Healthcare Delivery For Persons With Mental Illness

In 1965, there was a histrionic change in the method that mental health care was delivered in the United States. The focus went from State Mental Hospitals to outpatient settings for the treatment of mental health issues. With the passing of Medicaid, States were encouraged to move patients out of the hospital setting (Pan, 2013). This process failed miserably due to under funding and understaffing for the amout of patients that were released from the State Mental Hospitals. This resulted in patients, as well as their families, who were in dire need of mental health services. This population turned to either incarceration (jails and/or prisons) or emergency departments as a primary source of care for their loved ones.

A Community health center can be defined as a center where high quality primary and preventive healthcare is provided regardless of the ability of the patient’s financial situation. There are some basic characteristics a community health center must possess to be fully functional. Some of which are:

Deinstitutionalization is defined as the movement of severely mentally ill people out of large state institutions. In the 1950s, public hospitals housed well over 500,000 people. The reduction in the number of institutionalized people began in 1956. By 1980, the residential population in mental hospitals dropped by nearly three-quarters, an average of 154,000 individuals. This decrease is due to the process of closing public hospitals and transferring patients to community-based mental health services. Consequently, community services were implemented (Talbott 2004).

Overcrowding became a major problem during the 1940s. Public pressure to reduce the lengthy waiting lists for admission to state hospitals and to remove mentally ill individuals from local jails increased occupancy in already overcrowded hospitals. In 1943, the legislature converted the Confederate Home for Men into a hospital for mentally ill male geriatric patients in order to provide beds in the larger hospitals. In 100 years, the state system for caring for the mentally ill grew to nine state hospitals scattered about the state. Their population had, however, begun to decline as a result of new treatment techniques and changing social ideas about the role of state psychiatric hospitals in caring for afflicted individuals (Creson).

These two men set out on a campaign with the theme “fix the broken promise” which referred to Ronald Regan’s promise to use the funding that came from the closing of many mental hospitals for the care of the discharged patients (Peck 2005). The campaign put together “pilot programs” like the programs that are offered today in the actual act (Peck 2005). There was an overwhelming positive reaction with a “56% reduction in hospital stays, a 72% reduction in jail stays, and a 65% increase in people with full-time jobs” (Peck 2005). With law enforcement on their side (having seen what these programs would do to decrease the mentally ill population), they gained a tremendous amount of supporters for their cause. Darrell Stein dedicated a year of his life for this cause and helped raise close to $4.6 million for the campaign (Peck 2009).

Community based mental health care and service began to gain popularity in the United States in the 1930’s when psychologists began arguing against the legitimacy of institutionalization, calling it inhumane, and suggesting that diagnosis and treatment

In 1955, over 559,000 individuals resided in inpatient psychiatric hospitals. By 1995, however, the number had drastically diminished to 69,000, (National Health Policy Forum, 2000). This drastic reduction was largely due to the discovery of antipsychotic medications in the 1950s, and the deinstitutionalization movement of the 1960s, wherein several thousands of mentally ill individuals were released from psychiatric institutions to return to their communities for treatment. Mental health centers (MHCs) were conceptualized during deinstitutionalization to provide treatment to these newly-released mentally ill persons in their communities. Although efforts were well-intended, the MHCs failed to serve the

Access to mental health care is not as good as than other forms of medical services. Some Americans have reduced access to mental health care amenities because they are living in a countryside setting. Others cannot get to treatment for the reason of shortage of transportation or vast work and household tasks. In some areas, when a

The Community Mental Health Act of 1963, was the first federal law that inspired community-based mental health care, and it ignited the transformation of the public mental health system (Young Minds Advocacy, 2016). Other names of the Act are Mental Retardation and Community Mental Health Centers Construction Act of 1963. It was the beginning of the Deinstitutionalized movement in mental health treatment options for children, youth, and adults (National Council for Behavioral Health (NCBH), 2015). States received money from grants, from the Community Mental Health Act for the construction of these mental health centers. Initially, the intention of the grant program was to provide 1500 mental health centers nationally (Young Minds

The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.

Health care systems are organizations that are formed to meet the overall health needs of the population. Health care is regarded as one of the leading cause in promoting not only physical and mental health but the well-being of the population. Legislation is implemented requiring government to offer services to all members of its society. The role of health services and the organizations that provide aid is to focus on the health of an individual and to uphold their human rights. According to WHO (2013), a “well-functioning health care system requires a robust financing mechanism, a well-trained and adequately-paid workforce, reliable information on which to base decisions and policies, and well maintained facilities and logistics to deliver quality medicines and technologies (World Health Organization; 2013).

The negative stigma of mental health has lightened slightly over the years, however, it has not rescinded entirely. People still have an unmanageable time admitting that they may have a mental disorder and that they require assistance. Human beings struggle with these hindrances openly and also hidden on a daily basis. Therefore, our civilization needs to remove the shame associated with the treatment of mental disorders and work on devising a progressive suitable mental healthcare plan in order to ensure that many live a healthy, happy, and prosperous

In the state of Georgia there are 227 federally qualified health centers and two centers that are of are of particular interest to me, The Center For Health & Rehabilitation in Atlanta and East Dekalb Health Center Lithonia. These centers qualify because they are public entities that serve the population where they are located. The Center For Health & Rehabilitation provides mental health services to mentally inmate released from the prison system and to those individual whose mental illness treatment began in prison. In contrast East DeKalb Health Center provides primary and preventative health care services in an underserved

Mental health facilities have evolved over the last several hundred years. In 1965 the Mental Health Act was put in place. (A. Penden) It funded community mental health centers throughout the United States. (A. Penden) These outpatient mental health facilities are great places for those who suffer with certain mental illnesses that do not have to be placed in inpatient facilities to be

Additionally, legislative actions were taken in the 1960s and 1970s that made it even more difficult to help those who needed it the most. The system for community mental care was vastly underfunded and many people did not have access to care. As of 1977, according to statistics from Officer.com, “there are 650 community health facilities serving 1.9 million mentally ill patients a year” (Deinstitutionalization). A major problem was that funding was given and then taken away, or diverted to other causes (Thomas). This increasingly paints a picture of the community mental health initiative as a rapidly sinking ship. At this point, not only were mentally ill people being discharged from inpatient treatment facilities with nowhere else to go, they could not even get the help that they needed if they were willing to seek treatment. For those unwilling, or unable, to seek treatment, the Lanterman-Petris-Short Act, and others like it, made forcing the issue even more difficult. To make matters worse, underfunding was also having a negative impact on the few remaining state hospitals. Because the jobs paid so