Depression Can Be Killed Avail the Mental Health Care Ways

Out of the many health problems associated with people, there is yet another kind of sickness. This is the mental sickness, which finds its cure in the mental health care. There can be a wide variety of reasons due to which people may undergo depression. A depressed State of mind is something that can have its impact on the physical health as well. The mental health care is directed towards making people realize that life is to be happy. They can feel the positive energy rising high within them. The mental health care is extended towards those people who find it hard to meet the difficulties of life. As A result of this, they start feeling the helplessness that they have been exposed to. This makes it very difficult for such people to carry on with life.

There can be different reasons behind a person getting into such misbalanced state of mind. It may happen due to an unsuccessful marital Relationship, loss of someone very close or failures in the field of career. Present day, even students Undergo this problem due to the excessive pressure put on them for competing with the demanding world. In case of the situations wherein
They fear to meet people who hold high expectations; they get into the depressed state of mind. However,it is not something that has no remedy. Just like any other problem, it can also be dealt with the mental health care. This includes taking good care about the happiness of people. Mental health care Includes boosting up the confidence of people suffering from this kind of problem. The people having depressed state of mind are exposed to wider persecutions of life.

In some cases, the meditation is also a part of the mental health care so as to get a focused approach to solve any kind of problem. In case, proper mental health care is not provided to the person, he may even attempt to commit suicide. The best approach is to let him speak out his heart. A person who takes the aid of mental health care May feel the need to come out of his sad state of mind. As a result of this, he will even make efforts at his end to come out of this depressed state. The Responsibility of mental health care is to tell him ways to heal himself. An integral part of the mental health care is to understand the feelings of this person. This will help him to get proper guidance. As a result of the unhappy mind, one generally tends to shirk all meals. This may effect his health. Mental health care also takes care to give him good nutrition.

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The Prevalence of Mental Health Disorders, Emotional and Behavioral Disorders and Mental Illness in Children

Mental health disorders and mental illnesses affect a greater number of children and juveniles than many people are aware of. These emotional and behavioral disorders can have profound negative effects on the growth and development of children, especially when they go unnoticed and untreated. A greater proportion of children and youth in the child welfare and juvenile justice systems have mental health problems than children and youth in the general population.

-50% of children and youth in the child welfare system have mental health problems.
-67% to 70% of youth in the juvenile justice system have a diagnosable mental health disorder.

Prevalence Estimates of Mental, Emotional and Behavioral Disorders In Young People

DISORDER                                            PERCENTAGE OF YOUNG PEOPLE AFFECTED

Learning D/O:                                                                5%
Substance use / addiction disorder:                                  10.3%
CD:                                                                              3.5%
ODD:                                                                            2.8%
ADHD:                                                                           4.5%
Anxiety Disorders (various):                                             8%
Unipolar Disorder:                                                           5.2%
One or more disorders:                                                   17%

(D/O = Disorder; CD = Conduct Disorder; ODD = Oppositional Defiant Disorder; ADHD = Attention Deficit Hyperactivity Disorder Source: Preventing Mental, Emotional and Behavioral Disorders Among Young People, 2009. National Research Council and Institute of Medicine, of the National Academies.)

Early Detection and Intervention are Critical

The onset of major mental illness may occur as early as 7 to 11 years old.
-Research supported by the National Institute of Mental Health indicates that half of adults with MEB disorders were first diagnosed by age 14 and three fourths were diagnosed by age 24.  
-Factors that predict mental health problems can be identified in the early years, with children and youth from low-income  households at increased risk for mental health problems.  

Age at Onset of First Symptom of Full Psychiatric Disorder, by Age 21

DISORDER                        AVG. AGE OF FIRST SYMPTOM            AVG. AGE OF FIRST DIAGNOSIS

ADHD:                                            Age 5                                                 Age 5
ODD:                                              Age 5                                                 Age 10
CD:                                                Age 6                                                 Age 11
Anxiety Disorders (Various):              Age 7                                                 Age 8
Depression:                                     Age 12                                               Age 15
Substance Abuse:                             Age 14                                               Age 15
Substance Dependence:                    Age 16                                               Age 17
Any Psychiatric Diagnosis:                  Age 9                                                 Age 11

(Source: Preventing Mental, Emotional and Behavioral Disorders Among Young People, 2009. National Research Council and Institute of Medicine, of the National Academies)

Obstacles to Access and Quality in Mental Healthcare

Several federal commissions and workgroups federal task forces have documented the need for improved and expanded mental health services for children and youth.

