Behavioral Health Services

Mental illness refers to any condition or disease affecting the human brain that has an impact on a person’s thinking, feelings, behavior, and his interaction with other people and his environment. The symptoms of mental illness vary from mild to acute, depending on the exact illness involved; however, if mental illness goes untreated, the individual affected often finds difficulty, or inability in coping with their daily activities in life (MedicineNet, 2008, para. 1).Physical illnesses such as heart disease and diabetes are commonly easy to diagnose via a simple blood test or a diagnostic examination. This, unfortunately, is not the case with mental illnesses. The doctor would have to rely on the symptoms of the individual (e. g. how long they have been present, how severe they are, etc. ) and conduct a physiological examination to gather further information or to verify their initial diagnosis (National Institute of Mental Health, 2005).Although mental illnesses cannot be p revented, they can be treated using medications and various forms of therapy. Deinstitutionalization The deinstitutionalization of mental health patients during the 1960s was enforced to close down the operation of state mental institutions and was first believed to be a win-win situation for everyone—the conservatives wanted to cut costs, and the liberals envisioned the freedom of the residents of these institutions whom they believe are being treated involuntarily (Failer, 2002).However, disaster resulted from this movement. Huge numbers of obviously mentally-ill individuals materialized on the city streets. These individuals were dirty, wearing torn clothing, having hallucinations and talking to themselves or yelling at others, and on the whole, acting in a weird manner. Majority of the discharged patients were transferred to nursing homes, deteriorating neighborhoods, proprietary homes, and low-cost housing. The patients confined in nursing homes increased from 19-44% fro m1950 to 1970 (Kramer, 1975).Particularly affected by the nursing home conditions were the elderly who received short shrift because they were not admitted to custodial institutes and for months, they were forced to stay in acute care centers waiting for placement in cheaper and more suitable institutions. Also, a huge percentage of the discharged patients had nowhere to go because they no longer had families, or their families did not want to take them in. Deinstitutionalization resulted in the hindrance in the continued care and treatment of the mentally ill. Integrated Health CareMental health services are integrated into primary health care services as doing otherwise implies a number of disadvantages. Without mental health providers, there would be no one to conduct diagnostic, capacity, cognitive, and personality assessments for differentiating normal body processes from adjustment reactions, medication side effects, pathology, or a blend of these problems. Also, behavioral an d mental health problems would not be properly diagnosed and treated. Mental health experts are also needed as their expertise would contribute to the design, execution, and assessment of patient outcomes and team care.Depending on the degree of illness of the mentally-ill patient, other health and social services might be needed. Some simply needs a place where they would not accidentally hurt themselves. Others may just require therapy. Some need a place where there are people who will see to it that they are taking medication properly. Some mental illnesses are associated with physical illness, emphasizing the need for primary health care services. Some need social services such as vocational rehab, family support groups, and day care centers. Behavioral Health Services Mental illness refers to any condition or disease affecting the human brain that has an impact on a person’s thinking, feelings, behavior, and his interaction with other people and his environment. The symptoms of mental illness vary from mild to acute, depending on the exact illness involved; however, if mental illness goes untreated, the individual affected often finds difficulty, or inability in coping with their daily activities in life (MedicineNet, 2008, para. 1).Physical illnesses such as heart disease and diabetes are commonly easy to diagnose via a simple blood test or a diagnostic examination. This, unfortunately, is not the case with mental illnesses. The doctor would have to rely on the symptoms of the individual (e. g. how long they have been present, how severe they are, etc. ) and conduct a physiological examination to gather further information or to verify their initial diagnosis (National Institute of Mental Health, 2005).Although mental illnesses cannot be p revented, they can be treated using medications and various forms of therapy. Deinstitutionalization The deinstitutionalization of mental health patients during the 1960s was enforced to close down the operation of state mental institutions and was first believed to be a win-win situation for everyone—the conservatives wanted to cut costs, and the liberals envisioned the freedom of the residents of these institutions whom they believe are being treated involuntarily (Failer, 2002).However, disaster resulted from this movement. Huge numbers of obviously mentally-ill individuals materialized on the city streets. These individuals were dirty, wearing torn clothing, having hallucinations and talking to themselves or yelling at others, and on the whole, acting in a weird manner. Majority of the discharged patients were transferred to nursing homes, deteriorating neighborhoods, proprietary homes, and low-cost housing. The patients confined in nursing homes increased from 19-44% fro m1950 to 1970 (Kramer, 1975).Particularly affected by the