NURS 6050 Week 1 Discussion Presidential Agendas
Walden University NURS 6050 Week 1 Discussion Presidential Agendas-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6050 Week 1 Discussion Presidential Agendas assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
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Whether one passes or fails an academic assignment such as the Walden University NURS 6050 Week 1 Discussion Presidential Agendas depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6050 Week 1 Discussion Presidential Agendas
The introduction for the Walden University NURS 6050 Week 1 Discussion Presidential Agendas is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NURS 6050 Week 1 Discussion Presidential Agendas
After the introduction, move into the main part of the NURS 6050 Week 1 Discussion Presidential Agendas assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6050 Week 1 Discussion Presidential Agendas
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6050 Week 1 Discussion Presidential Agendas
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Mental health and substance abuse receive presidential attention as they profoundly affect the overall health of the nation. Although various social determinants affect mental health, socioeconomic status can have grave effects on this population. Lower income, lack of education and resources, as well as reduced access to healthcare are all part of the significant determinants that affect mental health. “Research shows that mental illnesses are common in the United States, affecting tens of millions of people each year. Estimates suggest that only half of the people with mental illnesses receive treatment” (National Institute of Mental Health [NIMH], 2021). Alongside mental health, the crisis of opioids has been brought to the forefront on the presidential level. “Opioid misuse and abuse in the USA has evolved into an epidemic of tragic pain and suffering, resulting in the estimated death of over 64,000 people in 2016. Governmental regulation has escalated alongside growing awareness of the epidemic’s severity, both on the state and federal levels” (Jones, 2018).
During Barak Obama’s presidency 2009-2017 he focused on mental health as part of his broader healthcare reform efforts. This was demonstrated by The Affordable Care Act (ACA), which was signed into law in 2010. The Affordable Care Act (ACA), was created to expand mental health coverage by requiring insurance plans to cover mental health services. Donald Trump, on the other hand, focused on Veterans’ mental health, through Executive Order 13861. PREVENTS, which was signed on March 5, 2019, was created to implement an “all of nation” approach to prevent suicide, and his efforts were also seen when he addressed the opioid crisis, also known to have significant effects on overall mental health. While they both had a unique way of approaching mental health, they both targeted limited access to mental health which contributes to disparities within this population. One thing I would do differently is to address the affordability. The Affordable Care Act has made healthcare coverage more accessible, however many families still can’t afford the high costs of premiums. One possible way to counteract the high costs is by promoting competition among issuers to keep the costs down. In order to address the continuous issue of healthcare disparities, a combination of changes needs to occur, such as public opinion, legislative processes along the priorities of policymakers.
NURS 6050 Week 1 Discussion Presidential Agendas
NURS 6050 Week 1 Discussion Presidential Agendas
The healthcare system is highly sensitive and that is why presidents have to make critical decisions and ensure the safety of their citizens. I agree with you that the opioid epidemic is one of the healthcare issues that rose to the presidential level. Opioid misuse presents various health risks and that is why it was necessary to engage the presidential intervention. President Bush’s administration approached the issue in three ways. First, the administration provided efforts to stop the kids from using the drug. Secondly, the treatment for those already using the drug was expanded and finally, the flow of the drug into America was controlled. The measure would be undertaken for infectious diseases that arise, Breaking the infection cycle is important in managing health crises and emergencies (Hedberg, et al., 2019).
The Obama administration approached the issue more comprehensively and approved the CAR bill to fight the epidemic. Similarly, President Donald Trump declared the epidemic a national state of emergency and this was appropriate. I agree that health issues require urgent intervention to curb the causative factors and prevent the issue from spreading further and this is what the three presidential administrations did.
The presidents must be sensitive to identify the impacts of given health issues and develop appropriate policies that will minimize the harmful effects the citizens suffer (Smith, 2020). In this case, the use of opioid drugs was on the rise and the level could have been very disastrous if the relevant measures developed were not adopted. It is important that government systems set aside funds to handle medical emergencies whenever they rise because they cannot be postponed (Katz, Attal-Juncqua & Fischer, 2017).
NURS 6050 Week 1 Discussion Presidential Agendas References
Hedberg, K., Bui, L. T., Livingston, C., Shields, L. M., & Van Otterloo, J. (2019). Integrating public health and health care strategies to address the opioid epidemic: the Oregon Health Authority’s Opioid Initiative. Journal of Public Health Management and Practice, 25(3), 214-220. doi: 10.1097/PHH.0000000000000849.
Katz, R., Attal-Juncqua, A., & Fischer, J. E. (2017). Funding public health emergency preparedness in the United States. American journal of public health, 107(S2), S148-S152. doi: 10.2105/AJPH.2017.303956
Smith, H. J. (2020). Ethics, Public Health, and Addressing the Opioid Crisis. AMA Journal of Ethics, 22(8), 647-650. doi: 10.1001/amajethics.2020.647.
