Mental illness contributes a significant amount of disease burden worldwide (World Health Organization, 2001). Around the world, approximately 450 million people develop from mental health complications and at least one fourth of the total world’s population are susceptible of developing mental or behavioral disorder at some point of time during their lives (Whiteford et al., 2013). Mental health disorders account for nearly 25% of mental health disability in the different parts of United States, Canada, Western parts of Europe and Australia. It is also regarded as the leading cause of premature death (Centre of Disease Control (CDC), 2017). In United States 22% of the adult population has more than one diagnosable mental disorder per year(Perou et al., 2013). Some of the common mental health disorders prevalent among the US population included anxiety, impulse control disorders, bipolar mood disorders and substance-abuse disorders(American Psychiatric Association, 2013). The effects of mental illness are evident throughout the cultural, racial and ethnic groups(Betancourt et al., 2016). Moreover, mental illness across United States cost $150 billion per year (excluding the cost of the research) (Croft & Parish, 2013).
The following report aims to compare the economic policies of mental health promotion, wellness and prevention programs in United States and Australia. The report also seeks to analyze the implications and disparities of the economic policies of mental health in terms of volume-based and values-based health care. At the end, the report aims to implement the policy of Australia in US and then estimate the consequences.
Economic policies of mental health promotion in America are mainly based over providing security and freedom to the people suffering from mental illness. This security and freedom is mainly based on providing adequate housing via supportive housing policy and social support for people with mental illness and their care givers. The economic policies for mental health promotion in America also encompass special health and social programs targeted towards the vulnerable group. These vulnerable groups are mainly the people residing in rural areas and chronic physical illness along with mental health disease. The economic policies also support and promote community development programs via evidence based approach in order to reduce the mental health burden on large scale (WHO, 2017a).
The economic policies of the mental health promotion in Australia aims to maximize the ability of youth, children, adults and older people to understand their potential, cope with daily stresses of life and to participate in community activities in meaningful ways. It also aims to increase the understanding and awareness of mental health illness and problems while decreasing the discrimination and stigma, which centers on mental health. It also promote help-seeking behaviors where needed (Australian Government Department of Health, 2017). Thus overall the economic policies in the mental health promotion in Australia is aimed towards designing community based educational program which will help to promote awareness in mental health along with reduction of mental health stigma. According to WHO (2017b), the economic policy of mental health promotion in Australia also aims towards the generation of supportive environment. Supportive environment helps in protecting direct and indirect effects of surrounding environment on mental health. Besides Australia has separate economic policies in order to control tobacco and alcohol use in order to reduce the mental health complications arising from substance-abuse.
According to VanLare and Conway (2012), volume-based health care signifies the payment that the healthcare providers receive as payment for providing a particular service regardless of the outcomes or the requirement. Value based health is a special health-care delivery model under which the service providers including the physicians and the hospitals are paid based on the patient’s health care outcomes.
In America, the main implications of the economic policies that are directed towards the mental health, prevention, promotion and wellness is optimal implementation of the Affordable Care Act (ACA) of 2010. It is an well-established health insurance act where the service consumers can contrast and compare and then enroll on different health insurance plans which includes separate plans for mental or behavioral health services. Mental and behavioral health services in America are regarded as Essential Health Benefits which signifies that all the health insurance plans which are private and are covered in the Marketplace must cover these services. During 2013, Mental Health America (MHA) was selected as one of the 105 organizations that obtained a special grant, “Navigator grant”. This grant is issued by the centers for Medicare and Medicaid Services (CMS). Via this grant, MHA participated as Navigator delivering direct in-person help to the individuals who are interested in applying for the health insurance coverage viathe health insurance exchange that is facilitated federally (Mental Health America, 2017). Thus it can be seen that the economic policies for the mental health promotion and wellness is based on the volume-based service. These volume-based services aimed towards covering as much as people under the ACA for comprehensive mental health promotion and prevention. However,in certain aspects, economic policies of mental health in America cover value-based service. This is because it provides in-person assistance to the individuals and this personalized approach is measured on the basis of its effectiveness.
