NURS 8100 Discussion Nursing and Health Policy in Other Nations

NURS 8100 Discussion Nursing and Health Policy in Other Nations

NURS 8100 Discussion Nursing and Health Policy in Other Nations

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There is no health care without mental health care and “access to mental health services is one of the most important and most neglected civil rights issues facing the Nation” (Haffajee et al., 2019). There are two policies addressing mental health in the United States (US), the Mental Health Parity Act (MHPA), enacted in 1996, to eliminate discriminatory insurance practices, and establish the no disparity principle, in health insurance between mental health and general medical benefits. The second was the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 to cover preventative services, mental health screenings and, eliminate the annual and lifetime benefit caps (Busch, 2012). The comparison policy is the Mental Health Act (1983) of the United Kingdom (UK), the main legislation that covers the mental health assessments, treatments, and the rights of these patients. This was amended to the Mental Health Act of  2007 mandating the health professionals, to detain, assess and treat these patients as needed, in the interests of their health, safety, or public safety (Keown et al., 2018).

The mental disorder still has associated stigma in both countries but has improved some. There are some notable differences in the policies: In the US a visit to a psychologist is perceived as routine, however, in Britain, the same visit is a major step, and an admission of an illness, which is still considered shameful, so these mental visits are publicized (Mills & Phull, 2017). This is mostly rooted in Britain’s reserved culture that, if a person is depressed, he should not make a fuss, but get on with it, or simply sort it out, so, these mental patients cannot share this information at work, fearing it would hamper their careers, and, if claiming that the job itself was contributing to that state, could be construed, as an admission that one is simply not up to the job (Mills & Phull, 2017). The U.S. has lesser mental health professionals, about 105 professionals per 100,000 people, while the UK has twice that number of mental health workers. In the UK, mental health services are available, and free for everyone through the National Health Service (NHS), with both psychiatrists and psychologists being part of the system, however, the consultant-led medical services have an 18-week maximum wait that is mandated by law. To be able to obtain mental health care under the NHS system, patients must be referred to a psychiatric specialist by their General Practitioner (GP), because mental health care is regarded as part of a patient’s overall health care and is approached in the light of their full medical history, with no reported issues or any care denial (Mulvaney-Day et al., 20 19) This applies to all mental patients, except those experiencing mental issues related to drug and, or alcohol abuse, who do not require a referral from a GP to obtain treatment. There is flexibility in the choice of practitioner, and the patients have the right to choose their first mental health practitioner, and if unsatisfied, can opt for a second opinion. There are still waiting lists for some treatments, like inpatient treatments, but most services are outpatient, similar to the US (Keown et al., 2018). The U.S mental health policies have been described as being in the dark ages because, they were not covered, and it was legal for the insurance companies to completely deny them, just because they could, and. It was only with the passage of the Affordable Care Act (ACA), in 2008, that the U.S system was slightly comparable to the U.K system. The UK system is considered very superior due to easy and free access through primary care, to the US system,  because its care access depends on the sick person’s ability to pay, leaving the patients at the mercy of the expensive inaccessible insurance coverage plans. US citizens in comparison to the UK citizens are among the most willing individuals, to seek mental health treatments, but they are the least likely to report access or affordability issues, which results in high unmet needs. This reflects a limited health system capacity, inability to meet the required needs, with data reporting that the US has some of the worst mental health-related outcomes, the highest suicide rates in the industrialized world, and the second-highest drug-related death rates in the world (Mulvaney-Day et al., 20 19).

Every U K resident has some form of health coverage, even before dissecting mental health services, which is distinctive, and their definition of health coverage includes mental health services. Nothing in the US mental system is free, and the patients solely depend on their insurance, and access to care depends on the affordability of the premiums, hindering much-needed care access. The NHS England expanded access to talk therapies in primary care settings more than a decade ago, through the Increasing Access to Psychological Therapies program. It now has more than 1.4 million patients in the program, served by specialized, nonclinical mental health practitioners, which has been described as the world’s most ambitious effort to treat depression, with reported favorable favorable outcomes (Keown et al., 2018). The US. leaders could learn from the UK, in terms of prioritizing mental health on the policy agenda, initiating interventions to reduce cost, and related access barriers, and overall improving and promoting the availability of community-based needed care.

