White paper-profs22

Working hypothesis 1: Requiring health insurance corporations to cover the cost of mental health treatments would make medication easier to access for people struggling with depression and dramatically reduce the rates of suicide.

Working hypothesis 2: Requiring health insurance companies to pay the cost of medicine regarding mental health is not ideological in our society.

Sources:

“Insurance Coverage of Mental Health and Substance Abuse Services for Children and Adolescents: A Consensus Statement”

As the rate of mental illnesses in adolescence continues to increase yet there is still not enough to be done to help low income families cover the cost of medication.  Insurance companies limit the options and narrow down a track that must be followed, not to a patient’s specific needs, but rather a basic generalized plan.  The only way to fix this dilemma is to increase the resources made available, or else families who can not afford it may avoid treatment all together.  The earlier adolescence can get health care, the less likely their illness will continue to develop and worsen.  The psychological factors within the brain are more easily treated while it is still growing.  Access, coordination, and monitoring are the three key issues that must be addressed.  In terms of access, medicine can be very difficult to obtain.  External processes are mandated to receive approval.  There must be a direct line of communication between medical and mental health services.  This goes hand in hand with coordination.  Because the sectors do not properly communicate with each other, responsibilities are left unclear.  Thus, why families should have direct coordination with health services.  Another remaining issue is monitoring.  Families are left unclear on the information regarding the quality of services, otherwise guidelines are not specified to uninformed clients.

https://pediatrics.aappublications.org/content/106/4/860

 

“Prescribing of Psychotropic Medications to Patients Without a Psychiatric Diagnosis”

A study was conducted to compare individual’s ability to obtain a prescription with and without a diagnosis.  The end result was that a majority of individuals without a prescription were able to have access that medicine.  It appeared that patients within an older age range were less likely to get a prescription.  The study, written by Weichers, argues that, “that prescribing psychotropic medication in the absence of a psychiatric diagnosis is not uncommon, increases with age of the individual, is more prevalent in general medical practice than in mental health specialty care, and is modestly accounted for by the severity of an individual’s general medical illness or by medical indications for use.”  When further investigating the study, it is shown that the categories were broken up into medication (with six subgroups) and diagnosis. It was then proven that age had a big influence on the results.  The end results proving the hypothesis to be true.

https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201200557

 

“Health Reform and the Scope of Benefits for Mental Health and Substance Use Disorder Services”

The Patient Protection and Affordable Care Act provides protection for citizens in the united states to expand health insurance coverage, which includes providing mental health care for those who need.  Individuals suffering with severe disorders are required to go through external processes in order to obtain the medication needed.  So, it seems that the prescriptions are even harder to get for those who suffer even more, what is the logic in that?  The way that the protection act works is it expands the coverage for those of a certain age or certain income, so those who do not fall within the specified category are left out.  Individuals who are uninsured most likely have low incomes and will not meet to requirement to for coverage.  States are allowed to set their own criteria for what deems appropriate to receive insurance coverage, and often times target individuals with more severe situations.  The laws created do not specify specific diagnoses or prescriptions but instead generalizes them so that those with specific needs cannot get essential medicine.

https://ps.psychiatryonline.org/doi/full/10.1176/ps.2010.61.11.1081

“Health Insurance May Be Improving-But Not for Individuals with Mental Illness”

As individuals suffering with mental illnesses continues to increase, the number of employers who are willing to provide benefits decreases.  People who suffer from such disorder are way more likely to experience poverty or unemployment thus will not be able to afford insurance on there own let alone the help they need.  The help that individuals need is there.  In our society today there have been major advancements in medicine and technology, but the one issues is, its not easily available.  With more and more people suffering from major psychiatric disorders, employers and insurance companies are more likely to limit coverage in order to save money.  It is proven that people who suffer from mental health disorders most likely are uninsured why people who have no history of mental illness are insured.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1089099/pdf/hsresearch00009-0087.pdf

“Economic Grand Rounds: Experience With Mandated Use of Generic Medications for Patients Covered by the Mental Health Safety Net”

In this article it was found that physicians were unaware of the cost of the medication they were prescribing.  But having them prescribe cheaper alternatives will not reduce pharmacy costs.  In order to do these pharmacies must stick to generic medication.  Thanks to the mandated generic psychotropic medication policy if medication was denied individuals could appeal and get access to generic medicine with lower costs.  Once applied the new plan significantly decreased the cost of prescriptions. The amount of prescribed medicine continued to increase meaning more patients were able to get the help they needed, as well as the number of individuals with covered benefits. 

https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201400075

Definition/classification: It is not often understood what prescription do and do not need a diagnosis.  Many severe mental disorders require a diagnosis for treatment.

Cause/effect:  Requiring health insurance costs to be covered allows low income families get the medication they need to get better.

Rebuttal: Some may say that some of the medications necessary for treatment are dangerous and should not be more easily available.

Current State of Research: I think after writing this white paper I feel more confident about my research.  I have now found the evidence to back up my hypothesis and solidify my argument.  I am still slightly still confused on which issue to lead more toward, insurance coverage or diagnostics because they are both relevant to one another.

 

 

 

 

 

 

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