Epidemiologic data on the prevalence of psychiatric and substance disorders compared with the nation’s behavioral health care needs highlights gaps in service adequacy. Continuing changes in organization and fiscal structures resulting from the implementation of the Patient Protection and Affordable Care Act (ACA), specifically how Medicaid expansion impacts behavioral health services, is an important area of concern. In addition, there are special challenges of the homeless and incarcerated mentally ill populations. Behavioral health also has a workforce shortage. This is another area for improvement in health care organizations throughout the nation.
Review and analyze the graphs in Figure 10-1, Prevalence of any Mental Illness Among U. S. Adults; Figure 10-2, Prevalence of Serious Mental Illness Among U.S. Adults; Figure 10-3, Top Leading Disease or Disorder Categories Contributing to U.S. Disability-Adjusted Life Years (DALYs) (2010), and Figure 10-4, U.S. DALYs for Mental and Behavioral Disorders as a Percent of Total U.S. DALYs.
Some of the barriers to care are provider geographic distribution, financial limitations, lack of or inadequate health insurance, stigma, misunderstandings about the treatability of conditions, personal and provider attitudes, cultural issues, and a poorly organized care delivery system (see page 285 of the textbook). Consider also the mental health services of children and adolescents. Consider the current events with mass shootings at schools, movie theaters, concerts, et cetera and have tough conversations about mental health.
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