In Australia, Medicare rebates which come under the provision of “Better Access to Psychiatrists”, “Psychologists and General Practitioners” via MBS initiative are especially available for the patients with mental health complications. These services are mainly delivered during the courses of treatment. Each course of treatment contains six different services procured by an allied mental health professional. Towards the end of each treatment, the allied mental health professionals are required to report back to the referencing medical practitioner about the progress of the patients. The main mental health services that are delivered under this initiative include Psychological therapy services which are given by eligible clinical psychologists and person focused psychological strategies services (FPS) procured by the general practitioners, occupational therapists, registered psychologists or social workers. Rebates for this mental health services financially benefit the patients with mental health disorder. Moreover, structured approach to management of mental health further provides economic benefits to the service users (Australian Government Department of Health, 2017a). People with higher mental health benefits, the waiting period of the psychiatric care are exempted in Australia. However, these benefits can only be accessed by a person once in their lifetime and is only available to the person after their preliminary waiting period for psychiatric benefits (2 months) is over. The exemption also covers drug and alcohol abuse. Anyone can upgrade the coverage and enjoy the waiting time exemption Australian Government Department of Health, 2017b). Thus it can be seen that the implications of the economic policies for the mental health promotion, prevention and wellness in Australia is more directed towards the value-based health care. This is because, the health insurance for the mental health in Australia is more directed towards the value service which covers comprehensive mental health needs of the patients via providing them proper access to the psychiatrics, mental health nurse, occupational therapists and social workers. Not only, at the end of each treatment, the concerned mental health professionals are required to report back to the referencing medical practitioner about the progress of the patients and thus the payment is based on the overall therapy outcome. Moreover, it also attempts to reduce the waiting time for patients to visit the doctors which further increases the quality outcome.
After the passage of the ACA in 2010, the traditional roles and responsibilities and special authority of the healthcare stakeholders can now be altered or tested. Moreover, the health care providers can now share in savings, take risks and subsequently form relationships which were previously forbidden. Tracking the innovation patterns and emerging trends during the post-ACA marketplace has resulted in the proper identification of numerous high-level strategic trends which are promising potentials (Santilli & Vogenberg, 2015). The trends that will increasingly impact numerous healthcare stakeholders during the upcoming years in the US health care market include
(Santilli & Vogenberg, 2015)
Affordable Care Act of the Obama Care is a package of genuine reforms which plan to make major advances in developing innovative ways to deliver can fund health care services while requiring improvement in quality and safety. It also aims to expand the health workforce while implementing a while-of government approach to prevent and tackling health disparities. Application of ACA will help to reduce the health care cost by US$109 billion in the next decade (The Conversation, 2013). So in order reduce the health care cost of the mental health in Australia via implementing ACA act, the Australia health structure must attempt to reduce the health inequalities which are prevalent among the aboriginals and Torres Strait Islanders. In doing so, he inequalities in the social determinants of the health will reduce and thereby promoting optimal implementation of ACA towards mental health promotion, prevention and wellness. Moreover, reduction in the health inequalities will also led to the decrease in the mental health complications among aboriginals which will in turn reduce the overall healthcare economic burden (Jorm et al., 2012).
Washington State is located in the far northwestern part of the United States and it is regarded as the 18th largest state in US in the terms of the acquired surface area. It has a population size of 7.53 million during the ignition of the year 2018. According to the US Census Bureau, the population of the Washington State has increased from 2010 (6.72 million). At present, Washington is enjoying healthy growth rate of about 1.27% and its ranks 8th position within the whole country (World Population Review, 2018). According to the reports published by the Puget Sound Business Journal (2015), Washington State ranks 47 in the domain of mental health care. The main concern is the shortage of the mental health providers in the rural parts of the state. More than half of the counties in the Washington State have no practicing physiologist, psychiatrist and social workers. So in order to adequately implement the affordable care act of US in terms of mental health promotion, prevention and wellness, the government must first come forward with adequate policies of economic funding in order to generate proper mental health hospitals and healthcare centers in the rural parts of the state. These mental health hospitals will be brimmed with trained mental professionals and this will help to increase the overall access of healthcare via the adequate implementation of the ACA. Moreover, proper mental health care based community activities must be developed so that the mental health promotion in community level.
Conclusion
Thus from the above discussion, it can be concluded that the economic policies in the mental health care and promotions in US is volume based and that in Australia is value-based in its implementation approach. Moreover, it also highlighted that in order to implement mental health promotion policy in Australia; the health equalities prevalent among the aboriginal Australian population must be reduced. The study also revealed that in order to implementation mental health promotion and wellness in Washington state proper access to the mental health care facilities in the rural parts of the state needs to developed under proper funding.
References
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