Mental health has always been a topic of discussion as I feel like since it isn’t something tangible it was easily misunderstood. Back in the day when mental health began to get treated, asylums were using shackles to restrain patients which was very inhumane so in 1953 those shackles were melted down and turned into the mental health bell as a sign of hope for the future of mental health treatments (Mental Health America, 2022). Throughout the years mental health resources and treatments have advanced and during the pandemic in quarantine it was extremely hard being isolated and alone which increased mental health awareness. However, mental health continues to be something to create more awareness and understanding around as it is still a huge stigma and people need to know that it is okay to talk about it and not be ashamed.
The current legislations for mental health currently are RISE which provides support for those who suffered a trauma, the Mental Health Services for Students Act which is meant to identify and intervene for the at-risk population, and three legislations aimed at integrated treatment (Mental Health America, 2022). These legislations are great, but being in healthcare there needs to be more support for us as the pandemic brought that to light.
NURS 6050 Week 1 Discussion Presidential Agendas References
Current Mental Health Legislation. Mental Health America. (2022). https://mhanational.org/issues/current-mental-health-legislation
The Mental Health Bell. Mental Health America. (2022). https://mhanational.org/mental-health-bell
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?
To Prepare:
- Review the Resources and reflect on the importance of agenda setting.
- Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
By Day 3 of Week 1
Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
RE: Discussion – Week 1
If you are having difficulty deciding on a topic, consider topics in Healthy People 2020 or Healthy People 2030. Some examples are opioids, HIV, mental health, prescription drug costs, obesity, vaccine hesitancy, and telehealth. President Biden is not one of the three If you are having any trouble, please email me. The post is due by Day 3 (Wednesday) and must use at least three sources. I am looking forward to reading your posts.
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RE: Discussion – Week 1
Presidential agendas and the Fight Against Opiates
In 2018, 1.6 million Americans had been diagnosed with Substance Use Disorder (Department of Health and Human Services, 2019). Each of the past three presidents has attempted to combat this issue in varying approaches. The opiate epidemic was declared a national emergency by President Trump in October of 2017. The Centers for Disease Control and Prevention estimates that the total economic burden of prescription opioid misuse alone in the United States is $78.5 billion a year, including healthcare costs, lost productivity, addiction treatment, and criminal justice involvement (NIH, 2018).
During the Bush administration, the white house outlined goals including education and resources for young people, healing America’s drug users, and disrupting drug markets (The White House, 2006). This outlined plan included The First Lady leading a community outreach website named “The Community Guide to Helping Americas Youth.” This site had data on poverty, unemployment, substance use, and a list of helpful resources. A key priority of this administration was to make drug screening and intervention programs part of the nation’s existing network of health, education, law enforcement, and counseling providers (The White House, 2006). The Bush administration focused on poly-substance use and the entrance of all substances coming into the U.S., focusing on prevention and community outreach.
During Obama’s presidency, the opiate epidemic significantly increased. The Obama administration announced the allocation of new grant funding to fight the nation’s growing opioid use and abuse epidemic. $53 million will be shared across the United States to allow access to treatment, increase data surveillance involving substance use disorder and curb the use of opiates (Petruzelli, 2017). The 2011 Prescription drug abuse Program included action plans to improve education, monitoring, proper medication disposal, and law enforcement (The White House, 2016). Ultimately, this program focused on preventing doctor shopping, overprescribing, and providing law enforcement tools to rid illegal opiate pill mills. Overall, this administration contributes much progress and funding to battle the rising opiate epidemic.
Lastly, The Trump administration declared a National Emergency in 2017, shortly after the president was elected. The Certified Community Behavioral Health Clinic Act was improved, which expanded care to treatment centers and addiction services. This Act included increasing the number of practitioners that can prescribe Buprenorphine, the gold standard for treatment of opiate use disorder, allow Medicare to include MAT (medicated assisted treatment), and removed barriers that will allow for medication-assisted treatment via telehealth. President Trump emphasized deterring international illicit drug supply chains by increasing monitoring at borders and ports into the U.S. (The White House, 2018). Trump advanced the SUPPORT Act, the single most extensive legislative package addressing a single drug crisis in history (White House, 2018). The SUPPORT Act ultimately includes all aspects of opiate use disorders, including neonatal withdrawal coverage, which hadn’t been previously covered.
Ultimately, The United States opioid epidemic has been worsening for many, many years. Each president was contributing and funding efforts in many of the same areas of the preceding president. Something that could have been done differently is a quicker emergency response to the increasing number of deaths by the day. Also, only in recent years has medication-assisted treatment (MAT) been funded to treat opiate use disorder. Suppose these medications, such as Buprenorphine, had been approved by Medicare in earlier stages of the epidemic. In that case, the number of deaths could have been decreased by utilizing this evidence-based practice.
