Mental Health Awareness Advocacy Campaign

Mental Health Awareness Advocacy Campaign

Depression and suicide among our youth in the United States are at staggeringly high numbers. Many reasons play a role in this from genetics, environmental, mental health disorders and more importantly, undiagnosed mental health disorders such as depression. Suicide is on the rise in the U.S. in almost every state. Based on numbers from a vital statistics report by the Centers for Disease Control and Prevention (CDC) approximately 45,000 Americans age 10 or older died by suicide in the year 2016. Suicide, more often due to depression among teens is one of just three leading causes that are on the rise in our country (CDC, 2018). The purpose of this paper is to present a possible change within our public policies and federal guidelines that all school personnel is trained and certified in depression and suicide awareness.

Population and Health Issue

Awareness of teen depression is vital for treatment and prevention. Major depression is a common disorder among teenagers but is more often overlooked by many adults with the thought that a teenager is being just that, a teenager or hormonal as opposed to truly addressing the problem that may be at hand. Research shows that the risk of depression grows with age and with it reaching its highest point in teenagers. The grave concern for this disease is its influence mental health disorders such as depression. Depression in teenagers leads to poor school performances and academic behaviors. It can also lead to suicide.
Suicide is the third leading cause of death among 15 to 24-year-old youths. Detecting a problem early on is paramount to the appropriate treatment and essential to prevent suicide. Education has been identified as a critical piece with interventions for depression and suicide and improving societies knowledge about depression and help-seeking behavior (Rubal, 2013). For decades teen suicide has been a massive public health issue in the U.S. and currently, it is the third leading cause of death for children ages ten through nineteen years of age. Although the suicide rates for this age group went down in the years 2004 to 2007, they have increased by nearly 16.5% from 2007 to 2010 (Strunk, 2014). A shocking number is the largest increases being with youths ages ten to fourteen. Then from 2007- 2010 the suicide numbers increased by 50%, for the same age from 2007 to 2010. In the year 2010, there were 1,926 children that died from suicide and their ages ranged from 10 to 19 (Strunk, 2014).

Depression Awareness Advocacy Programs

The National Children’s Mental Health Awareness campaign is aimed to bring awareness about how critical it is we recognize our children’s mental health and to show that positive mental health is essential to a child’s healthy development from birth (Substance Abuse and Mental Health Services Administration, 2018). The program encourages schools, nonprofits, and other community organizations to participate in this advocacy program and holds events that raise awareness to mental health disorders and the needs of our youth (Substance Abuse and Mental Health Services Administration, 2018). It will educate and train on how to handle signs and symptoms and communicate where children are able to get help with no judgment. The hope with this is that children will not isolate and feel so alone, and the depression can be treated before the worst-case scenario of suicide comes into play.
The reason this campaign was so effective was that it focused on the importance of addressing physical, mental, emotional, and behavioral health needs when providing services and support for our youth. Communities, national collaborating organizations, and federal programs organized observances around the country. Olympic champions like Michael Phelps and Allison Schmitt even serve as Honorary Chairs of Mental Health Awareness Day 2017. Specific areas where the program campaigned also showed a decline in suicide deaths due to depression for teens (Substance Abuse and Mental Health Services Administration, 2018).

Teen Suicide Prevention Advocacy Programs

An advocacy program was created in 2001 named The Jason Flatt Act. This act was presented to the legislator by a young man in New Jersey in 2001. The program believes that awareness and education are key and the first steps to prevention. They guide literature to create enough education on prevention by providing students, parents, and teachers the tools and resources to help identify early signs and symptoms and how to handle a situation if they recognize these signs and symptoms (The Jason Foundation, 2018). In 2007, The Jason Flatt Act passed first in Tennessee and became one of the nation’s most inclusive and mandatory youth suicide awareness and prevention program. The legislation required all educators in the state to complete two hours of youth suicide awareness and prevention training each year to be able to be licensed to teach in Tennessee (The Jason Foundation, 2018). This was soon followed by many other states, but not all. In all 20 states, The Jason Flatt Act has been supported by the state’s Department of Education and the state’s Teacher’s Association which points to the value seen in such preventative training. When introduced under The Jason Flatt Act, a state can pass this important life-saving/life-changing legislation without a fiscal note (The Jason Foundation, 2018). The Jason Foundation campaign was so effective because 20 states now hold federal guidelines that teachers must hold the suicide prevention training to hold their teaching licensure (The Jason Foundation, 2018).

