ill Americans should naturally be to provide universal coverage that doesn’t discriminate between healthcare and mental healthcare. The United States doesn’t have unlimited funds to provide universal healthcare at this point, but the country does have the ability to stop coverage discrimination. A quarter of the 15.7 million Americans who received mental health care listed themselves as the main payer for the services, according to one survey that looked at those services from 2005 to 2009. 3 Separate research from the same agency found 45 percent of those not receiving mental health care listing cost as a barrier.3 President Obama and the advisors who helped construct The Affordable Care Act recognized the problem that confronts the mentally ill. Mental healthcare had to be more affordable and different measures had to be taken to help patients recover. Although The Affordable Care Act doesn’t provide mentally ill patients will universal coverage, the act has made substantial changes to the options available to them.
The United States has the highest incarceration rate in the world and of that over sixty percent of jail inmates reported having a mental health issue and 316,000 of them are severely mentally ill (Raphael & Stoll, 2013). Correctional facilities in the United States have become the primary mental health institutions today (Adams & Ferrandino, 2008). This imprisonment of the mentally ill in the United States has increased the incarceration rate and has left those individuals medically untreated and emotionally unstable while in jail and after being released. Better housing facilities, medical treatment and psychiatric counseling can be helpful in alleviating their illness as well as upon their release. This paper will explore the increasing incarceration rate of the mentally ill in the jails and prisons of the United States, the lack of medical services available to the mentally ill, the roles of the police, the correctional officers and the community and the revolving door phenomenon (Soderstrom, 2007). It will also review some of the existing and present policies that have been ineffective and present new policies that can be effective with the proper resources and training. The main objective of this paper is to illustrate that the criminalization of the mentally ill has become a public health problem and that our policy should focus more on rehabilitation rather than punishment.
Mental health disparities, “the power imbalances that impact practices influencing access, quality, and outcomes of behavioral health care, or a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rate in a specific group of people defined along racial and ethnic lines, as compared with the general population” (Safran, 2011). Although there are many mental health care dipartites, I’m going to focus on the impact of poverty and lack of attention given to mental health. By advocating for a prevention, promotion, and intervention related to mental health, will aid in minimizing mental health disparities. Not only is it important to advocate on a macro level, but it is important to educate
Those with mental illness would live in the community with an array of services and be able to be free from the constraints of confinement. In the early 1960’s the United States began an initiative to reduce and close publicly-operated mental hospitals. This became known as deinstitutionalization. The goal of deinstitutionalization was to allow people suffering from mental illness to live more independently in the community with treatments provided through community health programs. Unfortunately, the federal government did not provide sufficient ongoing funding for the programs to meet the growing demand. States reduced their budgets for mental hospitals but failed to increase funding for on-going community-based mental health programs. As a result of deinstitutionalization hundreds of thousands of mentally ill people were released into the community without the proper resources they needed for their treatment. (Harcourt,
Continuing budget cuts on mental health care create negative and detrimental impacts on society due to increased improper care for mentally ill, public violence, and overcrowding in jails and emergency rooms. Origins, of mental health as people know it today, began in 1908. The movement initiated was known as “mental hygiene”, which was defined as referring to all things preserving mental health, including maintaining harmonious relation with others, and to participate in constructive changes in one’s social and physical environment (Bertolote 1). As a result of the current spending cuts approaching mental health care, proper treatment has declined drastically. The expanse of improper care to mentally ill peoples has elevated harmful threats of heightened public violence to society.
Mental illness is a disease that is misunderstood, miscommunicated, and viewed as predominantly negative in our society. Even in ancient times, anyone thought to be mentally ill was locked away in a facility for fear that they were a danger to others. Sometimes, the mentally ill person was even thought to even be possessed. The public’s view on mental health has improved with time and education, but the mental health stigmas still exist. Being someone who works full time within a behavioral health unit, my perception of mental health and the public’s perspective of mental health significantly differ.
Equally important is the lack of access for rural veterans seeking mental health treatment. According to Bennett, et al. (2004), in comparison to urban-based veterans, rural veterans have a greater concern in their ability to access transportation in their seeking of mental health services. As an illustration, after reaching out to their communities, the Alabama Veterans Rural Health Initiative (ARHI) found that of all their veteran participants, a total of 56 percent screened positive for at least one Axis I mental disorders (Davis et al.,
The Psychiatric Mental Health Nurse Practitioner (PMHNP), role and job description is providing primary mental health care services, to those with mental health problems, or psychiatric disorders. The PMHNP is required to assess, diagnose, provide treatment plans, prescribe medication therapy, and offer counsel across the lifespan. The PMHNP provides care in a wide range of settings to children, adolescents, adults, the elderly, and their families. This mental healthcare takes place in the primary care settings, emergency rooms, hospitals, outpatient mental health clinics, senior living communities and in private practices. Being culturally competent to care for the ever changing demographics of the United States is necessary. The PMHNP assess and treats in a holistic manor and utilizes evidenced based practice. Regardless of race, gender, age, religion, sexual orientation, political persuasion, or socio economic standing the PMHNP is there to treat. The PMHNP role also includes establishing a therapeutic relationship, being sensitive to many abnormal behaviors, and caring for those frequently distressed emotionally. Collaboration and the ability to make referrals are essential for the PMHNP. Patients present with undiagnosed problems and establishing the proper diagnosis by a qualified PMHNP begins with the initial assessment interview (Gilfedder, Barron, & Docherty, 2010).
According to the Webster’s Third New International Dictionary the definition for urban is 1)a: of, relating to, characteristic of, or taking place in a city, b: constituting or including and centered on a city, c: of, relating to, or concerned with an urban and specifically a densely populated area. The definition for rural is: 1) living in country areas: engaged in agricultural pursuits, 2): characterized by simplicity: lacking sophistication: uncomplicated, 3): of, relating to, or characteristic of people who live in the country, 4): of, relating to, associated with, or typical of the country, 5): of, relating to, or constituting a tenement in land adapted and used for agricultural or pastoral purpose-opposed to urban.
The thinking behind community mental health focuses on the altogether mental health of people in a particular community. To observe a communities mental health needs, nurses first must assess at least one common denomination among its members, which is called an aggregate group. For example, adolescent’s behavioral anger issues mothers who are victims of abuse, and the homeless elderly and middle age adults. Aggregate mental health refers to the way in which families and groups within a given environment contribute to or enhance interactions among people along the mental health-illness continuum (Nies & McEwan, 2007). During an uproar of untreated mentally ill people in1955, Congress passed the Mental Health Study Act to examine people with