Presidential Agendas
Rather than focus on the treatment of chronic disease, policies that influence population health tend to emphasize prevention and wellness; the reduction or elimination of waste and the eradication of health disparities based on race, ethnicity, language, income, gender, sexual orientation, disability and other factors. The reasoning is that good health belongs to the whole, not just an individual. (New York State Dept. of Health, n.d.)
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic (mental health, HIV, opioid epidemic, pandemics, obesity, prescription drug prices, or many others) that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently?
Reference:
New York State Department of Health. (n.d.). Making New York the healthiest state: Achieving the triple aim. Retrieved June 21, 2021 from https://www.health.ny.gov/events/population_health_summit/docs/what_is_population_health.pdf
To Prepare:
- Review the Resources and reflect on the importance of agenda setting.
- Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.
By Day 3 of Week 1
Post your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. How did two recent presidents handle the problem? What would you do differently?
Agenda setting refers to the systematic process of bringing a certain issue to the notice of the government, thereby facilitating the consideration of potential solutions. Healthcare professionals, including registered nurses, advanced practice registered nurses, and other interprofessional healthcare workers, have the opportunity to utilize the insights gained from these case studies to address the numerous challenges they encounter in their practice. The primary focus of early political science researchers was the examination of the subsequent stages of policy implementation and evaluation. Their objective was to acquire comprehensive insights into public policy, with the intention of providing policymakers with valuable knowledge that may facilitate the development of more effective public policies (Milstead & Short, 2019). The subject of discussion is the opioid pandemic, which is a prominent public health concern within the nation. The opioid epidemic is a significant public health crisis that has garnered widespread attention and concern.
According to Lyden and Binswanger (2019) The opioid epidemic in the United States is a pervasive public health concern that spans the entire nation. The first surge in the use and accessibility of pharmaceutical opioids is responsible for the rise in opioid overdoses. However, it is important to note that the current trend indicates a growing association between opioid overdoses and the use of heroin, as well as the illicit production of fentanyl and its analogs. In order to effectively tackle this widespread issue, it is imperative to confront the negative societal perception surrounding opioid use disorders and the treatment methods available for them. Furthermore, we should strive to improve the availability of effective treatment options, such as methadone and buprenorphine. Moreover, prioritizing the distribution of naloxone, an opioid antagonist and overdose reversal agent, can minimize fatalities resulting from opioid overdoses. The number of fatalities resulting from opioid overdoses in the United States exceeded 42,000 in the year 2016.
President Trump
According to The White House (n.d.), in October 2017, the declaration of the opioid crisis as a public health emergency was made by President Trump. Since its inception, the Trump administration has implemented a comprehensive approach across all branches of government to address the epidemic. This approach encompasses a wide array of activities that exemplify the president’s dedication to effectively curbing the issue. One strategy is the reduction of demand and overprescription, which encompasses the dissemination of knowledge among the American population on the perils associated with the misuse of opioids. The second component involves reducing the availability of illegal narcotics by implementing stricter measures against both the global and domestic networks responsible for distributing drugs, which have detrimental effects on American communities. The Third Part aims to provide assistance to individuals facing addiction by offering evidence-based treatment and support services for their recovery. As of October 2018, the Trump Administration had successfully obtained an additional $6 billion in funding within a two-year timeframe to combat the issue of opioid abuse. In order to address the issue of excessive prescription rates, the President has introduced a Safer Prescribing Plan aimed at reducing opioid prescription fills by 33% within a span of three years. President Trump actively engages in efforts to prevent the entry of hazardous pharmaceuticals into the United States by implementing measures that enhance security at land borders, ports of entry, and waterways, curbing smuggling activities. In 2018, President Trump and Congress successfully enacted the SUPPORT Act, which tackled a singular drug issue and became the most extensive legislative measure ever undertaken.
President Biden
President Biden acknowledges the profound ramifications that the overdose crisis has inflicted upon the United States, affecting major urban centers, rural areas, indigenous territories, and all other localities within the country. Hence, during his initial State of the Union address, President Biden prioritized the resolution of the opioid crisis as a fundamental component of his Unity Agenda. In doing so, he delineated essential measures that the Biden-Harris Administration is undertaking to combat this catastrophe and provide assistance to the substantial number of Americans engaged in the process of recovery. Today, the White House has made public a series of new and recent measures in observance of National Recovery Month. The allocation of $1.5 billion to all states and territories is intended to address the issue of addiction and the opioid crisis. The award programs allocate funds to states and territories with the aim of enhancing the availability of treatment for substance use disorder, eliminating obstacles to public-health measures like naloxone, and broadening the reach of recovery support services, including 24/7 opioid treatment programs. The allocation of funds will additionally enable governments to augment their efforts in overdose education, peer support specialists stationed in emergency departments, and other methods aimed at preserving lives in places severely affected by the crisis (The White House, 2022).
