Mental Health Drugs & Alcohol

Mental Health –Drugs & Alcohol

Week Assignment #5

Sonia Donaires

November 29, 2015

MPH 584, Community Health

Dr. Kelly Wheeler Mental Health - Drugs & Alcohol

1. Define mental health and the use of DSM -IV-TR.

Mental health is a neurological disorder that affects the brain in the way of thinking, mood, or behavior. People with mental illness are incapable functioning effectively in society (Mental

Health.gov). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a document that identifies various mental disorders, provides descriptive information and diagnostic instructions for each mental disease. Also, this document identify those in need a diagnosis, whether insurance should reimburse a treatment, to which school and social services a person is entitled, the top priorities for mental health research, and what kinds of new therapeutic medications should be developed (McKenzie & Pinger, 2015).

2. Define the term deinstitutionalization and list and discuss the propelling forces that brought it forth.

Deinstitutionalization was a term used to explain the release of thousand of patients from state-owned mental hospitals and to provide less restrictive community settings. The purpose of this plan was to reduce the number of resident patients in public hospitals. There were four important reasons: economics, idealism, legal considerations, and the development of marketing of antipsychotic drugs. The main purpose for these changes was to reduce federal expenditures to develop education, roads, and welfare. As remediation of these changes, Medicaid and Medicare legislations allow to reimburse the costs of outpatient and inpatient services for eligible people with mental illness who were not residing in a state institution. In 1960, the legality of institutionalizing people was questioned because of the misdistribution of funds and the American Bar Association discuss the rights of treatment of persons with mental disorders when institutionalized (McKenzie & Pinger, 2015).

3. List and describe 3 basic approaches to mental health services.

 Psychopharmacological therapy was developed since 1954 with the introduction of

chlorpromazine to treat and to reduce the severity of symptoms of schizophrenia, bipolar

disorder, major depression, anxiety, panic disorder, and obsessive-compulsive disorders.

 Psychotherapy or psychosocial therapy involves treatment through verbal

communication. The therapy is conducted individually, in-group, couple, or family. The

use of the Cognitive Behavioral Therapy is a useful tool to identify the risk factors that

lead to a distorted thinking.

 Technology is a therapy conducted via telephone, video conferencing, Internet, email,

and computer software through daily homework. This type of treatment is cheap and

more convenient for people that want privacy and reduce coerciveness. Also is effective

for those individuals that have language barrios (McKenzie & Pinger, 2015).

4. Describe the trends of alcohol and other drug use across the lifespan in the USA.

The cost of alcohol abuse and alcoholism in the United States is estimated to be $235 billion. That is $748.61 for every U.S. citizen. The population at high risk is underage drinkers, children, teenagers and college students younger than 21 years. Alcohol concerns can lead to many issues like violence, disease transmission and unintended pregnancies. Also, there are high prevalence due to unintentional injuries in car accidents (McKenzie & Pinger, 2015). In the United States an estimated 68.2 million American ages 12 or older use tobacco, one in five adults ages 18 and over are addicted to cigarettes. About 88% of adults smokes begin by age 18 and 99% start smoking by age 26. Most common Chronic diseases caused by nicotine include heart disease, lung cancer, chronic obstructive lung disease, stroke, emphysema, and other conditions (McKenzie & Pinger, 2015).

5. Cite an example of an effective community health program for drug abuse prevention.

One effective community health program is School- Based Drug Education Program.

Integrating prevention of alcohol and drug abuse into the curriculum of schools will reduce the prevalence of any drug abuse. Children as the most vulnerable population need to be aware of the effects of the consumption of alcohol, tobacco, and other drugs. Developing an active education program about drug abuse will ensure the reduction of alcohol, tobacco, and drug abuse (McKenzie & Pinger, 2015).

6. Create an outline of available health care delivery settings, across the lifespan, and the role they play in meeting the Healthy People 2020 objective for access to health services.

 1800s - The few hospitals served as a social welfare than health care. Health care moved

from the patient’s home to the physician’s office. Also, the scientific research identified

the principal agents and risk factor of the communicable disease (McKenzie & Pinger,

2015).

 1920 – Professionals such as doctors and nurses were trained and specialized in patients’

treatment. Also, the invention of new medical procedures such as X-ray therapy surgical

procedures, chemotherapy invention of electrocardiograph helped to measure the heart function. Emergence of chronic illnesses that surpassed in prevalence to infectious

diseases (McKenzie & Pinger, 2015).

 1946 - The Hospital Survey and Construction Act well known as the Hill-Burton Act

with support of Federal and State provided funds to build hospitals. The cost of health

care rose because of the new infrastructure of hospitals and new technology (McKenzie

& Pinger, 2015).

 End 1050s misdistribution of health care services: metropolitan areas were better served

than the less-developed rural areas (McKenzie & Pinger, 2015).

 1960s new negotiations to provide a better health insurance for workers. The third-party

payment for health care system was created resulting in rise of health care (McKenzie &

Pinger, 2015).

 1965 - Medicaid and Medicare by Titles XVIII and XIX respectively of the Social

Security Act were created (McKenzie & Pinger, 2015).

 1973 - The Health Maintenance Organization (HMO) was passed by the legislation

provided with both loans and grants for the planning, development, and implementation

of combined insurance and health care delivery organizations (McKenzie & Pinger,

2015).

 1981- The President Reagan established the competitive market to better health care costs

and adequate care (McKenzie & Pinger, 2015).  1992 - The first lady Hillary Rodham Clinton developed a plan to overcome the

shortcomings of the health care system called the American Health Security Act of 1993

with the purpose to provide universal coverage for all citizenship. The plan was never

approved. Also, Clinton created the State Children’s Health to benefit children with

health problems (McKenzie & Pinger, 2015).

