NR 552 Week 3 Discussion, Externalities of Public Services

Externalities of Public Services NAME Chamberlain College of Nursing NR 552: Economics of Healthcare Policy Dr. Poirier DATE Investigate a publically provided healthcare service in your community. Briefly describe the service provided, including the population served and how the program is funded. What are the negative and positive externalities of providing this service? Week 3: Externalities of Public Services It’s no mystery that mental health is a subject clouded by stigmas, misunderstandings, and discrimination by the public, thus those suffering from mental illness find it very difficult to access the necessary services needed to help them deal with their disease. The most important issue in addressing the mental health issue is ensuring that individuals with mental illnesses have access to mental health treatment. The Mental Health & Recovery Board of Portage County provides services to families, adults, veterans, teens, and children with mental illness, depression, addictions, in crisis and at risk for suicide living in Portage County, Ohio. The Mental Health & Recovery Board of Portage County funds services for residents through its network of agencies and coalitions, such as the Children's Advantage Family Behavioral Health Services, Family & Community Services, Inc., Suicide Prevention Coalition of Portage County, Coleman Professional Services, Townhall II, and the Portage Substance Abuse Community Coalition (Mental Health & Recovery Board of Portage County, n.d.). The services are funded by Portage County taxpayers, along with grants and funds from the State of Ohio (Mental Health & Recovery Board of Portage County, n.d.). According to Wahlbeck and McdAid (2012), “high frequencies of common mental disorders and suicide are associated with poverty, poor education, material disadvantage, social fragmentation and deprivation, and unemployment”. Therefore, the Mental Health & Recovery Board of Portage County offer mental health services to adults and families receiving help by what they can afford to pay, making their services accessible to as many citizens in the community as possible. The positive externalities of well-developed community-based mental health services are linked to the reduction in suicides and empower people suffering from mental illness to be productive members of the community. An integrated care approach with a focus on service provision in community-based care will increase access to mental health care and shift the focus to prevention and early detection of mental health problems (Wahlbeck & Mcdaid, 2012). Negative social judgment and feelings of shame and embarrassment over mental illness are each a barrier to treatment brought on by stigmas about mental illness. Community-based mental health services help to break down stigma to encourage people through education and community support to seek help with the awareness that behavioral health is a health issue. The negative externalities of community-based mental health services include ensuring resources are used effectively to the address needs of the community and to continually develop community-based services. Increasing the efficiency of services can go hand in hand with the development of modern community-based mental health services. Another important challenge may be the need to continue to fund excess services at the same time as investing in other services. In conclusion, the determinants of mental health often lie outside of the health system and all sectors of society must be involved in the promotion of mental health. Accessible and responsive community-based services support people at risk and can prevent mental health consequences. References Mental Health & Recovery Board of Portage County. (n.d.). About us. Retrieved on July 21, 2018, from Wahlbeck, K., & Mcdaid, D. (2012). Actions to alleviate the mental health impact of the economic crisis. World Psychiatry, 11(3), 139–145. PROFESSOR RESPONSE TO POST: Thank you Carole. Do you feel the positive externalities outweigh the negatives (e.g. cost of resources)? REPSONSE TO PROFESSOR POST: Dr. Poirier, I’m an advocate for alternative treatments, outside of hospital-based care, for individuals suffering from mental health conditions. People suffering from persistent mental illness need access to treatment, rehabilitation, and support services within the community. Mental health conditions impact not only the person who is living with the condition but also their family and the greater community, especially if the mental health condition restrict the person’s ability to engage in community life and contribute to the nation’s economic output. Community-based treatment enables people with mental disorders to maintain family relationships, friendships, and jobs while receiving treatment, which facilitates early treatment and rehabilitation. This type of care is also associated with continuity of care, greater users’ satisfaction, increased adherence to treatment, better protection of human rights, and prevention of stigma (Ayano, 2018). Funding continues to be an issue for both the organizations attempting to provide mental health services to the community they serve. The community mental health system's goal is an extremely difficult one and it continues to struggle against changing social priorities, funding deficits, and increasing need. The 2009 Federal Stimulus Package and Health Reform Act increased the funding for community health centers substantially (Wells, Morrissey, Lee, & Radford, 2010). Therefore, I believe the positive externalities of community-based treatment outweighs the negative, such as the cost of resources. References Ayano, G. (2018). Significance of mental health legislation for successful primary care for mental health and community mental health services: A review. African Journal of Primary Health Care & Family Medicine, 10(1). Retrieved on July 24, 2018, from Wells, R., Morrissey, J. P., Lee, I.-H., & Radford, A. (2010). Trends in Behavioral Health Care Service Provision by Community Health Centers, 1998–2007. Psychiatric Services (Washington, D.C.), 61(8), 759–764. PEER POST: Yale-New Haven health medical Toxicology provides for children emergency and elective consultations for children and adolescents with both acute and chronic poisonings. The Center for Children’s Environmental Toxicology houses the Hospital’s Lead Poisoning Regional Treatment program, this program has an outpatient diagnostic evaluation, ambulatory treatment, and hospitalization. The integrated approach is carried out through educational efforts and initiatives at the local, regional and state levels (YNHHH, 2016). The Lead Clinic team offers case management, including inpatient and outpatient treatment provided by social workers and pediatricians. Lead screening and follow-up of identified children, including outreach and home visits. Social work intervention to help families find safe affordable housing and to assist with other psychosocial needs (YNHHH, 2016). RESPONSE TO PEER POST: Amanda, They say great minds think alike! For last week’s assignment, I identified that lead exposure remains a public health concern largely due to inadequate lead abatement in older housing units. Children six years of age and younger are more susceptible to lead exposure because lower levels of lead exposure produce clinically significant impairments and such impairments are more severe and persistent at earlier stages of development. The primary health outcomes associated with childhood lead exposure, however, are related to brain development. Impairments of brain volume, general intelligence, cognitive development, academic performance, motor performance, and language development ultimately limit economic output on an individual level. According to the Department of Housing and Urban Development, more than a fifth of American homes contain enough lead-based paint to create a hazard to young children, whose developing brains can be harmed by even low levels of the toxic heavy metal (Doering & Wernick, 2017). Nevertheless, the Trump administration’s 2019 budget blueprint proposes $17 million cut to the Environmental Protection Agencies lead programs and leave lead-reduction initiatives to the states (Doering & Wernick, 2017). This proposed cut would include the Lead Risk Reduction Program, which trains building renovators on safe paint removal, maintains federal safety standards and educates the public about the detrimental health effects of lead exposure. With this proposed budget cut, poor African-Americans, especially children, in inner-city communities would be hit the hardest. The Glenville neighborhood, on Cleveland’s east side, embodies the neglect of the lead problem. According to the CDC, in 2014, approximately twenty-seven percent of 286 children living in Cleveland’s Glenville neighborhood tested had lead levels greater than five micrograms per deciliter (Wines, 2016). I learned that while some states have stricter regulations than other, the only properties that must be certified as lead-safe as a matter of federal policy are properties subsidized by the federal government (Pohl, Ingber, & Abadin, 2017). I proposed that subsidizing lead inspections, risk assessments, and lead abatement for low-income homeowners or renters with dependent children would be both an effective and fiscally sound way to ensure that children are not forced into lead exposure because of their parents’ or guardians’ inability to pay. References Doering, J. & Wernick, A. (2017, May 9). EPA budget cuts threaten programs to reduce kids' exposure to lead paint. Retrieved on July 26, 2018, from Pohl, H. R., Ingber, S. Z., & Abadin, H. G. (2017). Historical view on lead: guidelines and regulations. Lead: Its Effects on Environment and Health, 17, 435. Wines, M. (2016, March 3). Flint is in the news, but lead poisoning is even worse in Cleveland. Retrieved on July 26, 2018, from