Proactive Approaches Toward Healthcare Through Mental Health: Recommendations for a Replacement ACA Program
*Harkeet Kittu Pannu
Columbia University Mailman School of Public Health, USA
Submission: February 25, 2017; Published: March 09, 2017
*Corresponding author: Kittu Pannu, Columbia University Mailman School of Public Health, Client Care Manager at HK Counseling Services, New York, USA
How to cite this article: Kittu P. Proactive Approaches Toward Healthcare Through Mental Health: Recommendations for a Replacement ACA Program. JOJ Pub Health. 2017; 1(2): 555559. DOI:10.19080/JOJPH.2017.01.555559
Mental Health
Mental Health, it’s not the first type of health that comes to mind when one thinks of general wellbeing even when approximately 20 percent of the total U.S. population experienced some mental illness just last year [1]. We don’t usually even think of healthcare as a proactive measure, but, at its worst, we associate medicine with reactionary and cautionary tales chock-full of thankless staffers, long wait times, and “white coats” who care nothing for their patients. Many patients try to avoid health services if they can help it, resulting in worsening scenarios for patients when they actually do see a health practitioner. While medicine, in general, definitely has a public relations crisis on its hands, it also has a duty to ensure that people engage in proactive services that will curb patient suffering and can contribute positively to overall public health objectives.
Let’s start with the hot-button issue shaping our current healthcare decisions: the Affordable Care Act (ACA). It has been at the center of a spiraling debate that continues to leave consumers with the short end of the stick. The ACA even became a key rallying point for candidates during this past election season [2] [3]. As current and future practitioners, we have to do better by ensuring that our patients and clients receive the highest quality of care at the lowest feasible cost to them. It is our duty to ensure that consumers of healthcare at least maintain the same mental health benefits they have engaged with since the ACA rollout. This includes advocating for lawmakers to make mental healthcare more accessible in order to benefit patients and increase their overall quality of life.
Much of this headache regarding national healthcare could have been avoided. Originally, the ACA functioned as a way to alleviate health disparities amongst various economic groups and provide a more paternalistic means to help them understand the benefits of long-term healthcare coverage. The ACA resulted in more than 20 million citizens receiving healthcare benefits, including healthy young adults, who ultimately strengthen the fundamental premise of healthcare insurance [4], [5,6]. These are 20 million more people who are able to receive the care they may need when accidents or issues out of people’s control occur. The ACA set out not only to mandate that all citizens get health insurance, but also to regulate the health insurance citizens purchase in an effort to keep costs and premiums down. The original thought process was that if we could ensure insurance companies would lower costs, the consumers, or people who were now being forced to buy into a system they may not have been a part of beforehand, would at least not have to worry about costs rising.
Unfortunately, things tend to take a life of their own when processed through Congress. During negotiations amongst legislators, many of the original protections for consumers in the form of insurance company regulations fell to the cutting room floor. In an effort to pass the ACA into law, avid supporters of a regulated insurance marketplace chose to give into the demands of those lawmakers who believed a more capitalistic approach should be taken with insurance company regulations Young [7,8]. And the fallout is crystal clear: insurance premiums and co-pays around the nation have been high, causing economic strife for many Americans who did not believe they needed health insurance, and ultimately leading many to contemplate dropping their health insurance altogether. In other words, while the main premise of the ACA was to increase quality and access to care, it also drove up costs mainly due to a lack of regulations on insurance companies.
Now, when it comes to mental healthcare, studies have shown that better mental healthcare outcomes lead to an increased overall quality of life and fewer instances of physical ailments. This means that proactive treatment for mental health can lead to both better mental health and physical health outcomes. Mental healthcare for people with mild illnesses, or ones that do not fully debilitate and relegate one to relinquish one’s societalroles, has the ability to help patients and clients process issues that they may struggle with. It provides these clients and patients with the tools to become more productive and fulfilled members of society. [9], [10], [11], [12], [13], [14], [15].
These tools include providing patients with the coping strategies that can limit the effects of their chronic mental illnesses ontheir lives, such as the vicious cycles of educational failings, social role disengagement, physical health ailments, unemployment, poor nutritional choices, and developing even more harmful mental diseases and illnesses These conditions can create even more negative consequences for an individual. [9] Bogaert et al. [10] [11]. [12], [13], [14], [15]. Physicians and healthcare workers in other Western societies have integrated a proactive mental health approach into their overall healthcare programs. Countries implementing this strategy include the U.K., Australia, and Canada, where researchers have seen overall greater health outcomes in participants. [12]. So yes, proactive mental healthcare can lead to better physical healthcare and higher quality of life outcomes.