What modifications would I implement in order to achieve different outcomes?
Both presidents recognized these difficulties and implemented distinct approaches to address the crisis. The Biden-Harris Administration has corrected the deficiency of President Trump’s administration by addressing the rehabilitation and treatment part of the problem. Each successive president assimilates knowledge from the experiences of their predecessor and employs strategic measures to address emerging obstacles encountered during crisis resolution. President Biden demonstrated effective leadership by implementing programs and allocating funds to states and territories, thereby enhancing the availability of treatment options for individuals grappling with substance use disorder. Additionally, he endeavors to eliminate obstacles to the availability of naloxone and enhance the accessibility of recovery support programs, such as the 24/7 Opioid Treatment Program. This is what I would have done too. Both individuals did great and have contributed to the pride of Americans by employing distinct approaches to addressing this challenge.
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning
Lyden, J., & Binswanger, I. A. (2019). The United States opioid epidemic. Seminars in perinatology, 43(3), 123–131. https://doi.org/10.1053/j.semperi.2019.01.001
The White House (n.d.). Ending America’s Opioid Crisis. https://trumpwhitehouse.archives.gov/opioids/
The White House. (2022). FACT SHEET: Biden-Harris Administration Announces New Actions and Funding to Address the Overdose Epidemic and Support Recovery. https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/23/fact-sheet-biden-harris-administration-announces-new-actions-and-funding-to-address-the-overdose-epidemic-and-support-recovery/
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
Policies, Problems, and Planning to Reach Rural Veterans
Suicide accounts for 8.3% of deaths among U.S. adults, and Veterans alone represent an unignorable 14.3% of these tragedies (Department of Veterans Affairs [VA], 2018). Consequently, death by suicide for the veteran patient population is 1.5 times the rate of non-veteran sufferers (VA, 2018). Our current and previous presidential administrations have contributed to the funding and development of veteran suicide research and interventions. Since the inception of the Veterans Access, Choice and Accountability Act (CHOICE Act) of 2014, veteran suicide data and research has enabled policy makers to focus on reaching veterans living in rural areas. Veterans living in rural areas account for nearly one fourth of the veteran population (VA,2018). Veterans living in rural areas have a 20%-22% greater risk of death by suicide in comparison to veterans living in urban areas. According to the Veterans Affairs Office of Rural Health, 4.7 million veterans return from active military careers to live in rural areas, only 2.5 million are enrolled to receive VA health care services, and far more than half of enrolled veterans living in rural areas have service-connected disabilities (VA.gov: Veterans Affairs 2016).
In 2014, President Barrack Obama and Senator John McCain III set the groundwork for veteran mental health care reform with the passage of the Veterans Access, Choice and Accountability Act (CHOICE Act) of 2014. With this act, veterans in rural areas had expanded options to receive care from non-VA providers with the VHA’s coordination and approval. The CHOICE Act also highlighted health care staffing disparities via staff shortage reports required by the VA Office of Inspector General, and the identification of the need to increase Graduate Medical Education (GME) residency positions in the mental health specialty.
The Choice Act was further amended in 2016 with the passing of the Jeff Miller and Richard Blumentha Veterans Heath Care and Benefits Improvement Act to further increase the number of GME residency positions over 10 years instead of five and extended the program to 2024 (Albanese et al., 2019). Despite the increase in GME residency positions and extensions of program funding, health care disparities in rural areas continued their negative trend. At this point, veteran advocates and policy makers identified the physician shortage gap in rural areas as a mission-critical priority for the VHA and began working towards the John S McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal System and Strengthening Integrated Outside Networks (MISSION) Act of 2018.
In June 2018, the Obama administrations groundwork for the MISSION Act paved the way for the Trump Administration to see it through to fruition. With the problem stream of rural access leading policy formation, the MISSION Act created interventions based on physician shortages that now determine location, specialty, and amount GME residency positions within outlined parameters. Essentially focus has shifted from interventions to bring veterans to health care providers (HCP), to interventions to bring HCP to veterans. These interventions include expanding VA Health Care Profession Scholarships (HPSP) to graduate education for nurse practitioners select, who are allowed to practice at their full scope of practice without physician supervision. These expansions will increase patient access to quality health care and improve staffing shortages in rural veteran communities (American Association of Colleges of Nursing [AACN], 2016). In addition to GME improvements, veterans now could seek medical assistance from non-VA facilities without penalty when in need.
