Community Health Framework and Intervention Plan Essay

Community Health Framework and Intervention Plan - Essay Example This report will review several other models and policy initiatives that promote both mental and primary care for the elderly who have mental illnesses and, accordingly, suggest a prevention model. The Federal Government O'Conner et al (2009) point out that federal policy will have to change to realistically begin to face the growing needs of older adults with mental illnesses. The elderly population will be growing at increasing rates over the upcoming decades. The DHHS estimates that 20% of the elderly population have mental illnesses of which 2% are seen as serious. It is a population which requires ongoing mental health services. Elderly with mental illness in general face shorter life expectancy compounded by comorbid medical illnesses and unhealthy and limiting lifestyles that are sometimes characterized by alcohol and drug abuse, poor nutrition, obesity, and cigarette smoking. These characteristics often lead to medical problems of cardiovascular disease and diabetes among oth ers. Mental illnesses may also lie hidden underneath the combination of physical illnesses, leading to misdiagnosis and insufficient treatment regimens. The main concern of federal and state governments toward the mentally ill has been in regard to controlling costs. O’Conner et al outline the various federal programs for treating the elderly mentally ill and explain how these programs have had shortfalls usually in the more difficult area of providing consistent government funding. The authors discuss how federal and state policy struggle to provide long-term care for this population. Initially Medicaid policy did not cover institutions for mental diseases (IMDs) or nursing homes as coded by the Pre-Admission Screening and Resident Review (PASRR) stricture. Also, the Medicaid Home and Community Based Services (HCBS) further confounded housing support for the population. However, the new Patient Protection and Affordable Care Act of 2010 (ACA), recently created to reform Amer ican health, is now enabling states flexibility to create special benefit packages for specific populations. The ACA clarifies the Medicaid 1915(i) provision, the Home and Community Based Service (HCBS) state plan amendment option and importantly provides ways for the state to receive funding help in providing long term services to the elderly with mental illness. Integrated Services Models United States Marion et al discuss a model of integrating primary and mental health care to enable specific targeting of patients with severe and persistent mental illnesses (SPMI). Their project is an example of public policy planning that could represent coordination of services between a private agency that is federally qualified and an academic nursing school. People with SPMI are at a disadvantage of receiving only episodic and fragmented treatment. SPMI are sometimes typified as succumbing to comorbid conditions where physical illnesses are complicated by psychotropic medications. Substance abuse complicate and raise the risks of such individuals who many times live in impoverish conditions that may involve violent incidents, unprotected sex and poor nutrition. Medical care is not consistent but mainly provided by emergency care centers. One intervention scheme that may involve a measure of hope is social planning coordination between a school of