The World Health Organization (WHO) is a global, technical, and normative agency that encourages research sets standards, and develops a wide range of advisory for governments and other stakeholders in its active Mental Health Division. The WHO through its division of the Plan of Action on Mental Health (PAHO), engages in the development and implementation of programs for the promotion and prevention of mental health systems and services. It then approves and adopts them through the World Health Assembly, an example is the adoption of the Comprehensive Mental Health Action Plan 2013–2020 by the 66th World Health Assembly, with a goal to promote further development of mental health policies across the world (Jenkins et al., 2011). These were broad strategies for mental health promotion, prevention of mental illness, promotion of rights, early childhood programs, life course skills, healthy working conditions, protection against child abuse, and domestic and community violence among others.  In its 2001 Report, the WHO,  functioned as a catalyst, setting out the rationale, with a broad framework for the development of mental health programmers (Jenkins et al., 2011).

References.

Busch S. H. (2012). Implications of the Mental Health Parity and Addiction Equity Act. The American journal of psychiatry169(1), 1–3. https://doi.org/10.1176/appi.ajp.2011.11101543

Haffajee, R. L., Mello, M. M., Zhang, F., Busch, A. B., Zaslavsky, A. M., & Wharam, J. F. (2019). Association of Federal Mental Health Parity Legislation with Health Care Use and Spending Among High Utilizers of Services. Medical care, 57(4), 245–255. https://doi.org/10.1097/MLR.0000000000001076

Jenkins, R., Baingana, F., Ahmad, R., McDaid, D., & Atun, R. (2011). International and national policy challenges in mental health. Mental health in family medicine, 8(2), 101–114.

Keown, P., Murphy, H., McKenna, D., & McKinnon, I. (2018). Changes in the use of the Mental Health Act 1983 in England 1984/85 to 2015/16. The British Journal of Psychiatry, 213(4), 595-599. doi:10.1192/bjp.2018.123

Mills, J., & Phull, J. (2017). The Mental Health Act 1983. InnovAiT. 2017;10(11):638-643. doi:10.1177/1755738017727021

Mulvaney-Day, N., Gibbons, B. J., Alikhan, S., & Karakus, M. (2019). Mental Health Parity and Addiction Equity Act and the Use of Outpatient Behavioral Health Services in the United States, 2005-2016. American journal of public health, 109(S3), S190–S196. https://doi.org/10.2105/AJPH.2019.305023

Think for a moment about nurses who relocate because of professional opportunities. How could such a seemingly personal decision have a detrimental impact on global health care? As presented in this week’s Learning Resources, nurse migration is of global concern. In response to this issue, international health care organizations such as the World Health Organization (WHO) and the International Council of Nurses (ICN) have positioned themselves to craft related policy as a solution. This is just one example of a global nursing policy effort.

To prepare:

With information from the Learning Resources in mind, select a U.S. nursing- or health-related policy.
Search the web and locate a similar policy in another country.
Consider how the two policies are similar and dissimilar.
Was an international organization involved in promoting the policies? If not, should they have been?
By Day 3

Post a cohesive response that addresses the following:

Post information on the nursing or health-related policies you located including a reference to the source.
Indicate the country you are comparing to the U.S.
Compare and contrast the two policies. What insights did you gain as a result of this comparison?
What is the role of international organizations in developing policy? Provide a specific example.