 2003 - President Bush created the Medicare Prescription Drug, Improvement, and

Modernization Act (MMA) that benefit Medicare part D and Health Savings Accounts

(HSAs). Institute of Medicine (IOM) and the World Health People 2000 - Health

Systemic: Improving Performance changed the way it was delivered (McKenzie &

Pinger, 2015).

 2010 - President Obama signed the law of the Patient Protection and Affordable Health

Care Act (PPACA) and, the Health Care and Education Reconciliation Act (HCERA)

called now Affordable Care Act (McKenzie & Pinger, 2015).

 2010 - Healthy people were launched with a 10-year agenda for improving the Nation’s

health. The first responsibilities were to encourage collaboration across communities and

sectors, empower individuals toward making informed health decisions, and measure the

impact of prevention activities (Healthy People 2020, 2015).

7. Identify the components of the Affordable Care Act and the significance to community health programs and services. 459

 No pre-existing condition exclusion for children younger than age 19.  No arbitrary y rescission of insurance coverage, insures are prohibited to from rescinding

coverage for individuals or group of people, except in cases of fraud.

 No lifetimes limit on coverage

 Restricted annual limits on coverage

 Protecting choice of doctors

 Removing insurance company barriers to emergency department services (McKenzie &

Pinger, 2015).

The Affordable Care Act was created particularly to reduce the health disparities in the

United States. Providing an affordable health insurance for people of all ages helped to eliminate the injustice rules of the health insurance before the Affordable Care Act such as limiting the benefits for children with pre-existing conditions, cancellation of someone’s policy when they become sick, stop benefits for patients that reached a lifetime limit set by the insurance company, and higher copayments or co- insurance (U.S. Department of Health & Human Services, 2015).

8. Identify and describe the following: Medicare, Medicaid, CHIP, CDHPs p.448

Medicare is a the federal health insurance program for people who are 65 or older, younger people with disabilities, and people with End-stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD. Four specific services cover the insurance describe below:

 Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and

some home health care.  Part B is the medical insurance that includes regular doctor’s services, outpatient care,

medical supplies, and preventive services.

 Part C is the Medicare Advantage Plans that offers a plan provided by a private company

that makes agreements with Medicare to provide with all Part A and Part B benefits.

Also, this program provides prescription drug coverage.

 Part D adds prescription drug coverage to Original Medicare that are covered by

insurance and private companies approved by Medicare (Medicare.gov, n.d.)

Medicaid is a joint funded, Federal and State health insurance program for low-income and needy people. It covers children, elderly, blind, and or disabled and the people who are eligible to receive federally assisted income maintenance payment (McKenzie & Pinger, 2015).

CHIP stands for Children’s Health Insurance Program, is a program administered by the United

States Department of Health and Human Services that provides matching funds to states for health insurance to families with children. Also, Provides health care to low-cost health coverage to children in families that earn too much money to qualify for Medicaid. . Local Medicaid,

CHIP is a joint State-Federal funded program (McKenzie & Pinger, 2015).

CDHPS stands for a consumer-directed health plan, it can be a plan paired with an individual plan and some that must be paired with a group plan through an employer. It is common personal healthcare account used to pay for medical expenses. These plans are like medical savings accounts, giving you more control over your healthcare dollars. People pay using a combination of the medical insurance and your personal healthcare spending account (Pacific Source Health

Plans, n.d). 9. There are multiple types of health care providers available in the healthcare system. Discuss the following:

a. What is the evidence to support the use of allopathic vs. osteopathic providers? Is there a difference in approach or outcomes?

Allopathic providers are the medical systems that treat diseases with drugs or medicines.

In this category are the Doctors of Medicine (MDs). While the osteopathic providers are the called Doctors of Osteopathic Medicine (DOs) has a different philosophy that MDs. DOs treatments are more holistically oriented than MDs. DOs and MDs are very similar to the use of the same techniques of diagnosing diseases (McKenzie & Pinger, 2015). b. Is insurance reimbursement possible for CAM providers? What is the evidence to support this use, based on patient outcomes (provide an example).

CAM stands for Complementary/alternative medicine (CAM) or called non-allopathic providers will know as chiropractors, acupuncturists, naturopaths’ herbalists and homeopaths.

CAM is not considered as part of the conventional medicine. Private health insurance plans may offer coverage of certain CAM therapies such as chiropractic and massage. The lack of scientific evidence regarding the cost-effectiveness of CAM therapies. Based on the demand of people of

CAM there are more insurance company and care organizations may consider offering coverage of CAM (McKenzie & Pinger, 2015). Reference

Healthy People 2020. (2015). About healthy people. Retrieved from

http://www.healthypeople.gov/2020/About-Healthy-People

Medicare.gov. (n.d.). What is medicare? Retrieved from https://www.medicare.gov/sign-up-

change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html

Mental Health.gov. (n.d.). Whar is mental health? Retrieved from

http://www.mentalhealth.gov/basics/what-is-mental-health/

McKenzie, F.& Pinger, R. (2015). An Introduction to community & public health. (Eight Ed.)

Burlington, MA: Jones & Bartlett Learning

Pacific Source Health Plans. (n.d). What is CDHP. Retrieved from

https://pacificsource.com/consumer-directed-health-plans-101/page-1.aspx

U.S. Department of health & Human Services. (2015). Key features of the affordable care act.

Retrieved from http://www.hhs.gov/healthcare/facts-and-features/key-features-of-

aca/index.html