Behavioral Health

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Behavioral Health Essay

Looking at one’s own mind can be tricky. For example, how do we know if what we are thinking and feeling is actually normal? Or if being sad is really depression? Or being happy is really a state of complete denial of reality? Behavioral Health Essay

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In contrast to physical health, mental health does not have the same clarity of disease as breaking a bone, rupturing an artery, or having a viral infection. No – mental health is more…well, mental. It’s more in our heads, in our minds, and in the processes we use to think about things like mental health in the first place. Is “Behavioral Health” the same as “Mental Health?” Please start with your distinctions, if any, to provide context for the rest of your post.

But despite its lack of clarity, mental health is a real thing nevertheless. For example, the National Institute of Mental Health (NIMH) has noted that: “Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.” See: NIMH

But it’s not just depression that is at issue. According to the Anxiety and Depression Association of America (AADA), It’s not uncommon for someone with depression to also suffer form an anxiety disorder or vice versa. Further:

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older (18% of U.S. population). Behavioral Health Essay
Anxiety disorders are highly treatable, yet only about one-third of those suffering receive treatment.
So, bottom line is that mental health issues like excessive anxiety and depression are no joke – either at a personal level or at the macro level of the US healthcare system.

But while millions of people suffer from mental health issues, it is also noted above that millions of suffering people are left undiagnosed and untreated.

So what should we do? How can we significantly improve our ability to help people in need of mental health treatment?

What should we do about the stigma that some attach to seeing a mental health professional?

What about the equal stigma of being labeled as someone who is “mental?”

How do we, as healthcare professionals, best reach out to those that desperately need assistance –without making anyone think we are looking for “crazy” people?

Overall – what is the best way to address the large and underserved need for mental health care? Behavioral Health Essay

If health services research is a relatively new discipline, mental health services research is of even more recent vintage. In a brief ten or fifteen years the initial group of mental health services researchers have built on the early foundation of studies in health care and expanded the knowledge base, particularly regarding systems of care and the relationship of public and private services.

Health care reform comes at an opportune time, as the debate demonstrates daily the need for systematic knowledge to answer immediate questions and to develop, support, or oppose the myriad proposals and permutations under consideration. Whatever the outcome of the reform process, it is abundantly clear that services research is an essential element of the health care infrastructure.

Mental health now constitutes one of the most promising areas of opportunity in health services research. The availability of credible mental health information—unexpected by many policymakers—in the health care reform debate has enhanced the stature of the research and its practitioners. The reform debate itself has highlighted both the common and the specialized mental health issues within the health care framework. Behavioral Health Essay

The public sector remains the predominant source of funds for mental health services research, primarily via the National Institute of Mental Health (NIMH) and other federal agencies. On the private side, a review of annual reports of various private foundations with significant health services research interests reveals none with a specific focus on mental health. However, most of these foundations have funded several projects involving mental health in conjunction with their major areas of focus, such as substance abuse, homelessness, elderly, children, education, and primary health care. These include The Robert Wood Johnson Foundation, The Pew Charitable Trusts, The Commonwealth Fund, The Henry J. Kaiser Family Foundation, W.K. Kellogg Foundation, Milbank Memorial Fund, and The William T. Grant Foundation, The John D. and Catherine T. MacArthur Foundation health program, which does not accept unsolicited proposals, supports two endeavors to conduct and/or publish significant mental health services research: the Mental Health Policy Resource Center and Health Affairs. In addition, MacArthur’s Law and Mental Health Research Network focuses on many issues germane to mental health services research. This essay examines the development of mental health services research and the opportunities for future research that merit the attention of both public- and private-sector funders and researchers. Behavioral Health Essay

WHAT IS MENTAL HEALTH SERVICES RESEARCH?
Unlike other areas of health, mental health has long looked to a single federal agency—NIMH—as the major source of national funding for all types of research, services, training, and statistics. Perhaps for that reason, NIMH has defined the services research arena somewhat more broadly than does the Association for Health Services Research (AHSR), which defines services research as “a field of inquiry that examines the impact of the organization, financing and management of health care services on the delivery, quality, cost, access to and outcomes of such services.” For NIMH, the boundaries among clinical, epidemiological, treatment, and services research are not always clear. For instance, considerable attention has been devoted to distinguishing between clinical services research and service systems research, both of which have been treated as part of mental health services research. Behavioral Health Essay

Mental health services research began in the late 1970s and early 1980s; it grew out of NIMH’s epidemiology and data collection programs and emphasized statistical information and economics. The priority of the institute during this time was the public mental health system and the primary public patient population—persons with serious and persistent mental illness—and this priority was reflected in the services research program. In its 1991 report, Caring for People with Severe Mental Disorders: A National Plan of Research to Improve Services , a chapter entitled “Clinical Services Research: Enhancing the Real-World Applications of Clinical Science” articulates the boundary with other types of research: Behavioral Health Essay