Teen Depression Awareness and Suicide Prevention Policy Plan

The government works in partnership with the states on a federal level to address mental health, depression being one of your top concerns. Their role in mental health includes regulating our systems and providers, protecting the rights of consumers, providing funding for services, and supporting research and innovation. Currently, insurance companies and employers hold the right to maintain the amount of coverage they choose fit. That coverage in some instances is sometimes next to none. The average American has a limited amount of mental health days covered as opposed to the usual medical stay in a hospital sometimes being weeks. For example, the average non-compliant diabetic could end up in our hospital Intensive Care Units (ICU) numerous times and the coverage from their insurance is limitless. The average stay in a licensed mental health treatment center varies from two weeks to 30 days, per year. These are policies we need changed and federal guidelines enforced allowing for more mental health treatment. The plan for this paper and this policy change is to write legislation and advertise in communities of their need to be involved with getting our government to enforcing mental health care be as accessible as medical care.
When discussing a need for changes in policies for suicide prevention awareness, we need to focus on programs like the Jason Flatt. This is a program proven to be successful yet is not mandated in every state of our country and only required by teachers in twenty states. If we can pass legislation that all the United States requires all teachers who hold a license are in fact required to take the Jason Flatt training program which will aid in teem suicide awareness and prevention. Unfortunately, as it stands the only states required are Tennessee, Louisiana, California, Mississippi, Illinois, Arkansas, Utah, South Carolina, West Virginia, Alaska, Ohio, North Dakota, Wyoming, Georgia, Montana, Texas, South Dakota, Alabama, and Kansas. (The Jason Foundation, 2018). A change needs to be made.
Law Affecting Advocacy Efforts
In 1996, Congress passed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA). Otherwise known as the Parity Act. This public law was created and meant to end the stigma on mental health coverage/substance abuse and match the coverage insurance companies hold for example surgeries and other medical benefits. The Parity law is a state law and not on the federal level (Mental Health America, 2018). The purpose of this report is to discuss the Parity Act and its credibility. The question remains, does this law do its job or does there need to be amendments that force insurance commissioners to follow the large insurance companies and mandate that they support the Parity law.
There are significant influences that could affect the advocacy efforts with teen depression and suicide with the Parity Act. Some of the most critical will be at the level of policy and lawmakers. These policies and laws were founded or adjusted based on individuals in crises, the media, nurses, and others can influence Washington or at the state capital (Laureate Education, 2012). This is also true with personal experiences of members of Congress in that they can control how they respond to a healthcare challenge due to their own experiences. Research findings, special interest groups, market forces can also be a driver of health policy (Laureate Education, 2012).
The Parity Act was founded, so insurance companies are forced to legally recognize mental health conditions and substance use as equal to a physical medical illness. Without the parity act, mental health treatment is often covered at much lower levels in health insurance policies than any physical ailment. This ultimately means people do not get the care they need to experience true recovery (National Alliance on Mental Illness, 2018). Many state laws require that some level of coverage be provided for mental illness, severe mental illness, substance abuse or a combination of all (National Conference of State legislators, 2015). These are not considered full parity because they allow discrepancies in the level of benefits provided between mental illnesses and physical illnesses. These discrepancies can be in the form of different visit limits, copayments, deductibles, and annual and lifetime limits. The longer we allow the inconsistencies, the longer the countries mental health concerns will grow, and deaths will increase (NCSL, 2015). Insurance commissioners need to enforce the insurances companies to follow parity, and the public needs to be aware of the claims they can make to help lobby their care and advocate for themselves. The Parity Act is and should be a tool that any advocacy program could rely on to help fight and enforce the humane care that it was founded.
Legal Considerations
Official the government policies reflect the beliefs and values of the elected members and the administration that’s holding power while also reflecting the beliefs and values of the American people (Milstead and Short, 2019). It is because of this that a proposed policy change or amendment to the Parity law is crucially needed. People are still suffering from inadequate mental health care even with the Parity law. One reason is that this law is only on the state level and another is because we have nothing enforcing insurance commissioners to monitor compliance of Parity closely. This proposed policy change could be enacted through an amendment to the mental health parity act and mandate law at the federal level as opposed to strictly staying at the state level. With this amendment, require strict guidelines for insurance commissioners must follow to adhere to compliance with insurance companies and the healthcare offered and allowed.
Just as Milstead and Short state (2019), involvement in policymaking is to improve patient outcomes. Legislation addressing the needs of the mental health population already exists but does not seem to be a priority for those in office passing these bills. Nurses and the public themselves need to be more involved as a special interest group and aid in lobbying for this law to be federally mandated.
Lobbying
Milstead and Short (2019) describes effective lobbying to be the core of influencing a bill to be passed within the game of politics. Three significant influences contribute to the success of healthcare policymaking. These are known as the three-legged stool (Laureate Education Producer, 2012). The first of the three is the legislative process. The legislative process is where we mold and create the law that we want to set in place. The second of the three is the regulatory process. This is that incredibly long and detailed pages of what the law is, specifics, details to make it clear and overall outlining what is to be followed. The last of the three legs are the special interest groups. The special interest groups play a critical role in informing the legislators and the regulators just how vital the day to day needs of the bill in question is. They are the front-line individuals who will feel the effect of a new or amended law (Laureate Education Producer, 2012).
