Introduction
The mental health of individuals is one of the major concerns of the U.S. healthcare sector. The tendency towards the gradually increasing level of pressure caused by society on people preconditions the growth in stress rates. Additionally, complex economic situations, environmental factors, crime, disasters, and personal issues can also be considered stressors that might trigger the development of the disease and lay the ground for the appearance of multiple complications. That is why there is a critical need for improved monitoring in this sphere and effective intervention. Unfortunately, the scope of the problem and the complexity of the given task becomes a serious challenge to various states and authorities. For instance, the current state of mental health care in Louisiana can be considered catastrophic as there are multiple problems that demand immediate intervention and resolution. The presented paper outlines the existing situation in the given sector, factors that contributed to its appearance, and offers possible approaches to improve it.
Background
Discussing the given problem, Hurricane Katrina’s landfall in 2005 can be considered one of the root causes of the emergence and development of critical issues in Louisiana. Devastations of the main elements of infrastructure preconditioned the dramatic decrease in the effectiveness of care provision (Potash, 2008). The healthcare sector of the state has been trying to recover pre-storm resources to be able to help all individuals who returned after the natural disaster (Potash, 2008). However, it turned out to be a severe challenge, as mental health services did not follow the residents’ return (Potash, 2008). Reports state that out of 208 psychiatrists who worked in New Orleans, only 42 remained (Potash, 2008). Additionally, the number of beds available for mentally ill patients reduced from 487 to 190 (Potash, 2008). Along with the substantial harm done to healthcare units in the area, it resulted in the sector’s inability to assist patients with mental problems and contribute to their recovery. The situation signalized the need for intervention and improvement; however, it continued to deteriorate and preconditioned a crisis that can still be observed today.
Budget Cuts
Another factor that has a significant negative impact on the state of mental care in Louisiana is a chain of budget cuts in observed years. It limited caregivers in their ability to provide appropriate care to patients, especially those who have mental illnesses. At the moment, Louisiana holds the lowest rank in spending on mental health care if compare with the other 43 states (LBP, 2018). The lack of financing and state investment preconditions the further evolution of the crisis and the use of ineffective policies to deal with the problematic situation. The bigger part of these cuts took place in the last decade during the rule of Bobby Jindal, who failed to repair the health sector (Sayre, 2018). As a result, specialists working in the sphere do not get the needed training, and caregivers are deprived of a chance to help patients because of the limited resources available to them.
Hospitals
Poor financing also preconditions multiple psychiatric clinics’ closures or their inappropriate functioning. Being not able to work with this sort of client, health units prefer to turn away patients before they become this very unit’s responsibility (Potash, 2008). Moreover, reports show that many working hospitals accepted the decision to close psychiatric wards after the storm and avoid working with mentally ill patients mainly because of the increased amounts of uncompensated care that were associated with this sort of duties (Potash, 2008). In such a way, the core reason for the closure of healthcare facilities or their inability to open and support their psychiatric departments was inappropriate funding that deprived caregivers of a chance to offer needed interventions to patients of hospitalizing them (Potash, 2008). Moreover, the decrease in the number of hospitals preconditioned the appearance of problems in many other social spheres, which critically depend on the successful functioning of this very sector, and the penitentiary system belongs to this cohort.
Prisons
At the moment, Louisiana also faces a serious problem related to the imprisoned people. Statistics show that at the moment, jails are full of mentally ill patients who are not provided with the needed care (Sayre, 2018). The poor functioning of the healthcare sector preconditions the development of dangerous situations when people who need assistance are not provided with the demanded treatment and might pose a threat to other individuals who surround them (Moller, 2010). Additionally, human rights become infringed as incarcerated people should also be provided with all services needed for their living and development. In such a way, the appearance and evolution of multiple problems in mental health care also have a negative effect on jails and community health.
Emergency Rooms and Nursing Homes
Furthermore, the cuts in the budget discussed above should be taken as a limiting factor for the work of emergency rooms and nursing homes. Accepting the fact that that rates of mental illness remain especially high in the area, the effective work of these two types of facilities is fundamental for the improvement of care delivery and the quality of people’s lives. Unfortunately, the gaps in the system and problems with the budged also mean that people with this sort of problem remain uncovered and suffer from the further development of complications (Sayre, 2018). Emergency rooms might refuse to take a patient because of the absence of financing, specialists, or beds available for this cohort of clients (Sayre, 2018). As for the nursing homes, their number also has been decreasing since 2005 because of the uncompensated work and systematic problems in the whole sphere (Potash, 2008). For this reason, the existence of critical issues can be observed.
