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.
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
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