Among the stated objectives of the Healthy People 2010, a national, multi-stakeholder program that aims to improve the over-all health of the American people through health promotion and disease prevention is to expand treatment services for mental health disorders. In particular, the program is aimed at “increasing the proportion of children with mental health problems who receive treatment” by enhancing the support network of affected children and their families and improving their access to mental health and other social services.
The inclusion of mental health disorders as a priority public health issue that needs to be addressed stems from the acknowledgement of the gravity of the social and economic costs of mental health problems to families and communities. More importantly, the inclusion of mental health as a national health priority reflects a significant shift in attitude in public health policy.
Indeed, mental health disorders have affected a significant portion of the American population for a long time. Estimates from the United States Department of Health and Human Services reveal that mental health problems affect 20 percent of the population annually. Likewise, the risk of developing mental health disorders cuts across age, ethnicity, gender, education, and socio-economic status, making children almost as vulnerable as older people to mental health problems.
It is estimated, for instance, that 20 percent of children and adolescents within the 9 to 17 age group are likely to exhibit symptoms of mental health disturbances such as major depression, schizophrenia, and anxiety disorders; with 5 percent of the cases being severe and debilitating to children’s normal growth and development. (USDHHS (a), 2000)
Clearly, the impact of mental health disorders on children and adolescents’ well-being is grave. Children and adolescents with mental, behavioral, and emotional disorders usually perform poorly in school and are more vulnerable to alcohol and drug addiction. As in adults, mental health disorders also increase the risk of children and adolescents towards violent and aggressive behavior and suicide. In the 1999 alone, the suicide rate among children and adolescents was as high as 2.6 percent. (USDHHS (b), 2000)
Unfortunately, mental health disorders have been poorly understood which usually deprives those affected of access to necessary treatment and services. It is worth noting, for instance, that only 27 percent of children and adolescents afflicted with mental health disorders avail of treatments, most of them receiving help mainly from in-school facilities and services. (USDHHS (b), 2000) Prevailing health policies have largely ignored the fact that mental health problems usually begin during childhood and adolescence and may have a lifelong impact on affected children. In the same manner, the public and social costs of mental health disorders have been largely ignored or underrecognized.
On the other hand, mental health disorders have been shown to have a tremendous impact on public and private health spending, amounting to $69 Billion in diagnosis and treatment expenses. (USDHHS (b), 2000) Majority of these costs were shouldered by public funds while the remainder were paid for through private spending. The figures could be higher when the indirect costs of mental health illness on productivity, damages to property, criminal justice and litigation, and insurance claims are accounted for.
Likewise, mental health disorders also place a tremendous strain on the economic lives of families and communities. A study done by Busch and Barry (2007) aimed at determining the impact of childhood mental disorders on the financial well-being of families with afflicted children reveals that the impaired functioning of children with mental disturbances affects parents’ work productivity and caring for or arranging for the care of the child often leads to lost family income in terms of lost work hours. (p. 1090) The researchers contend that caring for children with mental health disorders are as costly as caring with children with other chronic illnesses. (p. 1088)
Busch and Barry’s study was conducted by analyzing the responses of respondents to the National Survey of Children with Special Health Care Needs (NS-CSHCN) to compare the effects of children’s mental health disorders on the family’s economy to the economic impact on the family of children requiring special health care needs. (p. 1089)
To this end, the researchers utilized propensity-score matching and logistic regression in controlling for differences between children with mental health disorders and the general population sample. Results of study supported their contention that caring for children with mental health disorders was a cause of financial burden especially for those who were privately insured. (p. 1089) Results of the study also showed that caring for a child with mental health disorder severely limited the labor-market participation of parents, increased the time they spent caring for or arranging for childcare, and consequently reduced the time parents spent on other activities. (p. 1091)
Thus, the authors encourage the implementation of programs and policies aimed at supporting the families of children with mental health disorders to alleviate the adverse economic outcomes brought about by heavy costs incurred from intensive and extensive child care and treatment requirements. (p. 1095) Such programs could include the elimination of mental health restrictions in private insurance policies that prevent or reduce children’s access to mental health services and treatment that increases the risk of prolonged and degenerative disability. Another suggestion made by the authors is extending financial assistance to families caring for children with mental disorders that would help defray some of the costs involved in the medical care of such children. (p. 1094)
It is clear that the social and economic impact of mental health disorders should be a great concern for the nursing community. Nurses, who are at the frontline of health service delivery, play an important role in health promotion and disease prevention. As a critical health workforce, nurses’ support in the implementation of mental health programs is crucial in meeting health objectives and achieving positive health outcomes. Nurses have the ability to contribute to the promotion of mental health through a renewed focus on patient-centered care that takes into account the holistic dimensions of health and places emphasis on early detection and diagnosis of mental health problems.
Nurses are an important part of the support network of families and communities with respect to the provision of information and other forms of resources. Given that mental health disorders are preventable and treatable diseases, the ability of nurses to provide a timely referral for treatment services and intervention for children and adolescents who exhibit the symptoms of mental, behavioral, and emotional disturbance would be a significant factor in improving the health and lives of children and adolescents. A significant improvement in the detection of mental health disorders, for instance, can be achieved with adequate attention on the part of nurses on the cognitive, emotional, and psychological aspects of their patients.
Therefore, the nursing community, as an important part of the health workforce, must be conscious of the prevalence of mental health disorders and be sufficiently informed about their role in the prevention and treatment of these problems. This way, nurses will be able to provide the needed support to reduce the economic and social costs of mental health-related diseases. Nurses will also be fully prepared to meet the exacting challenge of improving the health and quality of life of the individuals they serve.
Busch, Susan H. & Colleen L. Barry (2007). Mental health disorders in childhood: Assessing the burden on families. Health Affairs, 26(4): 1088-1095.
United States Department of Health and Human Services (a) (2000). Healthy People 2010: Leading Health Indicators. Retrieved 21 April 2008 from the Healthy People 2010 website: https://www.healthypeople.gov/Document/html/uih/uih_bw/uih_4.htm#mentalhealth