Ineffective System
Analyzing the given crisis and the main aspects associated with it, it should also be said that the fragmented character of the system and the existence of multiple flaws should be discussed. First, there is no effective plan for the alignment of continuous improvement in the given sector. It results in the failure of some successful incentives as they cannot evolve without federal or governmental support. Moreover, findings evidence the widespread incompetence and fraud in current Louisiana’s mental health system (Potash, 2008). The problematic financing and ineffective approach precondition the development of illegal schemes and approaches. At the same time, the level of staff preparedness decreases, which preconditions the increase in the rate of mistakes and deterioration in the quality of care offered to clients (Potash, 2008). The existing Medicaid program suggested care to more than 430,000 people in Louisiana; however, many doctors do not accept patients who fall under this category (Sayre, 2018). Additionally, low reimbursement rates limit patients’ opportunities to acquire the needed care and make practice management extremely challenging (Sayre, 2018). It results in the creation of a fragmented and ineffective system that cannot resolve the crisis.
Private Issues
The scope of the problem means that even some private firms and individuals with private insurance might have difficulties. First of all, because of the complex situation, several mental health providers insist on using out-of-pocket payments to treat patients (Sayre, 2018). Additionally, the effective work of the private sector faces problems similar to those deteriorating to work of all state’s facilities in Louisiana. The absence of the structured approach to working with clients who demand this sort of intervention and the gaps in this sphere mean that the number of patients will continue to increase, and private services will remain available only to a limited group of citizens (Moller, 2010). At the same time, there are not so many agents who want to act under these conditions and enter the given sphere because of the absence of a clear understanding of how to improve the situation.
Programs
There are also some public problems and governmental attempts to achieve serious alterations in care delivery and improve the quality of people’s lives in Louisiana. First, as it has already been stated, Medicaid was considered a proper intervention to help people with serious health problems to acquire care, but its effectiveness and ability to influence the situation was limited (Sayre, 2018). Additionally, there are some public programs aimed at assisting people with a low level of income to ensure that they can improve their living conditions and acquire the desired health (Hardy, 2018). This very intervention can be taken as an appropriate one as there is a high rate of household poverty that prevents people from enjoying their lives (Potash, 2008). However, these programs are not able to reconsider the whole sphere because of the need for some systematic approach.
Recommendations
As for the positive solutions to the problem, there are several recommendations that can be given regarding the existing situation. First, the fundamental step is to introduce the appropriate financing of the sphere to ensure that local mental health providers will work in communities and provide patients with the treatment they need. It can be organized in the form of retention grants or donations for the federal government because of the extreme complexity of the current situation and the tendency towards its further deterioration. Moreover, it is essential to achieve a pre-disaster number of working hospitals and psychiatric units for them to work with all mentally ill individuals and contribute to the improvement of their states. Finally, as a part of the improvement program, a deep investigation of the sphere should be performed to determine cases of fraud, malpractice, or low competence among employees.
Conclusion
Altogether, the state of mental healthcare in Louisiana remains complex. The area is still trying to recover from the hurricane and restore its health infrastructure. However, there is a set of problems that contribute to the appearance of negative tendencies and the further sophistication of the issue. First of all, the poor financing and ineffective distribution of costs cause substantial harm to the field and precondition closure of many facilities critical for people’s recovery. Moreover, the absence of trained health workers, a decrease in the number of beds, and a high level of household poverty precondition the need for immediate intervention to ensure that the question will be solved. The proposed solutions include better financing schemes to attract workers, restoration of infrastructure, and in-depth analysis of the sphere to create the basis for continuous improvement.
References
Hardy, S. (2018). Louisiana officials must take lead in mental healthcare, federal officials say. The Advocate. Web.
Louisiana Budget Project (LBP). (2018). Louisiana’s mental health crisis. Web.
Moller, J. (2010). Health care facing huge changes in Louisiana. Nola. Web.
Potash, M. (2008). The struggle for mental healthcare in New Orleans – One case at a time. Psychiatry, 5(7), 32-41.
Sayre, K. (2018). Louisiana’s mental health care system is broken. Here’s how we got here. Nola. Web.