-It is estimated that less than 1 in 5 of these children receive the appropriate needed treatment  
-Only 15% of youths who had difficulties had parents that actively talked to a health care provider or school staff about their child?s emotional or behavioral difficulties.  

There is not adequate financial support for quality services to prevent and treat mental health problems of children and youth. Many child mental health services are not covered by managed care payers. In 2007, 3.1 million youths, (12.5 percent of 12 to 17 year olds) received treatment or counseling for problems with behavior or emotional disturbances in specialty mental health settings (which include inpatient and outpatient care).

Effective Treatment and Prevention Exists

Clear windows of opportunity are available to prevent MEB disorders and related problems before they occur. An intervention before a disorder manifests itself is possible and offers the best opportunity to protect young people. Effective prevention includes strengthening families by targeting problems, strengthening individuals by building resilience and skills, preventing specific disorders by screening individuals at risk, promoting mental health in schools and promoting mental health through health care and community programs. The key to most approaches is to identify risks (biological, psychological and social factors) that may increase a child?s risk of MEB disorders.

Improve Veteran Mental Health

Improve Veteran Mental Health

“Increasing numbers of Veterans are being diagnosed with mental health conditions, often coexisting with other medical problems.  More than 1.5 million of the 5.5 million Veterans seen last year had a mental health diagnosis.  This concept paper identifies how to address the following three areas:

Identify and test new comprehensive approaches to improve mental health through prevention, diagnosis and treatment.
Identify specific measures to track their effectiveness so we can allocate resources more efficiently.
Develop and test new treatment models to remove stigma associated with admitting problems and seeking help.” (reference VA 13 challenges)

Challenge/Problem Understanding 

War and terrorist interdictions have a devastating effect on the psyche of the military soldier. There are no predictable patterns to rely upon and random events occur from hidden explosives to sniper attacks to hostile suicides that put the soldier at harm’s way.  Such fear and anxiety provoking stress produce ideal conditions for creating human psychopathology.  When people know the direction of their threat and can predict its occurrence, little if any neurotic or psychotic behavior typically develops.  Since this is not what happens especially in a war against terrorist where unpredictability and randomness are common, it is not surprising that over 20% of the military are diagnosed with mental health problems.

Also, seeing trauma first hand (e.g., one losing a limb, or experiencing others losing parts of their body, or others dying on the field) causes acute emotional trauma which if not adequately addressed will quickly evolve into a variety of post traumatic mental health problems.  Every human being seeks to adapt in order to survive.  When normal coping strategies fail to reduce their emotional pain, human beings revert to anything that lowers their pain.  Often this evolves into aberrant coping strategies that normal people would consider quite bizarre.  These bizarre behaviors are nothing more than a person attempting to stay alive and cope, albeit atypically, in which society recognizes as a mental health issue.  To the inflicted soldier, the maladaptive coping strategy is a life vest, one in which is very difficult to unravel once in place.

The RAND report “Invisible Wounds of War,” April 2008, notes that psychological and cognitive injuries are extremely pervasive, with traumatic brain injury (TBI) and post traumatic stress disorder (PTSD) being widespread and not yet fully understood: “These invisible wounds of war require special attention and high priority. An exceptional effort will be needed to ensure that they are appropriately recognized and treated.”  The Rand report further elaborates four recommendations that need to be standardized within both DoD and VA as well as extended into the community-based civilian sector:

Increase the cadre of providers who are trained and certified to deliver proven (evidenced-based) care, so that the capacity is adequate for current and future needs
Change policies to encourage active duty personnel and veterans to see needed care
Deliver proven, evidence-based care to service members and veterans whenever or wherever services are provided
Invest in research to close information gaps and plan effectively

