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.
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 ...
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...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.
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).
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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.
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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).
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Healthy People 2020 is a health promotion program that is aimed at improving the health, wellness and longevity of the nation by the year 2020. This paper will focus on the Healthy People 2020 goals, how they will impact the families of those suffering with mental health disorders and those at risk for injury due to violence. It will further discuss the potential barriers that exist between promoting these goals and the interventions nurses can utilize to achieve them.
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