Term Paper: Mental Health Organization

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Mental Health Organization

Mental Health Management in Today's Era of Managed Care: The Case of Full Circle Health

Full Circle Health is a Mental Health treatment organization that attempts to treat the needs of a community, mentally, physically, and spiritually. It serves an important societal role by offering counselors who provide professional mental health services to a Christian community. It is led by a management staff of trained therapists and social workers of a similar philosophical orientation who can lend support to the staff of case workers and counselors.

Its mission to give holistic care reflects the fact that traditionally, many Christians have unfortunately shied away from counseling, according to one article showcased on its website "Prayer not Prozac." This because depression is seen as a 'sin' or a weakness, rather than a natural part of the suffering human condition that can be treated. Full Circle Health stresses that is no more sinful to seek counseling and medication for depression than it is to take medication for a heart condition, and that both mind and body must be treated for an individual to feel spiritually whole and personally fulfilled (Suite 2008). Recently, the World Psychiatric Association stressed the need for institutional programs in the mental health field with "a strong educational and conceptual basis" within the domain of personalized, individualized medicine to "blend science with caring" and to "deliberately" create a "subtle fusion of art, science, and values (Cox, Campbell, Lewin-Fetter 2008, p. 812). This reflects Full Circle Health's approach, and its willingness to offer a unique and personalized battery of services. Its success demonstrates how mental health treatment can never be a purely standardized commodity with a one-size fits all approach.

Full Circle Health also strives to offer mental health care to the economically underserved by embracing a four stages model of inclusive healthcare, which includes "developing and recruiting a bicultural...health care workforce, structuring health care resources for maximum accessibility, expanding health care organizations, and integrating ethnicity-specific health care resources into the mainstream health care system" (Yang & Singer 2007, p.532). It recognizes that racial and ethnic disparities in health care have created "in part" the cultural divide between "certain patient populations and the health care system" in the mental health field (Yang & Singer 2007, p.532).

The organization has made a particular commitment to serving the Christian, African-American community. African-Americans of all socioeconomic status are less likely to seek out and follow up with psychological treatment -- in a recent study of patients suffering migraines, African-Americans were more likely to report symptoms of depression as the likely cause of their physical suffering yet were less likely to follow up with prescribed medical and psychological aftercare (Heckman, Holroyd, O'Donnell, Tietjen, Utley, Stillman, & Ellis 2008, p. 247).

But both structural solutions for improving mental health care are required as well as creating a center that offers cultural and ethnic-specific care. Perhaps, more so than any difficulties in reaching the population it strives to serve, the greatest challenge Full Circle Health faces is not the resistance of the community, but the lack of funding for mental health services in general, within America. The organization has a long-standing history of pressuring government organizations to provide better coverage for mental health related issues and to recognize what it also pressures its prospective patients to acknowledge, that mental and physical suffering are interconnected, and equally damage to the life and spirit of the patient. It reports "State Senator Jeff Klein and Dr. Derek Suite of Full Circle Health...support of Timothy's Law, the mental health parity bill named for Timothy O'Clair, the 12-year-old Schenectady boy who committed suicide after years of suffering from depression while his family was denied mental health insurance coverage" (McLeod 2005). Fair coverage for mental health related conditions is an issue for all psychological counseling. Full Circle Health would note to view the body and mind as separate entities, one in need of more 'critical care' than the other is a medical as well as a spiritual and psychological inaccuracy.

Still, the organization's management and staff must still cope with inequities of funding for treatment. Also, because it serves a poorer population, mostly minority, often with poor insurance, this issue is of even more importance for Full Circle Health than for other private facilities, although no matter what one's economic status, health care insurance is likely to play some factor in decision-making regarding one's health. But it is a cruel irony that those most in need of mental health treatment -- the poor, the chronically stressed, and the forgotten, have the least mental health insurance coverage. Even when they have flexibility in selecting plans or coverage, they are likely to select those that offer more physical, rather than mental health coverage, given the choice between life-sustaining medicine and the seemingly intangible rewards of mental health counseling.

The statistics are sobering. In "1990, mental health cost 9% of the medical dollar. In 2000, it was 3%. Managed care had trimmed an average of 8% from all other medical costs but 54% from...mental health. The Surgeon General's 1999 Report on Mental Health opposed this trend. It ranked mental health second only to heart disease as a cause of disability, and it reported that only one-third of the 20% of Americans who need psychiatric treatment in any given year receive it" (Houghton & Houghton 2002). For those who might feel a personal stigma or shame about seeking treatment, there is an added burden of hyper-scrutiny in an age of cost-cutting: "But cost-cutting is not the only effect of managed care. Also lost under managed care are the traditional transparency, immediacy, and confidentiality of the relationship between therapist and patient....In order to draw on insurance benefits, patients are now required to call their Managed Care Organization (MCO), ask for a list of approved therapists, be pre-authorized, and then call someone who can help them. After one or two meetings, the therapist must submit a treatment plan to an MCO manager (often a psychiatrist reaching retirement) that sets short-term goals and establishes medical necessity" (Houghton & Houghton 2002). In short, an individual suffering from mental illness must prove that he or she is 'sick enough' to 'deserve' treatment, which adds to the psychological burden of many suffering from mental health conditions, depression in particular, who may feel worthless already. The poor, and members of historically discriminated against minorities may have an additional psychological burden justifying their need for care before an impersonal authority figure.

This added level of scrutiny can act as another level of deterrence for those who are uncertain about seeking care, because of cultural pressures not to view mental health as a treatable illness. Furthermore, organizations that take innovative or unconventional approaches, like Full Circle Health, may not be deemed as appropriate treatment by insurance companies. Because of all of these systemic failures, the burden of diagnosing depression and other mental health conditions is increasingly falling into the hands of primary care physicians: "Despite a plethora of high quality efficacy and effectiveness studies and implementation of demonstration projects that have established that primary care patients with depression can be treated with cost-effective interventions within primary care settings, the accuracy of diagnosis and quality of care for many primary care patients with depression remains suboptimal....Although historically the purview of mental health specialists, depression care is increasingly being delivered by non-mental health physicians"(Seelig & Katon 2008, p.451). Individuals of color may also fall under the radar of diagnosing depression because they do not fit a preconceived profile of a 'depressed individual,' or may shy away from admitting to feelings of depression because of cultural discouragement in articulating such issues. Thus, while funding cuts may result in turning to physicians to treat mental illness, using primary care physicians to treat mental illnesses does not seem… [END OF PREVIEW]

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