Key Issues

There are several key issues that need to be explored regarding soldier mental well being.  To begin with, we need to look at this problem holistically, systemically and from a systems view point.   We need to understand that many of our soldiers are still very young and vulnerable and do not have the wisdom of experience to rely on to counter such traumatic events.   Prevention, early diagnosis and treatment cannot be dealt with without considering psychological, sociological and cultural factors and interventions associated with the individual soldier, his/her immediate family, and close friends.  To do less is to treat only part of the solution. We need to view the problem through the lens of systems thinking employing casual loop diagramming so as to unravel the true nature of the complexity facing the affected soldier.  Mitigating the potential problem before it occurs is the number one issue – this requires preparing the soldier and his extended social network to cope better with the impeding scenarios that the soldier will face.  Simulations, sage discussions with veterans, systematic calming techniques, and personal sensitivity training on personal emotional resilience factors of self-control, self-regulation and self-motivation are all needed.  Early diagnosis is the next issue which if done effectively will head off having to deal with the chronic nature of the illness and attack the issue while still in the acute stage where habits are not yet well ingrained.  The other remaining issue involves selecting the most robust and effective treatment modality once treatment is required.

The RAND report indicates the increased numbers of trained and certified professionals are needed to provide high-quality (evidenced-based, patient centered, efficient, equitable and timely care) in all sectors, both military and civilian serving previously deployed personnel.  Hiring and retaining such mental health providers is quite a challenge as will be determining the exact number of providers based on demand projections over time.  Although the precise number of newly trained providers is not yet known, it is likely to be in the thousands.  Additional training in evidenced-based treatment for trauma will also be required for tens of thousands of existing providers

Solution Approach

The RAND report recommends the following seven key strategies to employ:

Adjusting financial reimbursement for providers to offer appropriate compensation and incentives to attract and retain highly qualified professionals and ensure motivation for delivering quality care.
Developing a certification process to document the clinical qualifications of providers.  Providers would also be required to demonstrate requisite knowledge of unique military culture, military employment, and issues relevant to veterans.
Expanding existing training programs for psychiatrists, psychologists, social workers. Marriage and family therapists and other counselors to include in their curricula and practice settings training in specific therapies related to trauma and military culture.
Establishing regional training centers for joint training of DoD, VA, and civilian providers in evidenced-based care for PTSD and major depression.  The centers should be funded, federally, possibly outside of DoD and VA budgets
Linking certification to training to ensure that providers not only receive required training but also are supervised and monitored to verify that quality standards are met and maintained over time.
Retraining or expanding the number of existing providers within DoD and the VA (e.g., military community-service-program counselors) to include delivery or support of evidenced-based care.
Evaluating training efforts as they are rolled out, so that we understand how much training is needed and of what type, thereby delivery of effective care.

The VA is deeply concerned with finding creative ways to address the three areas of concern in Task 5.  Most of the areas address the seven key strategies, especially 2, 3, 5,6, and 7.

Phase/Idea 1: Identify and test new comprehensive approaches to improve mental health through prevention, diagnosis and treatment.

We will develop an experimental design using parametric and nonparametric statistical techniques to evaluate different approaches to prevention, diagnosis, and treatment where control groups are employed.  As aforementioned, a social forum of soldier and his/her connected family are to be involved prior to deployment in building a comprehensive set of coping capabilities.  Behavioral interviews will be developed and modeled for the immediate soldier’s leader to be able to quickly diagnose an impending mental health problem.  An array of treatment strategies will be developed by an interdisciplinary mental health team composed of a psychologist, psychiatrist, and social worker to support the soldier and extended family needs.  If the soldier is physically impaired, the interdisciplinary team will be extended to include health/nutritionist, occupation and physical therapist, and neurologist.  A follow-on career team composed of a set of occupational counselors will be provided for career reintegration.

Phase/Idea 2: Identify specific measures to track their effectiveness so we can allocate resources more efficiently.

We will employ a resource allocation system to methodologically maximize the allocation of resources to various prevention, diagnosis and treatment programs.  Decision support is available to facilitate resource allocation.   Through pareto-optimization techniques we will be able to maximize distribution of funding across multiple program areas.

To track and measure progress of treatment programs we will employ a constellation measure of life reintegration effectiveness composed of career, social, and personal factors associated with happiness, legacy, significance and achievement.  These measures will be qualitative in nature and be judged by the perspective soldier’s interdisciplinary team.  Prevention measure will entail reducing the number of soldiers diagnosed with mental health problems.  Diagnosis measures will entail how quickly they are identified by the soldier’s immediate leader and to the extent the diagnosis is comprehensive in nature.

Phase/Idea 3: Develop and test new treatment models to remove stigma associated with admitting problems and seeking help.

