Challenges and Solutions for Long-Term Care in Aging Populations
Author Note
Challenges and Solutions for Long-Term Care in Aging Populations
More than 10 million Americans are living with chronic disabilities. Long term health care services are needed to assist them in their daily activities. Mental health problems are widespread in the United States and if these conditions are not treated adequately then it can lead to increased health care costs. Most of the adults living in nursing homes face severe behavioral and psychiatric problems with an estimated prevalence of 65-91%. According to the data available, depression is the most common mental health condition among both community-dwelling and nursing homes. Despite the need for high-level care, people in the long term care system fail to get the appropriate mental health services. Current treatment for mental health care is not appropriate to address the complex mental illness challenges. There is a need to develop new research methods regarding mental health care delivery. The existing model of current treatment and care fails to address adequately the global challenges of mental health care ADDIN EN.CITE <EndNote><Cite><Author>Bronkhorst</Author><Year>2015</Year><RecNum>278</RecNum><DisplayText>(Bronkhorst, Tummers, Steijn, & Vijverberg, 2015)</DisplayText><record><rec-number>278</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573886946">278</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Bronkhorst, Babette</author><author>Tummers, Lars</author><author>Steijn, Bram</author><author>Vijverberg, Dominique</author></authors></contributors><titles><title>Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations</title><secondary-title>Health care management review</secondary-title></titles><periodical><full-title>Health care management review</full-title></periodical><pages>254-271</pages><volume>40</volume><number>3</number><dates><year>2015</year></dates><isbn>0361-6274</isbn><urls></urls></record></Cite></EndNote>(Bronkhorst, Tummers, Steijn, & Vijverberg, 2015).
Worldwide mental health problem accounts for 1/3rd of the disability resulting in socioeconomic cost and personal suffering. Severe mental health illness includes bipolar disorder, depressive disorder, substance use disorder and schizophrenia, affecting all age groups in both developed and developing countries. Mental health problem is a major global health challenge. During the last few decades, despite the increased availability of antidepressants, safety issue, limited efficacy and high cost of treatment is present. In the United States, enormous occupational, social and psychological costs are associated with mental health issues, which is one of the leading causes of disability among individuals aged 16- 45 years. Suicide is the second leading cause of death in 16 -30 years old, which results in great social disruption and productivity loss. Almost 10 – 20 million individuals with depression attempt suicide every year. In 2016, in response to these alarming conditions, WHO declared depression as one of the major causes of disability. Mental health care plan (2013-2020) was published by WHO with four major objectives:
Effective governance and leadership for mental health
Provision of integrated and comprehensive social care and mental health services in a community-based setting
Implementation of different strategies for prevention and promotion
Strengthening of evidence, research and information system
One of the most important opportunities to prevent mental health illness is to provide basic physiotherapy techniques and pharmacological regimens for common mental health problems. In the United States, it's become essential to improve the mental health of people. The economic burden of this disease is tremendous. In 2010, the estimated annual cost of depression was $210.5 billion including both indirect and direct costs such as cost associated with increased mortality rate and absenteeism. In 2013, the cost of opioid use disorder was estimated to be $78.5 billion. It is estimated that by 2020, the mental health disorder direct cost alone will increase to $280 billion. Despite the high prevalence of mental health problems, nursing home administrators are often ill-equipped to provide adequate services to patients with a mental illness.
Different studies have found that more than half of the nursing homes do not have access to adequate mental health consultations and more than 70% are not able to obtain educational services and consultations for their behavioral problems. There is a great need to improve the quality and access to mental healthcare services within the nursing homes. Today, mental health problem is a major concern not only among clinicians, administrators and advocates but also for the enforcement system and policymakers. Another challenge is a social stigma that is associated with seeking mental health care services. It prevents many individuals with mental health problems from obtaining and seeking adequate care. Collaborative and integrated care are effective models of care for addressing mental health issues. In this model, behavioral health clinicians work together with families and patients, using a cost-effective and systematic approach of providing patient-centered care. This model addresses substance abuse, health behaviors, life crises and stressors and ineffective patterns of health care ADDIN EN.CITE <EndNote><Cite><Author>Orthwein</Author><Year>2017</Year><RecNum>280</RecNum><DisplayText>(Orthwein, 2017)</DisplayText><record><rec-number>280</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887170">280</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Orthwein, William C</author></authors></contributors><titles><title>Psychiatric and mental health nursing: The craft of caring</title></titles><dates><year>2017</year></dates><publisher>CRC Press</publisher><isbn>1444166492</isbn><urls></urls></record></Cite></EndNote>(Orthwein, 2017).