Most recently, the Biden Administration passed the Sgt. Ketchum Rural Veterans Mental Health Act of 2021. This bill was created in honor of its name’s sake, Sergent Brandon Ketchum, in addition to many other sailors, marines, and soldiers who lost their battles with suicidal ideation in the face of limited access to care. Sgt. Ketchum was a 33-year-old Operation Iraqi Freedom Veteran who served in Iraq and Afghanistan struggled with post-traumatic stress disorder and substance abuse after returning home to a rural area in Iowa. In 2016 he presented to the Iowa City VA Hospital where he asked to be admitted before the psychiatrist determined inpatient care was not needed at the time. Brandon returned home and committed suicide that night. An investigation was completed and no HCP’s were found to be directly responsible for his death; however, quality patient education on suicidal ideation, risk factor ratings, and access to routine outpatient psychiatric mental health services or the lack there of could be at fault. Under this bill, rural veterans diagnosed with Schizophrenia, Schizoaffective Disorder, Bipolar Affective Disorder, Major Depression, PTSD, and any severe or chronic mental health condition will have access to Rural Access Network for Growth Enhancement (RANGE) programs (Veterans Health Administration, VA.gov: Veterans Affairs 2013). The RANGE program provides intensive case management to veterans with serious mental illness who are experiencing homelessness or who are at risk of experiencing homelessness with an emphasis on recovery. The Sgt. Ketchum Rural Veterans Mental Health Act of 2021 bill also requires the government to conduct a study and report on whether the VA has adequate resources to provide services to rural veterans whose lives depend on mental health care the is more intensive than traditional outpatient therapy (Monteith et al., 2020).
Unfortunately, VA healthcare reform is faced with similar challenges of establishing universal health care but on a smaller scale. Agendas, interest groups, insurance stakeholders, pharmaceutical suppliers, and access to care are all variables in creating policies that appear to be relentless barriers to healthcare reform; however, change is a process. The evolution of the CHOICE act to the Sgt. Ketchum Rural Veterans Mental Health Act of 2021 is promising. Findings from this living body of veteran health data and research will continue to shape policy improvement. I am hopeful that with each future bill and amendment passed, a new layer of protection will be provided to those who have sacrificed their lives to protect us.
NURS 6050 Week 1 Discussion Presidential Agendas References
Albanese, A. P., Bope, E. T., Sanders, K. M., & Bowman, M. (2019). The VA mission act of 2018: A potential game changer for rural GME expansion and Veteran health care. The Journal of Rural Health, 36(1), 133–136. https://doi.org/10.1111/jrh.12360
American Association of Colleges of Nursing. (2016, December 13). VA ruling on APRN practice: a breakthrough for veterans health care. Message posted on the American Association of Colleges of Nursing Listserv:[email protected]
Department of Veterans Affairs (2018b). VA National Suicide Data Report: 2005–2015. Retrieved from
https://www.mentalhealth.va.gov/ docs/data-sheets/OMHSP_National_Suicide_Da ta_Report_2005-2015_06-14-18_508-compliant.pdf
Monteith, L. L., Wendleton, L., Bahraini, N. H., Matarazzo, B. B., Brimner, G., & Mohatt, N. V. (2020). Together with veterans: Va national strategy alignment and lessons learned from community‐based suicide prevention for rural veterans. Suicide and Life-Threatening Behavior, 50(3), 588–600. https://doi.org/10.1111/sltb.12613
VA.gov: Veterans Affairs. RURAL VETERANS. (2016, January 19).
https://www.ruralhealth.va.gov/aboutus/ruralvets.asp.
Veterans Health Administration, D. U. S. for O. and M. (2013, May 8). VA.gov: Veterans Affairs. Enhanced RANGE Program. https://www.lexington.va.gov/services/Enhanced_RANGE_Program.asp.
Thank you for the question. I see this health care disparity as a priority within the context of social determinants of health because of its pervasive nature. According to the Health People 2030 objectives, social determinants of health (SDOH) are the dynamic qualities and characteristics of the environment an individual is born into, lives, learns, works, plays, worships, and ages. These environmental qualities and characteristics are considered social determinants because they will directly or indirectly determine or impact the health, functioning, risks, and quality-of-life outcomes of the people living within it (Office of Disease Prevention and Health Promotion, 2021). The Healthy People 2030 Framework identified the following five domains of SDOH: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.
Shortages of mental health care providers and poor access to mental health care services, especially in rural areas, fit perfectly under the health care access and quality domain; however, these same disparities have direct and indirect impacts on the existing four domains as well. Most mental illness diagnosis and disorders include a variable of pathology impacting your quality of life, or the impairment of your perception that thereof. Thus, the psychiatric mental health patient population in general, including veterans, require a scaled-up version of services due to the vary nature of the pervasiveness of untreated mental conditions on all domains of health and functioning. Effective mental health treatment has the power to help an individual function at work (economic stability), encourage self-actualization and improvement (by harnessing access to education or investing in their children’s), and find purpose and belonging in a community (neighborhood and community context). I would say the mental health provider shortage and poor access to mental health care services in the rural veteran community is a good place to start developing interventions and policies that can be translated to a larger population of people in need.
NURS 6050 Week 1 Discussion Presidential Agendas References
Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health. Social
Determinants of Health- Healthy People 2030. https://health.gov/healthypeople/objectives- and-data/social-determinants-health.