We will employ a wellness concept that builds mental well being and treats all facets of the soldier’s life – spiritually, professionally, socially, and personally.  Success will be defined in terms of positive mental health rather than psychopathology where self-worth, self-esteem and self-motivation will be emphasized.  We will emphasize adult development and deal with the soldier holistically rather than treating only the specific issue.

 

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4 Goals for Expanding the Mental Health Care Policy for Children and Youth

Change is the air, and everyone is cautiously optimistic for healthcare reform in the new administration. In the coming years, the national mental health organizations will begin expanding behavioral healthcare agenda for children and youth, and are looking to new members to help shape and prioritize policy goals. Focusing on children and youth is an important starting point.

With several healthcare reform proposals on the table from Congress, national mental health care organizations are working on a number of fronts to advance children’s behavioral healthcare in the new Administration. A top priority is securing additional Medicaid support through increased SCHIP funding and Federal Medical Assistance Percentages. In addition, mental health organizations are working closely with federal partners to include behavioral health issues for children and youth in federal initiatives. The unique healthcare needs of children are a priority in any health reform proposal.

Other child health policy goals will likely mirror and advance the objectives of many community mental health organizations around the US. The following four goals are objectives that are universally accepted by many mental and behavioral health care providers.

1.) Service needs, rather than financing streams, should shape the structure of delivery systems for children and youth.

Often, the rules and regulations governing coverage and reimbursement narrowly dictate how and which clients can be served. Early diagnosis and intervention remains more of a vision than the reality. Federal and state financing need to support — not impede — early intervention and prevention, care for the “whole child,” and incentives for statewide approaches to improving age-appropriate services.

2.) Behavioral health services for children and adolescents require a family focus

Child disorders can engender dysfunction even in relatively strong families. This phenomenon is especially challenging in families that may have difficulty accessing medical appointments or taking time off work. Policy should support services delivered by behavioral and mental health organizations in and across natural settings such as early childhood programs, homes, primary health care settings, and schools in order to successfully reach children and their families. More and more community mental health organizations are helping families obtain supports beyond traditional services like income support or public health insurance.

3.) Delivery systems should be both flexible and accountable

The focus on mental health care for children should dovetail with ongoing efforts to use data to drive clinical and administrative decision-making. Delivery systems must be flexible to support collaboration between providers and service sites that treat the “whole” individual while also being more attentive and responsive to functional outcomes. To do this, child mental health authorities, child welfare authorities, and state juvenile courts, in conjunction with federal partners, must develop a comprehensive strategy to work together in new ways: more cooperatively, transparently, effectively and efficiently.

These delivery systems need to be able to jointly measure effectiveness of services over time and to coordinate services within or between systems in order to improve outcomes experienced by children and their families. Meaningful, measurable, and manageable measures of performance across systems are critical. Community mental health organizations need to work closely with their members to advance policy that improves interagency financing and service networks, to develop methodologies for integrating and coordinating mental health resources for children and families, and to create a quality driven mental health system.

4.) Increase workforce capacity and competence, with greater attention to cultural responsiveness

Everyone needs to work at the federal and state levels to build a qualified and adequately trained workforce — one prepared to recognize, diagnose and provide mental health services for children and their families and a workforce trained to deliver care and treatment under a new paradigm that stresses collective responsibility for child mental health and well-being.

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Child & Adolescent Mental Health: the Right Career at the Right Time

According to the Substance Abuse and Mental Health Services Administration, an estimated two-thirds of the young people who need mental health services aren’t getting them. The time is now for a career in child and adolescent mental health.

Mental Health Career Profile
Establish and maintain interpersonal relationships, discover private, and very often hidden, information, and then use that information to potentially save someone’s life. If you believe a meaningful career is about more than just a paycheck, mental health could your profession. With a growing population and the identification of new disorders, the field is ripe for growth and discovery.

Child and adolescent mental health services typically focus on a variety of mental, emotional, and substance abuse issues kids experience daily. This may mean working with patients as individuals or in group settings in order to find answers to developmental difficulties. Working environments may include hospitals, clinics, schools, as well as mental health facilities.

A Career at the Competitive Edge
Why mental services? In a word, diversity. One of the primary benefits of a career in this profession is that you’re typically not restricted to a predictable track. There are multi-level tiers that cater to a variety of interests and education levels. Many of the niches overlap, which can allow you to explore your preferences. A few of your options include:
• psychiatry occupational therapy
• clinical psychology
• psychiatric nursing
• social services
• psychotherapy
• language development

Flexibility is another key benefit. A surprising percentage of mental health professionals are self-employed, working within their own established practice or as a freelance consultant. Because mental health is such an in-demand profession, graduates may find that they can create their own schedules, deciding when and how much to work based on their own professional and personal obligations.