Honestly, I can see where opponents to a proactive approach are coming from. The ACA, as implemented, has cost millions of Americans a ton of money [2], [3]. Premium rates have skyrocketed as a result of deregulation from a federal standpoint of insurance markets. Wait times are getting out of control, with many patients relying on Emergency Medicine and ERs to solve issues that do not require the expertise of a doctor. Doctors and healthcare workers in general have been charged with providing even higher quality care for lesser pay. And as globalization continues to dominate every aspect of our lives, Americans have to continually push themselves to be the best, leading overlystressful lives to maintain a level of success that may have been more achievable through easier means only 20 years ago. [11]. So yes, it’s a dire situation.
But, as healthcare practitioners, it is up to us to remedy these broad issues through strategic emphasis on proactive care. As discussed above, the research points to a direct relationship between mental and physical health. Giving patients the tools to handle their daily stresses has the potential to decrease the frequency of hospital visits, freeing up the time of health practitioners and allowing them to focus on those accidents and non-preventative ailments. [9], [11], [12]. [13]. National Alliance on Mental Illness [1] [14], [15]. As alluded to throughout this editorial, stress is a leading contributor to many of the major physical health issues that American patients face. By prioritizing mental health as a more proactive form of healthcare, we create a system that fulfills our professional creed to provide quality care to those who need it. It is up to us as the experts in patient care to use our clout and voice to shape upcoming healthcarerelated legislation. We are the ones who understand patients; we are the ones who interact with them on a daily basis; we are the ones who are charged with promoting better healthcare practices across the nation. And this includes clamoring for Congress to understand the impacts that mental healthcare can have on increasing its constituents’ overall quality of life.
This is our call to arms. This is where we need to step up and fulfill our Hippocratic Oath. This is where we go from vilified white coats who remain out of touch with the issues our clients face to woke individuals capable of advocating for a better life for them. We can be the force that brings the vicious mental health cycle to a halt. We can diagnose and treat mental illnesses before they wreak havoc on patients’ lives. We can be the levelers of patient care in the U.S., creating a system that values proactive approaches and patient-centered care instead of reactive medicine that can result in things becoming much worse than needed. Please join me in advocating for federal healthcare regulations that provide proactive mental healthcare for its citizens.
References
- Mental Health By the Numbers (2015) National Alliance on Mental Illness.
- Goldstein A (2016) Obamacare’s future in critical condition after Trump’s victory. American Pharmacists Association, Washington DC,USA.
- Sanger-Katz RA(2016) A Quick Guide to Rising Obamacare Rates. The Upshot, Public Health USA
- Does Your Insurance Cover Mental Health Services? (2014) American Psychiatric Association. USA.
- US Dept of Health & Human Services (2016) 20 million people have gained health insurance coverage because of the Affordable Care Act, new estimates show, Blog AIDS Gov USA.
- Health Insurance and Mental Health Services (2013) US Dept of Health & Human Services, USA.
- Young J (2009) Rockefeller’s public option defeated 8-15 in Senate Finance Committee vote. The Hill, Washington DC, USA.
- Young J (2009) Senate passes historic healthcare reform legislation in 60-39 vote. The Hill, Washington DC, USA.
- Acharya B, Maru D, Schwarz R, Citrin D, Tenpa J, et al. (2017) Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal. Globalization and Health 13(1): 2.
- Bogaert PV, Peremans L, Heusden DV, Verspuy M, Kureckova V, et al.(2017) Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC Nursing 16(1): 5.
- Dewa CS, Loong D, Bonato S, Hees H (2014) Incidence rates of sickness absence related to mental disorders: a systematic literature review. BMC Public Health 14(1): 205.
- Frost BG, Tirupati S, Johnston S, Turrell M, Lewin TJ, et al. (2017) An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges. BMC Psychiatry 17(1): 22.
- Madhombiro M, Dube Marimbe B, Dube M, Chibanda D, Zunza M, et al. (2017). A cluster randomised controlled trial protocol of an adapted intervention for alcohol use disorders in people living with HIV and AIDS: impact on alcohol use, general functional ability, quality of life and adherence to HAART. BMC Psychiatry 17(1): 44.
- Spagnolo J, Champagne F, Leduc N, Piat M, Melki W (2017) Building system capacity for the integration of mental health at the level of primary care in Tunisia: a study protocol in global mental health. BMC Health Services Research 17(1): 38.
- Yung AR (2016) Youth services: the need to integrate mental health, physical health and social care. Social Psychiatry and Psychiatric Epidemiology 51(3): 327-329.