Chisholm, D., Sweeny, K., Sheehan, P,. Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling-
up treatment of depression and anxiety: A global return on investment analysis. The Lancet Psychiatry, 3(5), 415-424. https://doi.org/10.1016/s22150366(16)30024-4
Thank you for your post. Suicide continues to devastate the military community at an alarming rate. This nurse is personally aware of 5 deaths within this past year alone at the base we were stationed at. This can be attributed to the culture of the military when it comes to how a person who is suffering from mental illness is treated. I can speak firsthand to this as I have a very close friend that has been struggling with her mental health and when she hinted at it to her bosses she was made to feel as if her job was in jeopardy because heaven forbid military men and women are human and suffer mentally. Active-duty members are not allowed to seek mental health treatment from an outside provider, Tricare mandates that all active-duty members must receive a referral from their Primary Care Provider to receive mental health services (Military One Source , 2020). I would like to see a President change that requirement, as many military men and women do not seek treatment because they must go through their PCP and that goes on their permanent record. I believe mental health services should be covered without a referral.
NURS 6050 Week 1 Discussion Presidential Agendas Reference:
Military One Source . (2020, August 12). 7 Counseling Options for Service Members and Their Families. Retrieved from Military One Source : https://www.militaryonesource.mil/confidential-help/non-medical-counseling/military-and-family-life-counseling/7-counseling-options-for-service-members-and-their-families/
I agree with you that most people living the US and the world have had mental illness at one stage of their lives. It is absolutely true that most communities have neglected mental illness such as emotional distress, depression, and stress. Unexpected and sudden death is common among mental health patients. Persons with mental illness are known to have poor health status and considerable premature mortality. I concur with my colleague that the previous presidents, George W Bush, Barrack Obama, and Donald Trump, have made fundamental reforms to reduce the number of mental health patients in America. Bush created a commission that come up with 19 impressive recommendations to reduce mental illness. His successor, Obama, signed ACA that added mental health patients to Medicaid. Lastly, Trump supported a group of health clinics for mentally ill patients with US$700 million.
Mental health disorders affect a person’s feeling, thinking, mood, or behavior, such as anxiety, depression, panic disorder, prevalence, schizophrenia, or bipolar disorder (Valentine, & Shipherd, 2018). These conditions may either be chronic (long-lasting) or occasional, affecting the person’s ability to perform their daily activities. In 2019, nearly 21% of Americans had a mental illness. The number signifies that 1 in 5 Americans experienced mental health disorders in 2019 (Czeisler et al., 2020). Mental health disorder does not discriminate, and it can affect all people regardless of their social status, income, geography, age, sexual orientation, ethnicity/race, or spirituality/religion. Unfortunately, people who are mentally ill do not want to talk about it. There is nothing to be ashamed of about this condition; it is a medical condition like diabetes, cancer, or cardiovascular diseases. Most mental disorders disorders are treatable.
NURS 6050 Week 1 Discussion Presidential Agendas References
Czeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., … & Rajaratnam, S. M. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020. Morbidity and Mortality Weekly Report, 69(32), 1049. Doi: doi: 10.15585/mmwr.mm6932a1
Valentine, S. E., & Shipherd, J. C. (2018). A systematic review of social stress and mental health among transgender and gender non-conforming people in the United States. Clinical Psychology Review, 66, 24-38. Doi: 10.1016/j.cpr.2018.03.003
Each year in the U.S., millions of people are affected by mental illness. The CDC reports that 50% of Americans will at one time in their life be diagnosed with a mental disorder (CDC, 2019). As nurses, we must understand the physical, social and financial impact mental health has on our nation. We must raise awareness, reduce the negative stigma, and advocate for better health care.
I focused my post on mental health care because it is my nursing specialty. After reviewing what the last three presidents have accomplished, I was surprised and pleased with president Bush’s and Obama’s attempts to address mental health; however, I was disappointed in President Trump’s apparent lack of support.
In 2002 President Bush created the New Freedom Commission Act, which would improve mental health services for children, adolescents, and adults by coordinating treatments and services to promote their successful integration into the community (President`s New Freedom Commission on Mental Health, 2019). His support for mental health didn’t stop there. Throughout his presidency, he continued to make positive changes for those living with mental illness. In his final year as president, he signed an act establishing health insurance coverage for people with mental health disorders, seeing it as just as important as physical health (Hart, 2016).
Two years later, under the Obama administration, President Obama signed the Patient Protection and Affordable Care Act, much like Bush, demonstrating that mental health is as important as physical health. In 2016, the president proposed a budget that included a new $500 million investment to increase access to mental health care (Hart, 2016). As stated above, both Presidents acknowledged mental health and the importance of treating it as equal to physical health. Conversely, during his time in office, President Trump advocated for the reduction in Medicaid funding to each state, which directly impacted the mental health services to the aged and disabled who qualified under this program (The Trump Administration and Mental Health, 2018).