Mental Health in the Numbers
When most people think of mental health, the psychologist usually comes immediately to mind. And it can be a good place to start when looking at the growth potential in the field of child and adolescent mental health. The Bureau of Labor Statistics reports that psychologists alone held 166,000 positions in 2006. And employment of psychologists projected to increase by 15 percent through 2016–that’s faster than the national average. Also, psychologists working in elementary and secondary schools enjoyed one of the higher annual mean salary levels at $66,040.

To Follow This Career Path
While all professionals in the mental health field typically possess a bachelor’s degree in a pertinent subject, students wishing to be competitive for the top jobs should pursue a specialist’s or doctoral degree in psychiatry, psychology, or counseling. For example, if you have your sights set on serving in an educational setting, a specialist (EdS) degree in school psychology traditionally requires 3 years of full-time graduate study plus a 1-year full-time internship.

The requirements for potential psychologists are usually more stringent. Geri Fox, Director of Psychiatry Undergraduate Medical Education with the University of Illinois at Chicago, encourages board certification by completing two years of child and adolescent psychiatry training in addition to earning board certification in general psychiatry.

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Economic Recovery and Healthcare Reform – Opportunities for Mental Health and Addictions

2009 is a critical year. Promised economic recovery and healthcare reform legislation are opportunities for meaningful financial commitments to mental health and addictions services and mental healthcare organizations are offering a practical actionable agenda:

- The integration of primary care services in behavioral health settings: The Healthcare Collaborative Project brings together behavioral health and primary care organizations offering a bi-directional approach for care. The need for behavioral health services in primary care is widely accepted. But the integration of primary care services in behavioral health settings remains controversial despite the fact that individuals with serious mental illness appear to have the worst mortality rates in the public health system. Therefore, mental healthcare organizations are actively pursuing single points of accountability to enhance continuity of care for this underserved population.

- Cost-based-plus financing that supports service excellence: People want and deserve quality services but quality services depend on skilled staff. Low salaries have created – and are perpetuating – a recruitment, retention, and quality crisis for behavioral healthcare. We need a workforce of skilled staff delivering nationally recognized practices within organizations that live by the rule “If you don?t measure it, you can?t improve it.”For mental healthcare organizations, healthcare reform is an opportunity to bring “parity” to public mental health services by ending the second class status of community mental health and addiction providers in America?s safety net.

- Federal mental health funding stream dedicated to mental health and integrated treatment services for the uninsured: The uninsured have exceptionally high rates of untreated mental illnesses with co-occurring addiction disorders and there is no safety net. State plans to cover the uninsured have all but disappeared and federal universal coverage plans may well be incremental. We have large numbers of individuals with treatable mental illnesses and addictions in our overburdened emergency rooms, in jails, and on the streets with no access to services that can engage them, treat them and return them to work. We must stop denying our economy productive taxpayers and wasting human lives.

- Eligibility for social security disability for people with addiction disorders: Addiction has come a long way from the days when it was perceived as merely a failure of will. Today, there is growing public awareness and acceptance of addiction as a chronic, relapsing condition that requires continual monitoring and management, as do other chronic illnesses like diabetes, asthma, and hypertension and yes, mental illness. If we accept addiction as a chronic illness then we must advocate that people with addiction disorders be eligible for disability support.

- Funds to support investments by behavioral healthcare organizations in information technology: We talk about information technology and service transparency, but behavioral healthcare organizations that move forward to automate their clinical systems get no support, funding, or technical assistance. We and those we serve cannot continue to be marginalized. Healthcare reform and economic recovery will depend upon the expansion of information technologies and behavioral health providers must be included.

- Expansion of research-based education and prevention practices: There are mental health and addiction prevention and education programs that work. These include research-based prevention initiatives that reduce the risk of childhood serious emotional disturbance by treating maternal depression, the Nurse-Family Partnership Program that has an array of consistent positive effects across multiple trials, and Mental Health First Aid – an evidence-based mental health literacy program. Now we must adequately fund and support the spread of these interventions to communities across the country.

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