Mental Health And Health Services

While there is agreement that trauma informed care generally refers to a philosophical stance integrating awareness and understanding of trauma and its ongoing impact on patients’ health and lives, there is not yet consensus on a definition or clarity on how the model can be applied in a variety of settings. The philosophical underpinnings of trauma informed care trace to the feminist movements of the 1970s (Burgess & Holstrom, 1974), and the emergence of child-advocacy centers and awareness and response to child abuse in the 1980s. In combination with the growth of research in combat-related posttraumatic stress after the Vietnam War, the focus then expanded to mental health practice, especially in the context of traumatic events. By the late 1990s and early 2000s, social work and mental health professionals began to articulate organizational frameworks for delivery of trauma informed care, as well as conceptual models based on scientific evidence about how traumatic stress impacts brains and behavior (Bloom, 1997; Harris & Fallot, 2001; Covington, 2002; Rivard, Bloom, & Abramovitz, 2003; Ko, Ford, Kassam-Adams, et al. 2008; Bloom, 2010). In 1998, SAMHSA launched the Women, Co-Occurring Disorders and Violence study, a seminal study in 27 sites over five years that examined trauma-integrated services counseling. Following that, the National Child Traumatic Stress Network (NCTSN) began identification and distribution of empirically supported trauma-specific mental health

Mental Health coverage prior to the Affordable Care Act was far to none. With about nearly one-third of currently covered individuals having no coverage for substance abuse disorder services and approximately 20% having no coverage for mental health services. Services such as outpatient therapy visits, impatient crisis intervention and stabilization were among many that were not offered. Since the Affordable Health Care Act has been passed more individuals are able to afford health insurance that were once uninsured. It has helped many individuals in being able to obtain medical services that were once inaccessible.

The term “Psychological trauma” refers to damage wrought from a traumatic event, which that damages one’s ability to cope with stressors. “Trauma” is commonly defined as an exposure to a situation in which a person is confronted with an event that involves actual or threatened death or serious injury, or a threat to self or others’ physical well-being (American Psychiatric Association, 2000). Specific types of client trauma frequently encountered by which therapists and other mental health workers frequently encounter in a clinical setting include sexual abuse, physical , or sexual assault, natural disasters such as earthquakes or tsunamis, domestic violence, and school or/and work related violence (James & Gilliland, 2001). Traumatic

The study of psychology refers to collective trauma as the effect experienced by many people in the aftermath of a tragedy or event. The pain of collective traumatic disorders is common among soldiers who experienced military combat, but has the potential to affect an entire community. Although, Post Traumatic Stress Disorder (PTSD) can alter relationships with the family and the community, future generations will not have to endure combat directly to experience collective trauma. Many Veterans suffering from PTSD might shy away from others due to stigmas associated with the diagnosis. Some might have difficulty concentrating, or have guilty feelings, cannot find work, feel helpless, fearful, or have a loss of interest in usual activities. All

According to the World Health Organization, mental illness will affect approximately 25% of people at some point in their life (“WHO Qualityrights”, n.d.). Despite that, the current mental health care system in the United States is inadequate. Many aspects of the system need improving, especially the barriers to service. In fact, approximately 20% of individuals are left without necessary treatment for their mental health disorder (“Mental Health”, 2016). Mentally ill individuals have difficulty accessing necessary mental health care services for various reasons; insurance, socioeconomic status, and mental health stigma can all function as barriers to treatment. Insurance discrimination can make it difficult for individuals to find treatment (Han, Call, Pintor, Alarcon-Espinoza, & Simon, 2015). Gaps in insurance coverage can also be a barrier, as they disrupt the long-term treatment process (Gulley, Rasch, & Chan 2011). Socioeconomic status has been found to negatively affect appointment scheduling (Kugelmass, 2016). Finally, stigma in our society can also stop people from seeking out treatment that they need (Bathje & Pryor, 2011). The mental health system in the United States is not capable of caring for the mentally ill, as insurance, socioeconomic status, and perceived stigma all act as barriers that prevent people from receiving the treatment they need.

Dementia is a set of symptoms that affect the way people think and interact with each other. It is not a disease, but can often be linked to a disease or damage done to the brain. Short-time memory, mind, speech and motor skills are affected. Certain forms of dementia cause a change in the personality of the individual. A person suffering from dementia will lose certain skills and knowledge they already had. This is the main difference to other conditions that affect the mind. People who suffer from learning problems, or lower intelligence will never acquire certain skills, people suffering from dementia will lose skills they have acquired. Dementia is

An interesting finding by Huskamp and Iglehart (2016) is that between the Mental Health Parity Act (MHPA) and the Affordable Care Act (ACA), there should be a rise in people with mental illness seeking services, however, services are underutilized more than ever (Huskamp & Iglehart, 2016). According to Bendant (2014), in 2013 a total of 47 million people uninsured and 25% of those suffer mental illness (Bendant, 2014). These numbers are staggering for a service that is more inclusive now more than ever. The Center for Medicare & Medicaid Services (CMS) site indicates that the MHPA is regulated differently depending on the state (CMS, n. d.). The Department of Labor (DOL) has identified a few problems with the MHPA and addressed these issues to Congress via a 2017 report (DOL, n.