Clinical services research begins where clinical research itself leaves off. It is concerned with the application of clinical knowledge gained in a controlled research environment, to the larger, relatively uncontrolled environment in which the mentally ill actually function. Its goal is to improve the quality of care of everyday clinical practices so that they consistently meet existing state-of-the-art criteria. 1

Major areas of concern for this research include salient characteristics of mental illness, such as demographics, risk factors, cultural influences, and family issues; assessment in terms of specific diagnoses as well as physical, social, and vocational functioning; specific treatment and rehabilitation interventions; and outcomes and effectiveness of services. Behavioral Health Essay

The next chapter of NIMH’s 1991 report, “Service Systems Research: Improving the Organization and Financing of Care,” describes service systems research as focusing on how to provide services most efficiently, economically, and equitably. It encompasses a broad and eclectic set of questions and issues: identifying the nature and scope of local needs; matching local services to needs; structuring integrated care that reaches the consumer; allocating financial resources so that consumers and providers have proper protection and incentives to use services appropriately; legal issues such as the role of the criminal justice system, civil commitment, patient rights, and confidentiality; human resource issues; and stigma and strategies for changing attitudes.

The Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) Reorganization Act of 1992 (P.L. 102-321) split the services and research programs of NIMH, the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and transferred the three as research-only institutes to the National Institutes of Health (NIH). Services research went with the research portfolios, protected by a mandatory set-aside—12 percent of research funds in fiscal year 1993 and 15 percent in fiscal years 1994 and 1995 must be spent on services research. The new Substance Abuse and Mental Health Services Administration (SAMHSA)—including its new mental health component, the Center for Mental Health Services (CMHS)—was given evaluation authority but no specific funding in the form of a line item to support evaluation studies. Behavioral Health Essay

The ADAMHA Reorganization Act defined health services research as “study of the impact of the organization, financing, and management of health services on the quality, cost, access to, and outcomes of care.” This definition is essentially the same as that used by AHSR. Mental health services research may be defined most simply as a subset of this domain.

Given the mandated set-aside, it has become particularly important to distinguish between mental health services research and other forms of research. A recent work group convened by the Foundation for Health Services Research (FHSR) suggested two key distinguishing factors: (1) the intent of the study and nature of the hypotheses, and (2) the distinction between studies of factors influencing the effectiveness of health services in “real-world settings” (health services research) and studies concerning the efficacy of specific preventive, diagnostic, or treatment services done under highly controlled conditions (not health services research). 2 One NIMH services research official recently offered the following general definition: Behavioral Health Essay

Services research differs from treatment research, which examines clinical treatments under highly controlled experimental conditions, by including factors such as costs, reimbursement mechanisms, treatment ideologies, and personal and organizational interests that affect how providers actually deliver services.

For this essay we reviewed recent and active projects in mental health services research and consulted with selected knowledgeable persons; this provides a descriptive snapshot of the kind of work currently funded and under way. This base, together with the newer areas of priority resulting from the health care reform process, suggests many promising opportunities for the future. Behavioral Health Essay

CURRENT WORK
For an overview of recent grants identified as mental health projects, we turned to the Health Services Research Grants Information System, a database of ongoing and recently completed health services research projects that is being developed by FHSR and the Cecil G. Sheps Center for Health Services Research of the University of North Carolina at Chapel Hill. This database, whose creation was funded by The Pew Charitable Trusts, will allow researchers as well as policymakers to keep abreast of current research, rather than waiting until the results are published. Behavioral Health Essay

The Health Services Research Grants Information System will become a part of the National Library of Medicine’s MEDLARS system. The information system is scheduled for completion in late 1993. Information in the database will include the name and address of the performing organization and principal investigator, amount of the award, an abstract of the project, and a description of the population studied. Initial funding agencies include the Agency for Health Care Policy and Research (AHCPR), the Health Care Financing Administration (HCFA), NIH, the Health Resources and Services Administration (HRSA), the Department of Veterans Affairs (VA), and seven private foundations (The Pew Charitable Trusts, The Robert Wood Johnson Foundation, The John A. Hartford Foundation, W.K. Kellogg Foundation, The Henry J. Kaiser Family Foundation, The Commonwealth Fund, and The William T. Grant Foundation). Additional federal agencies and private foundations will join the effort in the future. Behavioral Health Essay

Our database search turned up nearly 200 grants (of a total of 1,500 listed) that focused on mental health issues. All but a handful were funded by NIMH and other federal agencies. Of these, roughly one-third could be generally categorized as targeting services for persons with the most serious mental illnesses. The remaining two-thirds covered a wide spectrum of topics, including mental health issues related to aging, women, family violence, adoption, various minority groups, alcohol and/or drug abuse (which generally coincide with mental health problems), general health care, homelessness, and many more.