If I were to do anything different, I would have built on the legacy of Bush and Obama to increase awareness, policies, and funds to address mental health. Mental health issues are not going away, and decreasing funding for programs that meet the needs of the mentally ill is a step in the wrong direction.
I concur with you that as medical providers, it is our job to let drug addicts and people in recovery know they are not alone and that others care about their health and wellbeing. It is also important for healthcare professionals to recognize that weekly outpatient appointments might not be enough for every patient, especially those with more free time on their hands during the pandemic (Ornell et al., 2020). Medical providers should coordinate care with other providers as needed, focusing on adding as much structure and support to their patients’ routine as possible. For example, when treating a patient with a substance use disorder in an outpatient setting once weekly, the patient can also participate in intensive outpatient care through another local provider. Nevertheless, clinicians should also consider encouraging patients to participate in virtual community support groups. This is because there is no black-and-white approach to helping patients struggling with substance use but it is really about tailoring to what each patient needs (Jemberie et al., 2020).
References
Jemberie, W. B., Williams, J. S., Eriksson, M., Grönlund, A. S., Ng, N., Nilsson, M. B., … & Lundgren, L. M. (2020). Substance use disorders and COVID-19: multi-faceted problems which require multi-pronged solutions. Frontiers in psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00714
Ornell, F., Moura, H. F., Scherer, J. N., Pechansky, F., Kessler, F. H. P., & von Diemen, L. (2020). The COVID-19 pandemic and its impact on substance use: implications for prevention and treatment. Psychiatry research, 289, 113096. https://dx.doi.org/10.1016%2Fj.psychres.2020.113096
NURS 6050 Week 1 Discussion Presidential Agendas Rubric
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A public health topic which needs more attention is the opioid abuse epidemic. As a registered nurse in a large city, I often see the unfortunate effects of opioid addiction. According to Centers for Disease Control and Prevention (n.d.) nearly 69,000 overdose deaths involved opioids in 2020. The number of opioid overdoses has increased 8.5 times since year 1999 (Centers for Disease Control and Prevention, n.d.). Although all social determinants affect the opioid epidemic, most recently the most prevalent social determinant is social environment. Social environment plays a huge role in the opioid epidemic, the dramatic increase in opioid overdoses correlates with the timeline of the COVID-19 pandemic. There is a correlation between mental illnesses and drug addiction. Because of various reasons such as social isolation or workplace stress for front line personnel the pandemic caused or exacerbated many people’s mental illnesses which in response worsened the opioid crisis.
President Trump declared the opioid epidemic as a nationwide public health emergency (National Archives and Records Administration, n.d.). This was essential for the country and government officials to recognize the colossal problem the opioid epidemic had become in the United States. President Trump’s primary initiative against the opioid epidemic was stopping drug trafficking across the borders. In 2019 Mexico’s heroin production decreased by 27%, which is the largest decrease in history (National Archives and Records Administration, n.d.). Although this statistic shows that President Trump’s actions decreased heroin production in Mexico, heroin is only one type of many opioids contributing to the opioid epidemic.
President Biden also implemented changes to address the opioid epidemic. President Biden’s focus is meeting people where they are, increasing access to harm reduction such as naloxone and safe syringe access (The White House, 2022). President Biden initiative also includes disrupting transnational drug producing and trafficking criminal organizations’ finances to stop the smuggling of drugs into the United States, as well as stopping drugs from entering the United States from across the borders (The White House, 2022). Although the two presidents have a different focus on interventions to stop the opioid epidemic, they both have initiatives to stop drugs from crossing the borders.
Although it is important to decrease the availability of illicit drugs on the street and provide access to harm reduction interventions, I believe the focus should be on preventing addiction in the first place. Primary preventative measures of opioid abuse include using evidence-based guidelines when prescribing medications, increasing school-based prevention education programs, and increased access to behavioral health supports (Livingston et al., 2022). Education programs should be implemented in schools to prevent drug abuse. Also access to mental health care providers needs to be more readily available and interventions should be done to decrease the stigma around mental health care.
References
Centers for Disease Control and Prevention. (n.d). Opioid data analysis and resources. https://www.cdc.gov/opioids/data/analysis-resources.html
Livingston, C. J., Berenji, M., Titus, T. M., Caplan, L. S., Freeman, R. J., Sherin, K. M., Mohammad, A., & Salisbury-Afshar, E. M. (2022). American college of preventive medicine: Addressing the opioid epidemic through a prevention framework. American Journal of Preventive Medicine, 63(3), 454–465. https://doi.org/10.1016/j.amepre.2022.04.021
National Archives and Records Administration. (n.d.). Healthcare. https://trumpwhitehouse.archives.gov/issues/healthcare/
The White House. (2022, April 21). Fact Sheet: White house releases 2022 national drug control strategy that outlines comprehensive path forward to address addiction and overdose epidemic. https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/21/fact-sheet-white-house-releases-2022-national-drug-control-strategy-that-outlines-comprehensive-path-forward-to-address-addiction-and-the-overdose-epidemic/
Sample Answer for NURS 6050 Week 1 Discussion Presidential Agendas
Shannon Roberts
RE: Discussion – Week 1
For every presidency, healthcare will be a top priority to make changes to and improve. The availability of prescription drug coverage is always a touchy subject with each political party. Everyone wants to provide prescription drug coverages, but are they going about it the right way? I will look into how Bush, Obama and Trump attempted to improve and change the prescription drug coverage through their agendas.