In the United States, there are two parallel education systems and clinical care i.e. CAM-related training programs in herbal medicine, naturopathy and Chinese traditional medicine and Conventional training programs in psychiatry. However, most of the training programs offer no or limited opportunities for training, education and research. Successful implementation of the integrative medicine program can provide rigorous training with the main emphasis on the integrated mental health care plan ADDIN EN.CITE <EndNote><Cite><Author>Happell</Author><Year>2015</Year><RecNum>282</RecNum><DisplayText>(Happell et al., 2015)</DisplayText><record><rec-number>282</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887234">282</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Happell, Brenda</author><author>Bennetts, Wanda</author><author>Harris, Scott</author><author>Platania‐Phung, Chris</author><author>Tohotoa, Jenny</author><author>Byrne, Louise</author><author>Wynaden, Dianne</author></authors></contributors><titles><title>Lived experience in teaching mental health nursing: Issues of fear and power</title><secondary-title>International Journal of Mental Health Nursing</secondary-title></titles><periodical><full-title>International Journal of Mental Health Nursing</full-title></periodical><pages>19-27</pages><volume>24</volume><number>1</number><dates><year>2015</year></dates><isbn>1445-8330</isbn><urls></urls></record></Cite></EndNote>(Happell et al., 2015). The web-based education program can also play an important part in the training of integrative practitioners. Psychiatric rehabilitation seeks to influence both the challenges and strengths of individuals. Psychosocial rehabilitation supports people with mental health problems in developing emotional, social and cognitive skills. However, this type of intervention is considered as a second and third line of treatment. The government and health care administration have recognized the importance of the mental wellbeing of all citizens. Mental health is fundamental to the quality of life that enables individuals to be active and more creative. Generic and educational mental health training is important for health care administration to improve job satisfaction, staff performance and quality of care to individuals with mental health problems. Good communication skills are essential for positive resident staff interaction. Research has shown a positive effect of communication skills in individuals with mental health issues. Another challenge associated with the mental health problem is the implementation of interventions that are supported by scientific evidence ADDIN EN.CITE <EndNote><Cite><Author>Levecque</Author><Year>2017</Year><RecNum>279</RecNum><DisplayText>(Levecque, Anseel, De Beuckelaer, Van der Heyden, & Gisle, 2017)</DisplayText><record><rec-number>279</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887018">279</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Levecque, Katia</author><author>Anseel, Frederik</author><author>De Beuckelaer, Alain</author><author>Van der Heyden, Johan</author><author>Gisle, Lydia</author></authors></contributors><titles><title>Work organization and mental health problems in PhD students</title><secondary-title>Research Policy</secondary-title></titles><periodical><full-title>Research Policy</full-title></periodical><pages>868-879</pages><volume>46</volume><number>4</number><dates><year>2017</year></dates><isbn>0048-7333</isbn><urls></urls></record></Cite></EndNote>(Levecque, Anseel, De Beuckelaer, Van der Heyden, & Gisle, 2017). To overcome these training programs, hospital administration should be designed to improve their knowledge and communication skills.
One of the most important steps that is needed to improve mental health care is the development of plan and policy. This will guide health care administrators of the principles and objectives of mental health care. Steps should be taken to educate the public about the nature and scope of mental health disorders ADDIN EN.CITE <EndNote><Cite><Author>Slimmer</Author><Year>2016</Year><RecNum>281</RecNum><DisplayText>(Slimmer, Wendt, & Martinkus, 2016)</DisplayText><record><rec-number>281</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1573887200">281</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Slimmer, Lynda W</author><author>Wendt, Anne</author><author>Martinkus, Dalia</author></authors></contributors><titles><title>Effect of psychiatric clinical learning site on nursing students' attitudes toward mental illness and psychiatric nursing</title><secondary-title>Journal of Nursing Education</secondary-title></titles><periodical><full-title>Journal of Nursing Education</full-title></periodical><pages>127-133</pages><volume>29</volume><number>3</number><dates><year>2016</year></dates><isbn>0148-4834</isbn><urls></urls></record></Cite></EndNote>(Slimmer, Wendt, & Martinkus, 2016). Community mental health care services should be provided such as rehabilitation services, group homes, support services and assistance to families.
References
ADDIN EN.REFLIST Bronkhorst, B., Tummers, L., Steijn, B., & Vijverberg, D. (2015). Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations. Health care management review, 40(3), 254-271.
Happell, B., Bennetts, W., Harris, S., Platania‐Phung, C., Tohotoa, J., Byrne, L., & Wynaden, D. (2015). Lived experience in teaching mental health nursing: Issues of fear and power. International Journal of Mental Health Nursing, 24(1), 19-27.
Levecque, K., Anseel, F., De Beuckelaer, A., Van der Heyden, J., & Gisle, L. (2017). Work organization and mental health problems in PhD students. Research Policy, 46(4), 868-879.
Orthwein, W. C. (2017). Psychiatric and mental health nursing: The craft of caring: CRC Press.
Slimmer, L. W., Wendt, A., & Martinkus, D. (2016). Effect of psychiatric clinical learning site on nursing students' attitudes toward mental illness and psychiatric nursing. Journal of Nursing Education, 29(3), 127-133.
