I am replying to a peer’s post on Health Initiatives

NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I

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Week 7 Discussion 1: Health Initiatives

Done: Make forum posts: 1

Value: 100 points

Due: In an effort to facilitate scholarly discourse, create your initial post by Day 4, and reply to at least two of your classmates, on two separate days, by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the question below.

Initial Post

Watch the video clip below:

Overcoming barriers to mental health care and stigma in communities of color

Video Transcript

  • Briefly describe the availability of and access to mental health care in your community and geographical area.
  • How has the Covid-19 Pandemic revealed equity issues in certain communities?
  • What do you see as the greatest barrier to access and how do you feel this would be best addressed? Be specific in regard to addressing this issue in your “community” or geographical area. Do you believe that private or public entities are best suited to address this? How do other countries address these issues?

Replies

Reply to at least two of your classmates. Your reply posts should build on the original post and demonstrate substantive reflection. Offer your peers an evidenced based solution to their identified ‘greatest barrier.’

Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.   

 

 

Re: Week 7 Discussion 1: Health Initiatives

by William Nichols – Monday, 12 June 2023, 8:47 PM

 

Introduction

New Hampshire is an amazing state to live in with a great opportunity and access to general healthcare. It is located near Boston where McLean hospital which is regarded as one of the top psychiatric hospitals in the country are located, but the mental health system can still use some improvement for underserved communities. In this post the availability and access to mental healthcare in New Hampshire, how the covid 19 pandemic showed equity issues within certain communities Will be discussed. Barriers to improving the mental health system, and if private or public entities are best suited to address the issue, while we will also look at how other countries address the issues.

Availability of access in New Hampshire

In my current place of employment within the seacoast of New Hampshire a couple problems I have noticed such as the lack of bed available which leads to back logs in the emergency department with client staying weeks awaiting care at a psychiatric hospital. Low income and homeless in New Hampshire have a severe lack of access having to wait months to get appointment at government funded outpatient clinics (Human Services Research Institute, 2023). Lack of adequate discharge planning like follow up services and when patient have nowhere to go also contributes to access. Currently it can take a couple months to get an intake appointment at my current place I am doing clinical which is within my home community. Another contradicting factor to this was the covid 19 pandemic.

Covid 19 and Equity

With the expansion of telehealth during the covid 19 pandemic due to many visits no longer being allowed in person was both a gift and an added barrier that was found when it came to the low income and homeless population it only widened the disparity to low income and especially the vulnerable homeless community (Bekasi et al. 2022).  If clinics were closed to in person visits and with no access to phone, internet or computers, how could we have not seen the barrier to homeless receiving preventative care. No being able to receive basic care can lead to simple problems getting larger which leads to hospitalizations, extended stayed due to the complexity of the medical issue.

Greatest Barrier to Access and what can be Done?

In regards to access some countries have been doing very well in finding methods to close the gap between homeless and access to telemedicine. Within homeless shelters in Hungry, funding was used to place computers and tablets for access to telemedicine within the shelter (Bekasi et al. 2022). It was found positive satisfaction with persons experiencing homelessness and can decrease the number of emergency room visits. After actually discussing with some homeless clients who I met via telemedicine who were using computers at the shelter and speaking to social workers, my geographic area is implementing tools like this to ensure access to care.

            New Hampshire itself and my community has been taking great strides in improving access and trying to limit psychiatric hospitalizations. Mobile crisis units which enable a qualified team to respond to a person in crisis house and assess and possibly treat the client preventing the back log of boarding in the emergency room. My clinic was given funding and has a mobile crisis unit which performs these duties in my seacoast community (New Hampshire Public, 2022). In regards to state or private funding to help access, it is a hard question. I lean toward putting more government resources to healthcare and mental health rather than other unnecessary programs and this has assisted the lack of bed barrier. Recently a local private psychiatric hospital was bought by the state and they used workers from other state facilities to own 35 more beds that had been closed due to staffing.

The New Hampshire department of Health and human services revealed a zero hold plan by 2025 and has earmarked 25 million dollar initiates to build additional psychiatric hospital and create more bed (NH DHHS, 2022). If funds are used correctly, we can do this without over burdening tax payers. This does not mean private institutions do not play a role as well. HCA has offered to work with the state if they provide some funding to build another psychiatric hospital as well in addition to the additional units they have at their hospitals within the state. Overall we have a long way to go, but my community is showing they are willing to implement resources to help increase access to quick mental healthcare to prevent bottle necks in hospitals where medical care is needed.

 

References

 

Evaluation of the capacity of the New Hampshire Behavioral Health System. Human Services Research Institute (HSRI). (2023). https://www.hsri.org/project/evaluation-of-the-capacity-of-the-new-hampshire-behavioral-health-system

Békási, S., Girasek, E., & Győrffy, Z. (2022). Telemedicine in community shelters: possibilities to improve chronic care among people experiencing homelessness in Hungary. International Journal for Equity in Health, 21(1), 1–17. https://doi.org/10.1186/s12939-022-01803-4

NH DHHS announces “mission zero,” A plan to eliminate emergency department boarding of psychiatric patients by 2025. New Hampshire Department of Health and Human Services. (2022). https://www.dhhs.nh.gov/news-and-media/nh-dhhs-announces-mission-zero-plan-eliminate-emergency-department-boarding

New Hampshire Public Radio |By Alli Fam. (2022, July 15). How N.H. is building a new system for Handling Mental Health Emergencies. New Hampshire Public Radio. https://www.nhpr.org/nh-news/2022-07-15/how-nh-is-building-a-new-system-for-handling-mental-health-emergencies-988-suicide-prevention-hotline

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