When President George W. Bush took office, he wanted to provide a prescription drug plan that would benefit the people. He developed the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003” (The Bush Record- Fact Sheet: Empowering Medicare Beneficiaries With Affordable Options, n.d.). Thanks to this act, over 40 million Americans have better access to medications and other health services. Taxpayers were able to save approximately $240 Billion dollars with this initiative. Unfortunately, this created a gap in coverage called the “donut hole”. (The Medicare Part D Coverage Gap (“Donut Hole”, 2014). Having an improved medication coverage plan was originally a great idea, but many Americans have struggled immensely affording prescriptions while they are in the “Donut Hole”. Bush’s prescription health plans ended up having to many loopholes. And the “donut hole” was disastrous for the American poor.
Obama took office in 2009 and immediately wanted to work on getting health care for all. (Improving Health for All Americans, 2015). He worked to ensure that the “Donut Hole” was to be phased out. Health care coverage become more affordable and eliminated the pre-existing condition clause that eliminated the availability of health care for all. This was huge for the dialysis population that I serve. This allowed many to find coverage that was more financially reasonable and better for them. However, they became a small portion of the overall healthcare dollars. Obama also worked with Centers for Medicare and developed a payment system to have providers be reimbursed based on metrics and outcomes versus just being reimbursed for preforming a procedure or seeing the patient. (Continuing the Affordable Care Act’s Progress on Delivery System Reform Is an Economic Imperative, 2015). I believe this was a game changer to have providers hold themselves accountable for outcomes and patient overall health.
Beginning day one of Trumps administration he wanted to get “Great Healthcare for Americans” (Healthcare – The White House, n.d.) at a reasonable cost to the government. Trump was able to lower drug prices. Allow pharmacies and practitioners to educate patients on coupons for prescriptions and use of importing drugs from Canada where costs are typically less. This change saved dialysis patients thousands of dollars a year by having access to prescription sites like GoodRx to find what pharmacy will have the cheapest medications and any coupons they have available. In my opinion, this is the beginning to manage overall healthcare against cost.
Bush, Obama and Trump have all taken initiatives to continue to improve healthcare and prescription drug coverage in America. I believe that we still have improvements to be made. Prescription drug coverage is expensive. We as healthcare providers will always need to do our part to continue to make changes and better the lives of that patients that we touch to improve the overall health of patients to assist with decreasing the financial burden that is put on our healthcare system.
References
The Bush Record- Fact Sheet: Empowering Medicare Beneficiaries With Affordable Options. (n.d.). Georgewbush-whitehouse.archives.gov. Retrieved from https://georgewbush-whitehouse.archives.gov/index.html
The Medicare Part D Coverage Gap (“Donut Hole”). (2014, November 13). Medicare Information, Help and Plan Enrollment- Medicare.com. Retrieved from https://medicare.com/medicare-part-d/coverage-gap-donut-hole-made-simple/
Improving Health for All Americans. (2015, December) Whitehouse.gov; Whitehouse. Retrieved from https://obamawhitehouse.archives.gov/the-record/health-care
Healthcare- The White House. (n.d.). Trumpwhitehouse.archives.gov. Retrieved from https://trumpwhitehouse.archives.gov/issues/healthcare/
Continuing the Affordable Care Act’s Progress on Delivery System Reform Is an Economic Imperative. (2015, March 24). Whitehouse.gov. Retrieved from https://obamawhitehouse.archives.gov/blog/2015/03/24/continuing-affordable-care-act-s-progress-delivery-system-reform-economic-imperative
Sample Response for NURS 6050 Week 1 Discussion Presidential Agendas
Hi Shannon,
Good topic. The time for generics to be on the market has decreased but could possibly be decreased more. Novack found one pharmacy had a mark-up of 48% and another 84% for ophthalmic drops. Another example was an antidepressant for $220 at one pharmacy and the same prescription for $55 at a nearby warehouse store (2016). Why is the U.S. not able to get medications from other reliable countries?
Dr. Robin
Novack, G. D. (2016). What determines how much your patient pays for their medication in the united states? American Journal of Ophthalmology, 167, 48-51. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.ajo.2016.04.010
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