nursing home conditions were the elderly who received short shrift because they were not admitted to custodial institutes and for months, they were forced to stay in acute care centers waiting for placement in cheaper and more suitable institutions. Also, a huge percentage of the discharged patients had nowhere to go because they no longer had families, or their families did not want to take them in. Deinstitutionalization resulted in the hindrance in the continued care and treatment of the mentally ill. Integrated Health CareMental health services are integrated into primary health care services as doing otherwise implies a number of disadvantages. Without mental health providers, there would be no one to conduct diagnostic, capacity, cognitive, and personality assessments for differentiating normal body processes from adjustment reactions, medication side effects, pathology, or a blend of these problems. Also, behavioral an d mental health problems would not be properly diagnosed and treated. Mental health experts are also needed as their expertise would contribute to the design, execution, and assessment of patient outcomes and team care.Depending on the degree of illness of the mentally-ill patient, other health and social services might be needed. Some simply needs a place where they would not accidentally hurt themselves. Others may just require therapy. Some need a place where there are people who will see to it that they are taking medication properly. Some mental illnesses are associated with physical illness, emphasizing the need for primary health care services. Some need social services such as vocational rehab, family support groups, and day care centers. The Managed Care ApproachOn the whole, managed care involves paying for what is â€Å"adequate† and what is â€Å"medically necessary†, using the cheapest alternative. The Center for Mental Health Services (CHMS) outlines its possible benefits and drawbacks: Advantages 1) Better facilities, with more proficient medical professionals. 2) Expanded alternatives, consisting of support services and treatment options. 3) Money saved may be used for making health insurance cheaper. Disadvantages 1) Patients with long-term mental illnesses may require not just short-term acute care (the preferred alternative in managed care).2) The symptoms of the patient may worsen if hospitalization is denied without offering options for intensive care. 3) Difficulty in protecting confidentiality. 4) Difficulty in the continuity of care for patients who receive short-term treatments at different locations. Mental Health Care Funding The three governmental sources that provide benefits for mental health care include Medicare, Medicaid, and the Department of Veteran Affairs. The following outlines the populations eligible for these programs. Note, however, that these are the ‘basic’ descriptions of who are eligible. Eligibility would still depend on various specific factors and criteria. Medicare Eligible populations include: – individuals aged 65 and above, – individuals under age of 65 with certain disabilities, and – individuals with End-Stage Renal Disease, regardless of age (US Department of Health and Human Services). Medicaid Eligible populations include certain low-income individuals who qualify for an eligibility group recognized by the laws that vary according to state (US Department of Health and Human Services). Department of Veteran Affairs.Eligible populations include veterans actively engaged in one of the seven uniformed military services. If a veteran has been discharged from the military, he/she can still be eligible if the discharge was not due to dishonorable service (GovBenefits. gov). Recommendations 1) Have primary health care practitioners undergo mental health training or instigate collaboration with mental health experts. This allows primary health care practitioners to attend to the health needs of mentally-ill patients, and the mental health needs of patients with chronic or infectious diseases.2) Develop a system for identifying the exact need of the mentally-ill patient before he/she is admitted. Incorporate clinical and behavioral assessments to determine whether the patient needs medication, counseling, therapy, or a combination of these. 3) Develop and provide rehabilitation programs, therapies, and counseling for the patients and their families and friends. 4) Develop recording systems that permit the continuous supervision, assessment and updating of the patients’ mental health activities to gather data that would be used for service improvements. References Failer, J. (2002).Who qualifies for rights? Homelessness, Mental illness, and Civil Commitment. Cornell University Press. GovBenefits. gov. VA – Health Care – Basic Medical Benefits Package for Veterans. Retrieved August 14, 2010 from http:// www. govbenefits. gov/govbenefits_en. portal? _nfpb=true&_pageLabel=gbcc_page_category&_nfls=false&bid=303&mode=report Kramer, M. (1975). Psychiatric Services and the Changing Institutional Scene. Rockville, Maryland. MedicineNet, Inc. (2008). Mental Illness Basics. Retrieved August 13, 2010, from http://www. medicinenet. com/mental_illness/article. htm National Institute of Mental Health.(2005). Information about Mental Illness and the Brain. Retrieved August 13, 2010, from http://science. education. nih. gov/supplements/nih5/mental/guide/info-mental-a. htm The Center for Mental Health Services. Managed Mental Health: What to Look For – What to Ask. Retrieved August 14, 2010, from http://mentalhealth. about. com/library/ken/blmmh. htm US Department of Health and Human Services. Medicaid Program – General Information. Retrieved August 14, 2010, from http://www. cms. gov/MedicaidGenInfo/ US Department of Health and Human Services. Medicare Program – General Infor mation.