Just as Milstead and Short state (2019), just knowing the process of politics and how the money and understanding effects it isn’t enough. Nurses must become more vocal within Congress to help the fight with equality of care for mental health patients. We can do better educating and helping to remove the stigma from mental health disorders, so people are not afraid to seek help. We must apply those same critical thinking skills we use on the floor and use them in policy making. Some successful ways to help campaign would be mass communication such as handing out flyers, using social media, newsletters in work forums or school and reaching out to local and federal politicians via letters or even media interviews if able.
Policymakers that do not agree and other barriers are to be expected. With this, support from the public is a crucial piece to the political game. One way we could try and defeat this barrier while trying to support the parity law to become federal is to guide politicians to real-life stories of those who are affected daily by a mental health disorder and yet do not receive the appropriate health care they deserve and as outlined in the parity law. Encourage the community also to write letters to their local politicians and to obtain as much media coverage as possible. Being more visually publicized and more vocal has proven to be useful with such things as drunk driving laws, social media bullying and many more.
Ethical Dilemmas
The purpose of this section is to discuss the ethical dilemmas a nurse could face when working with the youth who suffer from depression and thoughts of suicide. Nonmaleficence and patient confidentiality are two major ethical dilemmas that are faced when dealing with the youth who suffer from depression and thoughts of suicide. Do no harm to your patient but does abiding to this rule then break the trust between a nurse and their patient or is it for their own good? This is the main question that a nurse would face and must be able to answer before breaking that confidentiality to notify parents (Syracuse University School of Education, 2018). The professional dealing with the child must know if it’s suicidal ideations and not a substantial threat; yet, but they must also consider the consequence of the risk is so great that even a relatively remote possibility of a suicide may be enough to establish what their duty is as a nurse (Stone and Zirkel, 2012).
Preventing this ethical dilemma is a critical and very narrow line. It is a nurse’s responsibility to do no harm and this includes the removal of present harm and the prevention of future harm (Syracuse University School of Education, 2018). With that said, confidentiality is the ethical duty to fulfill the promise that the patient information received during a conversation will not be disclosed without consent. Because confidentiality is such a critical issue the exceptions to confidentiality must also be heavily considered by the nurse and they must always ask themselves if breaking the confidentiality would lead to harm. This is because, confidentiality can become a legal ethical concern if it is broken intentionally or not (Syracuse University School of Education, 2018). If these two guidelines are followed, any ethical concerns are addressed and handled as best and as safely as possible with the best interest of the child at hand.
Special Ethical Challenges with Teens
When dealing with the youth there are always special considerations to make and challenges that are faced. Confidentiality is one of the more critical and complex ethical dilemmas that professionals face. As healthcare professionals you are trained to maintain the confidentiality between yourself and your patient but when the patient is a minor there are a whole new set of rules to take into consideration. This is due, in part, to the fact that minors are not seen as competent to give informed consent and therefore this power belongs to parents (Syracuse University School of Education, 2018). When evaluating whether or not a patient is at risk of committing suicide, this leads to actions that can be exceptionally disruptive to the patient’s life. Healthcare workers can be accused of malpractice for neglecting to take action to prevent harm when a client is determined to be suicidal but can also be accused of wrongdoing if they overreact and precipitously take actions that violate a client’s privacy or freedom when there is no basis for doing so (Syracuse University School of Education, 2018). With that said, considerations as to whether this is in the ultimate best interest of the child remain the critical piece especially if the youth states it is his or her relationship with the parent or parents that is the reasoning factor in the decision to attempt suicide (Syracuse University School of Education, 2018).
Ethics and Lobbying Laws with Teen Suicide
You suicide is the second-leading cause of death among thirteen and nineteen-year-olds. With this data, research shows that healthcare professionals cannot determine exactly why this number climbs and they don’t know enough about what causes an individual thinking about suicide to in fact follow through with it. Lobbying for more school-based suicide prevention programs are vital to the reduction of this staggering number. Researchers are hopeful that new studies as well as assistance from the Parity law will increase the understanding of teen suicide and lead to better identification and treatment of these high-risk teens. Meanwhile, a growing number of states are requiring their educators to be trained and how to recognize as well as respond to potential suicidal youths (Mantel, 2014). With that said, suicide-prevention programs in schools may raise awareness, but the evidence that they increase mental health referrals and reduce suicide rates is mixed. This is why awareness across the board, in schools, at home and all healthcare professionals is vital in the prevention of suicide.
Summary
It is evident that teen depression and teen suicide go hand in hand. It is also clearly outlined that awareness and prevention are key factors in these serious public health concerns. A school-based educational intervention improved knowledge about depression and attitudes toward help-seeking in adolescents. Federal guidelines can be set in place for more appropriate health care for mental health benefits. These same federal guidelines and assistance are just as pivotal for public awareness and prevention with reducing the epidemic of teen depression and the horrific numbers involved with teen suicides by mandating stricter laws for schools. Patient advocacy is the core of nursing, and it is evident that the mental health population suffers from unfair and biased treatment. The proposal of this amendment to the law, otherwise known as the Mental Health Parity Act of 1996, public law 104-204 will offer individuals would no longer be able to discriminate against patients with mental illness, including substance use disorders, Nationwide (National Conference of State legislators, 2015). It is also clear that with the depression and suicide rates at such an all-time high, those who seek mental health treatment have chronic, recurring symptoms that require ongoing availability of treatment. As nurses, we must become part of that three-legged system, be the interest group that brings attention to this much-needed topic.