Every year, the U.S. Department of Health and Human Services designates topics and dates for specific National Health Observances every month. October 2011 appears to be a "month for the mind" with at least three events that focus on mental health. The first is Mental Illness Awareness Week from October 2 to October 8, organized by the National Alliance on Mental Illness and titled, "Changing Attitudes, Changing Lives." The second is National Depression Screening Day on October 6, organized by Screening for Mental Health. The third is World Mental Health Day on October 10, sponsored by the World Federation for Mental Health and titled, "The Great Push: Investing in Mental Health." The main goal of all these activities is to raise awareness about mental health issues in the community and among health professionals. The fear of stigma continues to plague persons affected by mental illness; education, access, and treatment are steps to breaking down that barrier. Depression accounts for numerous visits annually to primary care providers and is the "leading contributor to disability-adjusted life years" in the United States and Canada.1 No one can dispute the reality that resources for mental health, personnel and programming, are inadequate to meet the needs of the nation's population. This month's CE activity on page 14 features an in-depth view of pharmacogenetics and pharmacological management of depression.
Plans to improve mental health
Healthy People 2020's (HP2020) overall objective for the category Mental Health and Mental Disorders (MHMD) is to "improve mental health through prevention and by ensuring access to appropriate, quality mental health services." MHMD-11 aims to "increase depression screening by primary care providers." The document specifically identifies three new mental health issues affecting certain populations: "veterans who have experienced physical and mental trauma; people in communities with large-scale psychological trauma caused by natural disasters; and older adults, as the understanding and treatment of dementia and mood disorders continues to improve."2 I would add another category, individuals who have had difficulty coping with the effects of today's economic uncertainty and the direct impact on their individual lives.
NPs routinely assess the mental health status of their patients, but might not always systematically record that evaluation. With interactive computerized clinical decision support systems, however, depression is frequently one of the conditions integrated into the assessment at scheduled intervals as a reminder to clinicians. An evaluation outside the norm will prompt a sooner reevaluation, making documentation relative to mental health interventions easier.
Undiagnosed mental illness can pose a problem for the individual and others in contact with that person, as witnessed by the numerous violent attacks that have been reported in the news this year. It is only natural to question why this person had not received professional help for suspected or even known emotional instability. Provisions in the Affordable Care Act should increase access to mental health and substance abuse services and payment by insurers for treatment in parity with services provided for physical health conditions.
Getting the word out
Increased awareness and acceptance of mental health will, hopefully, lead to improved access and treatment. On the websites of the three organizations mentioned above are suggestions for activities you can plan not just on designated days but everyday. Non-healthcare providers are also encouraged to initiate activities such as educational programs and screenings in churches, schools, or any open venue. Visit HP2020 often at http://www.healthypeople.gov to review overall goals and objectives for the nation's health, including mental health. Evidence-based solutions are provided for every category, and as always prevention is the key.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP
Editor-in-Chief mailto:[email protected]
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