The current state of mental health care, like any health care, varies state to state. What mental health care currently has in common with normal medical care is the fact that the majority of the current resources go to acute treatment of illnesses (Radnofsky, 2013) and there is a need to shift focus and resources to prevention. Like medical illnesses, there are many mental illnesses that are hereditary and cannot be prevented, and there are many illnesses that are environmental and can be prevented at times through healthy living.
The primary mental illnesses that people are born with are the variety of forms of Bipolar Disorder and Schizophrenia. These illnesses are currently treatable with medication and when properly treated, people with mental illness can have a higher quality of life without the need for multiple hospitalizations. The current problem with these illnesses is that they are frequently not properly treated. Denial and lack of insight are prominent in mental illness and most people with these illnesses have multiple relapses throughout their lives, usually requiring a hospitalization to stabilize them on their medication.
These hospitalizations can be frequent, lengthy and expensive. I believe that in the near future, as policy makers become more educated and notice these trends, there will be a major push to provide the necessary resources in the community to help minimize the need for Psychiatric hospitalizations. Community mental health centers currently do the majority of the work to keep the people with severe and persistent mental illness in the community as much as possible and out of the hospitals, but these community mental health centers are understaffed and underfunded, lacking proper resources to perform their task as efficiently as possible.
In the recent years, there has been increase in violent crimes committed by mentally ill. Many people have requested an improvement in mental health services to keep our communities safe, but with the country in a current fiscal and political crisis, there is little being done to revamp the system. I believe that because of the recent crimes by mentally ill, the first area that will be targeted for improvement will be forensic mental health, the area of mental health that targets the criminal element.
Currently, in Rhode Island, we have a lack of resources in this area. The forensic state hospital at Eleanor Slater Hospital is overflowing into the mental health side of the hospital and creating a backlog in referrals causing patients to wait in Psychiatric Hospitals for up to a year seeking placement on the mental health side. There is a plan in the works for construction of a new hospital, increasing the number of state hospital beds.
This method of providing health care is necessary, but while money is being placed in the acute treatment of illnesses, such as long-term hospitalizations at state hospitals, it is not being placed in prevention in the community. I hope that after the push for a stronger forensic system, there will be a greater push to provide services to people with severe and persistent mental illnesses that minimizes the need for those higher levels of care. Increases in quality shelters is a strategy that the city of Seattle recently tried to limit the number of ER visits by the homeless with mental illness, this is a great strategy.
Many of the mentally ill seek out hospitalization to provide them with food and shelter when they run out of their disability checks and quality shelters are a lot cheaper in the long run than acute care (from the website of National Alliance to end Homelessness). Another trend that has started in some parts of the world, and to some degree here, is the approach to substance abuse as an illness and public health issue, rather than a criminal activity. Portugal recently decriminalized all drugs and it seems that it has not caused the fabric of their society to collapse (Blackstone, 2012).
I believe that this shift in perspective will also take place in this country at some point. In the long term, technology will ultimately have a major impact on the future of mental health care. There will be incredible advancements in medical science of the next 20-50 years and they will have extremely large impacts on every aspect of our lives. There is current research that has come close to finding a vaccine that would prevent Alzheimer’s (Universite Laval, 2013); this would eliminate the need for a large amount of the Geriatric Psychiatry field.
Other advancements in medicine could eventually find cures for depression or Schizophrenia, essentially eliminating the need for the majority of mental health care. I recently read an article stating that in 20 years it could be possible for humans to have advanced our technology enough that we would be able to live forever (Willis, 2009). This theoretical possibility is the use of Nanotechnology, or computers small enough to be implanted in our body in order to regulate functioning.
The prospect of technology like this brings to mind such a variety of dystopian and utopian possibilities that whatever approach we take to addressing our health care needs, we should be aware that the approach will always have to be changed and modified to suit the evolving needs and resources of our society. My current approach to the future of mental health care would focus on prevention, from the start of the lifespan. In many places in Europe they have begun providing new mothers with in home assistance and training for the earlier parts of the child’s life.
I feel this would be a very useful program here, educating new parents on proper nutrition and proper discipline methods would be helpful in starting more lives off on a positive note and have a positive effect on the mental health of those children. I feel that the support from the community should not stop there; children should have access to education and socialization programs at an early age to help them continue their lives on a positive path. Kids in school often seem to lack proper guidance these days. I feel like all children attending public schools should be given a case manager or advisor for their K-12 years.
These advisors could act as liaisons between the family and the school and assist the children in finding resources to improve their education and socialization, eventually making them more prepared for independence. The one on one attention given to each child will be a great method of preventing mental illness. Large amounts of people currently suffering from substance abuse disorders, depression and anxiety, all also suffer from a lack of support. For many of them, this has been the norm in their lives and I believe strongly that with proper guidance many of them would have a much higher quality of life.
As these children get older, the one on one attention would also be useful in identifying people that are suffering from mental illness early and facilitating them acquiring preventative treatment as early as possible. As people get older, the preventative measures for mental illness become more varied.
The needs will still be there for people with severe and persistent mental illness to require acute hospitalizations, long term hospital level care, residential group home care, supervised apartment settings, mobile treatment teams, counseling, day activity programs and all the things that are in place currently to minimize the need for acute hospitalizations and I think those people should always have access to those services and be provided with the support they need to function at the lowest level of care possible.
The current state of this country has become difficult for many to navigate and I feel that with my approach of positive guidance throughout the lifespan, it would increase the number of people capable of independence.
More people with the skills to contribute to society, instead of feeling hopeless and living off welfare or becoming institutionalized. This would have a positive effect on the mental health of those individuals and our society as a whole. Works Cited 1. Radnofsky, L. (2013 April 8). Health Care Costs: A state by state comparison. The Wall Street Journal. Retrieved from http://online. wsj. com/news/articles/SB10001424127887323884304578328173966380066 2. From The Website of National Alliance to end Homelessness. Cost of Homelessness. http://www. endhomelessness. org/pages/cost_of_homelessness 3. Blackstone, S.
(2012 July 17). Portugal Decriminalized All Drugs Eleven Years Ago And The Results Are Staggering. Business Insider. Retrieved from http://www. businessinsider. com/portugal-drug-policy-decriminalization-works-2012-7#ixzz2sb1TotO8 4. Universite Laval. (2013 January 15). Major Step toward Alzheimer’s vaccine. Science Daily. Retrieved from http://www. sciencedaily. com/releases/2013/01/130115143852. htm 5. Willis, A. (2009 Sept. 22) Immortality only 20 years away says scientist. The Telegraph. Retrieved from http://www. telegraph. co. uk/science/science-news/6217676/Immortality-only-20-years-away-says-scientist. html