This paper will define The Effects of Trauma and Crisis on Clients and Mental Health Counselors and give a brief overview on how these Natural and man-made disasters, crises, and other trauma-causing events have become a focus of the clinical mental health counseling profession. Due to the extreme trauma that children, adolescents and adult experience after a traumatic event it, is noted that most individuals that are exposed to traumatic experience usually develop major depression, generalized anxiety, and Post-Traumatic Stress Disorder (PTSD) later in

“One of my biggest struggles with dealing with my ‘problems’ was being able to pay for help. At some points I thought the process to receive help was more draining than my illness itself” (May). Mental illness has plagued millions of people in the United States alone, and with the stigma it carried, getting the help that is needed is not always possible. With Proposition 63 in California it is speculated that with proper aid from the government and community those with mental health problems will be better suited to face their demons. That by having a budget to help those desperately in need we can better the lives of those who struggle with mental illness.

The black community has its own opinion about how effect mental heath services could be. The most apparent opinion is how African Americans feel that using mental health services is something that is stigmatized to be not useful. There’s been plenty of occasions by which African Americans don’t seek the guidance because of their assumptions on the effectiveness of these interventions. In order to understand this better, Cauce has a three step model that includes problem definition, the decision to seek help, and the selection of a treatment service or service provider. This is called the help seeking pathway because it helps us understand the culture and context of the process to seek help. This process could happen in any order because

“The Mental Health Parity and Addiction Equity Act of 2008, also known as MHPAEA is defined as a federal law that prevents group health plans and health insurance issuers that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than on medical or surgical benefits” (Centers for Medicare and Medicaid Services, para 1). Originally, MHPAEA applied only to group health plans and group health insurance coverage, but was “amended by the Patient Protection and Affordable Care Act” to also apply to individual health insurance coverage (Centers for Medicare and Medicaid Services, para 2). “The Mental Health Parity Act of 1996 (MHPA) defined that large group health plans could not impose annual dollar limits on mental health benefits that are less favorable than any limits imposed on medical or surgical benefits” (Centers for Medicare and Medicaid Services, para 6).

In order to discuss the Affordable Care Act as it relates to mental health and addiction there needs to be an understanding of the historical development of mental health parity in the United States. There has been a long time struggle to make mental health comparable physical health in health benefits. In 1996 the Mental Health Parity Act (MHPA) was passed due to the crusade efforts of Paul Wellstone and Pete Domenici under the Presidency of Bill Clinton (Frank, Goldman, & McGuire, 2001). The Mental Health Parity act was designed to ensure that large employers that provided health plans did not use lower limits on lifetime dollar amount for mental health in comparison to physical health (Frank, Koyanagi, & McGuire, 1997). In order to continue to build on the MHPA the congress passed the

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is an act that requires parity or equality between mental health treatment and medical/surgical treatment covered by private and public insurers with over 50 employees. That means that if an insurance covers mental health issues they can’t impose more stringent limits and financial requirements than medical/surgical coverage. The act was signed into law in 2008 by President George W. Bush. Before the act was signed into law, mental health care was not as affordable or accessible for individuals. (United States Department of Labor, 2016)

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008. MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Federal Register, 2013). The MHPAEA is an extension of the Mental Health Parity Act of 1996, which prohibited annual or aggregate lifetime financial limits on mental health coverage by addressing other restrictions, such as limits on outpatient visits or inpatient days (DOL, 2010). MHPAEA expands parity requirements to treatment limitations, financial requirements, and in- and out-of-network covered benefits (Smaldone, 2010). It also expands the opportunity of mental health parity requirements at the federal level and includes substance use disorders within its scope. Prior to 1996, health insurance coverage for mental illness had historically been less generous than that of other physical illness (Sarata, 2011). Mental health parity is a response to this disparity in insurance coverage, and generally refers to the concept that health insurance coverage for mental health services should be offered equally with covered medical and surgical benefits (Smaldone, 2010).

Health plans have limited treatment of mental illnesses by covering fewer inpatient hospitalizations and outpatient office visits, increasing cost sharing for mental health care by increasing deductibles and copays, and imposing more stringent annual or lifetime dollar limits on mental health coverage (Chamberlin, 2015). Even with the passing of The Mental Health Parity and Addiction Equity Act (MHPAEA), there is not a uniform consensus about the extent to which state government should require coverage for mental health (NCSL, 2015). There is a major role for social workers to push for a uniform consensus in how state government should require coverage for mental health.