NIMH is by far the largest funder of projects identified specifically as mental health services research. The NIMH Services Research Branch oversees a broad program of investigator-initiated grants addressing virtually any area related to mental health services. Funding in fiscal year 1987 was $18 million. The current set-aside (12 percent of the total NIMH research budget) translates into roughly $50 million for fiscal year 1993. Behavioral Health Essay

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More than 250 active grants (listed with NIMH as of January 1993) are concentrated in the following areas in descending order: severely mentally ill adults; mental health economics; children and adolescents; rural mental health; adult primary health care; and multiple diagnoses of alcohol, drug abuse, and mental (ADM) disorders. Significant numbers focus on mental health service systems, minority mental health, homeless mentally ill, and research scientist awards, and some are devoted to disability and rehabilitation, human immunodeficiency virus (HIV) infection, self-help services, research methods, and state research capacity building.

NIMH has established a program to develop and maintain Centers for Research in particular areas of priority: severely mentally ill adults, children and adolescents, minority mental health, rural mental health, and self-help. Exhibit 1 lists specific grant announcements that detail areas of focus and priority. Behavioral Health Essay

In addition to NIMH, a variety of federal agencies have services research programs that include mental health issues as a component, although not as a priority. Agencies that are funding projects included in the FHSR database are the Department of Veterans Affairs, the National Institute on Aging (NIA), NIDA, NIAAA, HCFA, the Office of Rural Health Policy, the National Center for Nursing Research, and AHCPR.

FUTURE OPPORTUNITIES
The heightened health care reform debate has accelerated the development of agendas in mental health services research and is likely to provide a framework for setting priorities for the next several years, both in foundations and in the various federal agencies. Even at this early date it is possible to discern several significant themes. These can provide some guidance for the development of mental health services research ideas and extended programs during the next several years. Behavioral Health Essay

REFORM-RELATED ISSUES WITH A SIGNIFICANT MENTAL HEALTH DIMENSION.
The issue of risk adjustment in health insurance has particular relevance to mental health. Risk adjustment has to do with the probability that any given health plan may become responsible for a larger number of persons with more serious health problems than other competing health plans-Health plans that fear this situation could develop procedures that discriminate against persons with known high-cost illnesses; the more severe mental illnesses, as well as acquired immunodeficiency syndrome (AIDS), cancer, and others, lead the list of illnesses that insurers wish to avoid. A concern will be how to protect health plans with disproportionate numbers of high-risk enrollees and how to protect high-risk persons from creative forms of exclusion. Behavioral Health Essay

In this section going to explain how the stigma often attached to having a mental health disorder and the various ways society views mental health can affect people with mental health issues. My view is to focus on treatment in ways that will involve educating yourself so that it will not only have a positive effect on you but will also give you a positive understanding of not only your own views but hopefully some insight into the views held by many factions of the society in which we live.

Hopefully this will be a step into you getting a more accurate diagnosis and treatment plan and you being able to filter out the negative nonessential opinions that stereotypes and stigma attached to mental health and mental health treatments.
Let’s get started with the stigma and misconceptions regarding mental health and get those negative issues out of the way initially. Following are some quotes from online blogs on how mental health is often perceived. Behavioral Health Essay

The sad part is that stereotypes ,and the stigmas attached to those stereotypes and the abuse that goes along with these is so easy to fix.

It involves merely recognizing the damage your words, actions or both are actually causing and developing an understanding through educating yourself and a self awareness of how your words and or actions are directly or indirectly affecting other people.

Mental health is a term that refers to a person’s psychological, emotional, behavioral and social well-being – how a person thinks, feels, acts, relates to others, makes choices and handles stress. The term is also sometimes used to denote the absence of mental illness. Some psychologists and health experts have proposed a spectrum of symptoms, with good mental health at one end and mental disorders at the other.

Being mentally healthy is one of the most important things in life – it contributes to physical health and happiness, makes a person resilient and capable of handling adversity in all its forms. Behavioral Health Essay

What is Mental Illness
Mental illness is a wide-ranging term encompassing several conditions that affect how a person thinks, feels or acts. Mental illness also affects a person’s ability to negotiate day-to-day life. According to experts, anyone can become a victim of mental illness, regardless of age, gender, ethnicity or socio-economic status.

Statistically, about 1 in 5 Americans suffer from some form of mental illness, with a large proportion experiencing more than one. In fact, mental illness in the United States and much of the developed world, is a leading cause of disability. Behavioral Health Essay

Some of the factors that contribute to mental illness include:

Biological factors – brain chemistry, genes, certain kinds of brain infection or defects, injury to the brain, prenatal trauma
Psychological factors – Physical/sexual/emotional abuse, neglect, early loss of an important loved one Behavioral Health Essay
Environmental factors – Dysfunctional family life, divorce or death of spouse or parents, changing schools, jobs or homes, substance abuse, socio-cultural expectations
Mental illness is common, but many disorders can be treated and a lot of people with mental health problems do get better or even recover completely.

Here is a comprehensive list of mental health essays and academic papers that explore the subject from various perspectives. Behavioral Health Essay