Read a selection of your colleagues’ postings.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

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Ask a probing question, substantiated with additional background information, evidence or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

NURS 8100 Discussion Nursing and Health Policy in Other Nations

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Submission and Grading Information
Grading Criteria

To access your rubric:

Week 10 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 10 Discussion

Name: NURS_8100_Week10_Discussion_Rubric

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List View

Excellent Good Fair Poor

RESPONSIVENESS TO DISCUSSION QUESTION

Discussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE

Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

CONTRIBUTION TO THE DISCUSSION

Points Range: 8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.Points Range: 7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

Points Range: 0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING

Points Range: 6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

Points Range: 5 (16.67%) – 5 (16.67%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

Points Range: 4 (13.33%) – 4 (13.33%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

In this week’s learning resources we reviewed how healthcare is provided in various countries impacting the international continuum of care.  This international continuum of care has been a topic of interest for centuries, but really pick up momentum as individuals gained access to convenient and fast international travel.  Bodenheimer & Grumback (2020) shared that there is no universal design for healthcare delivery. This discrepancy can be a barrier and opportunity for each country to tailor the delivery system to what their population of citizens.  For example, social determinants of health are addressed differently in each country.  Additionally, various nursing organizations are also focused on the international continuum of care.  The International Council of Nursing (n.d.) is focused on several international nursing policies like socio-economic welfare.  This is a demonstration of the role of an international organization in developing policy.

I am currently working in collaboration with a university in Rwanda creating curriculum content for a Nursing Leadership and Midwifery graduate level program.  I am also an international nursing mentor and am working with students in Rwanda and Kenya on implementing quality improvement projects.  The country that I am comparing to the U.S. is Rwanda.

A policy that Rwanda’s Ministry of Health (n.d.) is working on is related to how social determinants of health are addressed.  Rwanda is currently rebounding from civil war in the mid 1990’s.  In the past several decades they have made significant improvements in address it’s citizens social determinants of health.  However, the country has an opportunity to optimize this effort due to persistent extreme poverty, overexploited land, and effects of climate change on housing and healthcare (Government of the Republic of Rwanda Ministry of Health, n.d.).  The country’s nursing population is also largely midwives due to lack of providers in the country.  Bazirete et. al. (2020) shared how social determinants of health impact maternal mortality and morbidity in rural Rwanda.

Social determinants of health is also a policy that is address in the U.S.  The American Academy of Nursing has a policy from 2019 which prioritizes a focus on social determinants of health for nursing (Kuehnert et. al., 2022).  We’ve incorporated social determinants of health into screening tools and electronic health records to provide targeted population health to support our existing healthcare system and reduce the burden on resources.  Bedside nursing is incorporating social determinants of health into clinical practice by allowing the information to impact clinical decision making for improved health outcomes (Phillips et. al., 2020).

From the comparison between how Rwanda and the U.S. are creating policy around social determinants of health I’ve gained an understanding of how different the social needs of each country can be.  Additionally, I’ve gained an understanding that it’s challenging to compare a third world and first world healthcare system.  Each country is working with vastly different healthcare resources, infrastructure, and population health needs.

References

Bazirete, O., Nzayirambaho, M., Umubyeyi, A., Uwimana, M. C., & Evans, M. (2020).    Influencing factors for prevention of postpartum hemorrhage and early detection of      childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives. BMC Pregnancy and Childbirth, 20(1), 678.     https://doi.org/10.1186/s12884-020-03389-7

Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th    ed.). McGraw-Hill.

Government of the Republic of Rwanda Ministry of Health. (n.d.). Policies.             https://www.moh.gov.rw/publications/policies

International Council of Nurses. (n.d.). https://www.icn.ch/nursing-policy

Kuehnert, P., Fawcett, J., DePriest, K. N., Chinn, P., Cousin, L., Ervin, N., Flanagan, J., Fry-        Bowers, E., Killion, C., Maliski, S., Manughan, E., Meade, C., Murray, T., Schenk, B., &        Waite, R. (2022). Defining the social determinants of health for nursing action to achieve         health equity: A consensus paper from the American Academy of Nursing. Nursing       Outlook, 70(1), 10-27. http://doi.org/10.1016/j.outlook.2021.08.003

Phillips, J., Richard, A., Mayer, K. M., Shilkaitis, M., Fogg, L. F., & Vondracek, H. (2020).         Integrating the social determinants of health into nursing practice: Nurses’        perspectives. Journal of Nursing Scholarship, 52(5), 497–505. https://doi.org/10.1111/jnu.12584