What do you feel is the biggest health issue facing your community?
It is incredibly difficult to pick just one health issue facing my community. My community is affected by mental health, obesity, diabetes, and drug and alcohol use. These health conditions and behaviors coupled with unstable systems and social determinants makes it incredibly difficult for any one of them to be solved. However, for the sake of this post I will focus on mental health and mental disorders.
Explain what has been the historical progression of the health issue you have chosen (e.g., is it improving, worsening, reaching a plateau?).
In the late 1950’s California had just under 37,000 patients in mental hospitals (Kelly, 2020). Between the years 1969-1971 state mental hospitals began to close after implementation and changes to the Short-Doyle Act that began providing funding to both cities and counties that provided community-based mental health services (Kelly, 2020). These changes created service shortages. While we have made vast improvements in how we address mental health we still have a long way to go. One of the best things that was implemented for mental health was The Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act of 2010 (Spector, 2020). The question about whether mental health is improving is difficult to answer as we become more comfortable speaking out about it and more people seek help, numbers are continuously fluctuating. The Federal Bureau of Investigation (FBI) reported in their National Instant Criminal Background (NICS) operational report a 5.68% increase in adjudicated mental health from December 2021 to December 2022 (2022) resulting in federal denials (U.S. Department of Justice Federal Bureau of Investigation (2022). Older references show a continued growth in the NICS for mental health denials.
List approximately how many are affected.
In 2019/20 it was estimated that just over 26,000 residents in San Bernardino County needed mental health services, but did not receive them (San Bernardino County, 2024). This number could be a lot higher.
Describe the demographic information of those affected.
Latinos and White residents are among the most affected with just over 44% Latinos and over 23% White (San Bernardino County, 2024). The San Bernardino County reports that ages 25-44 has remained the highest age group from 2012-2021 (2024). I would have to do more research to better understand why these two groups are so high.
Explain if there are any policies in place to address this health issue.
In May of 2023, the U.S. Department of Education moved in the positive direction in trying to remove the parental consent requirement before Medicaid could be billed (Stanford, 2023). Almost half of the states have now extended Medicaid so that more services in schools can be covered, which includes mental health care (Stanford, 2023).
Describe if the policies been effective.
Personally, I feel it is too early to see if the policies being implemented are being worked on. To identify effective change the data will require a few years for proper tracking.
Explain what policies you would implement to cause a positive change.
One of the first things I would implement would be including mental health assessments in children as part of their yearly check-ups. Mental health assessments would also catch earlier children that are in abusive situations. Abusive situations lead children to self-medicate with drugs and alcohol as they get older turning into a cycle of addiction and mental health disorders. I would also make Psychologists and Psychiatrists easily available in schools. Changing the culture and creating a generation of children that are comfortable seeking help when needed will not eliminate mental health concerns; but it will allow for those that need it to learn coping mechanisms without resorting to drugs and alcohol.
Explain what assurances you would utilize to maintain the positive change from your proposed policy.
First and foremost, before proposing policies, it is important to get buy-in from stakeholders. A community that is able to organize can help solve problems, even health problems (Seabert et al., 2022). Then continual monitoring will be vital. Unfortunately, as with most policies funding is difficult to obtain in the first place so making changes as needed will not be easy. But being open to change and adjusting the policy will be required for permanent, positive change.
reply 2
What do you feel is the biggest health issue facing your community?
In my community, one of the biggest health issues is access to prevention programs regarding mental health for students. In the last six months, there were three known suicides of students ages 14-18 within our county. There are a variety of factors; societal, biological, and psychological, that directly impact these results. However, the greatest of these is access to prevention programs within the public school district and its priority among high school educators.
Explain what has been the historical progression of the health issue you have chosen (e.g., is it improving, worsening, or reaching a plateau?).
Mental health among adolescents has continued to worsen, especially after the COVID-19 Pandemic. An increase in mental health issues among students regardless of demographic or socioeconomic status was linked directly to the isolation and limited peer interactions that were a result of COVID-19 shutdowns. (Berryhill, 2023). Research regarding the pandemic's effect on adolescent mental health is still in process, but many scholars are concluding that the mental health and developmental implications of the pandemic far supersede the mortality risk of the actual virus. Hospital data from the United States, Europe, and the Middle East showed an increase in admissions surrounding mental health crises and suicide attempts during the COVID-19 pandemic. (Bouter, 2023). As things began to readjust after the pandemic, mental health became a topic for many school districts within the United States. Studies have shown an increase in mental health challenges specifically depression and anxiety as schools began to reopen resulting in decreased academic performance. (Puteikis, 2022).
List approximately how many are affected.
There are 43,012,350 adolescents between the ages of 10-19 in the United States, a whopping 13% of our total population. (US Census Bureau, 2022). With over 40% of teens suffering from a mental health challenge by the time they are 18 years old, there is a strong need for effective prevention programming. (Shim, 2022). Although not all students are struggling with mental health disorders, they will have peers who do; which emphasizes the need for effective prevention programming.
Describe the demographic information of those affected.
Mental health challenges affect every demographic of adolescents regardless of race, economic status, or age. However, one group that is adversely affected by this is the LGBTQ+ population. LGBTQ+ students are more likely to suffer from long-term depression and are more likely to attempt suicide than heterosexual students. (CDCP, 2021).
Explain if there are any policies in place to address this health issue.
Although no formal laws or policies are in place to address this issue there is an ongoing mandate from the Governor of New Jersey to implement prevention-based mental health programming in New Jersey Public Schools. In addition to this is a policy proposal for pediatric practices to have an increased scope to handle a family's psychological needs. (Wissow, 2021).
Describe if the policies have been effective.
These policies have begun to be effective, but face barriers to financing and acquiring the workforce to implement these programs. This becomes increasingly hard as economic strain rises, and school districts' budgets are on a steady decline.
Explain what policies you would implement to cause a positive change.
Requiring Mental Health First Aid, or similar training certifications for all teachers and staff in a public school would be a policy I would seek to implement. Similar to the desire for traditional First Aid or CPR training, mental health training equips educators with the tools to recognize the signs and symptoms of someone with a mental health challenge and provide them with support and connection to a mental health professional before a crisis. (Ross, 2023)
Explain what assurances you would utilize to maintain the positive change from your proposed policy.
Seeking out community members who not only support mental health programming but have a desire to support students and their needs is important. One thing that will need to happen for these projects is funding. The importance of utilizing grant funding and other avenues so that schools with lower operating budgets can participate is crucial for the success of the program in a community.
