Kristi Zayas

HSA4850
October 25, 2015
Work from HSA3111
US Health Care Fall 2013
Professor Dr. Kezia D. Awadzi

MEMO
To:

Kathleen Sebelius, Secretary of the U.S. Department of Health and Human

Services

From: Kristi Zayas, Health Administration and Policy Intern

RE:

Mental Health Reform (Chapters 7 & 11)

Date: 28, September 2013

-----------------------------------------------------------------------------------------------------------Mental health is a growing concern, especially with all the recent shootings that have
been connected to mental health issues. Mental disorders are common psychiatric
illnesses that show no age discrimination and needs to be reformed in the health care
system to be considered a primary health care concern. According to the World Health
Organization (WHO), primary health care is essential health care that is based on
practical, scientifically sound, and socially acceptable methods and technology. (Shi &
Singh, 2013, p. 171). This type care is accessible to everyone in the community, cost
effective, and can be maintained at every stage of development. Primary health care
serves as the foundation of ambulatory services, characterized by the first level of contact
between individuals, the family, and the community on the one hand and health care
delivery system on the other, bringing health care as close as possible to where people
live and work. (Shi & Singh, 2013, p. 171).
Mental illness ranks second as a nationwide burden on health and productivity. (Shi &
Singh, 2013, p. 275). It has been connected to recent shootings here in the U.S. causing
an uprising for stricter gun laws where the mentally ill are concerned. Statistics show that
an estimated 26.2% of adults in the U.S. have at least one diagnosable disorder in any

given year, with 22.3% of those individuals facing a sever mental illness. Only 41% of
those individuals facing a severe mental illness receive any treatment. (Shi & Singh,
2013, p. 275). About 61% of victims of gun violence die by their own hand, leaving the
potential for clinical intervention a powerful one. (Frattaroli, Webster & Wintemute,
2013).
Thousands of people, of every age, are affected by mental health issues everyday. That
does not make all those individuals a threat to the population at large. Dr. Colin Ross MD
states, Psychiatry doesnt have the ability to identify the people who are going to
become violent, even when they have them in treatment, and do anything about it.
(Psyche Today, 2013). The problem with that is most people are referred out to receive
psychiatric help and only see that physician for as many times allotted by the insurance
companies. This treatment can stop at any time by the patient without the primary care
doctor knowing and the patient going untreated.
While Dr. Ross doesnt believe that a person in treatment with a psychiatrist can stop a
shooting, there are those who believe that physicians serve an important role in providing
treatment for people in crisis. (Frattaroli, Webster & Wintemute, 2013). It is important to
support the efforts to make mental health treatment available and with it include options
to prohibit or limit the sale of guns or to remove them from those while in treatment.
Physicians need the tools, to arm themselves, with the ability to identify those individuals
and make available to the proper authority the potential that those individuals, in
treatment, might pose a threat to themselves or community. Physicians also need those
tools to help identify those individuals that might need intervention in the near future.

Since mental illness shows no age discrimination, there needs to be an urgency to

maintain care for the individuals who slip through the mental health care system
unchecked or forgotten, making it harder or impossible for them to buy or own a gun.
Mental health care needs to be with primary care, where it can also play a central role in
the health care delivery system. (Shi & Singh, 2013, p. 170). It may take a different
doctor, with a different degree, to care for an individual with mental health issues, but all
the doctors involved with that individual need to be in communication with one another
to best care for and treat that individual. If diagnosis and treatment can begin in
adolescence then there is a possibility that individuals, affected by mental illness, will not
become part of the statistics of gun violence.

References

Frattaroli, S., Webster, D. W., & Wintemute, G. J. (2013). Implementing a public health
approach to gun violence prevention:the importance of physician engagement.
Ideas and Opinions, Retrieved from
http://ehis.ebscohost.com.db25.linccweb.org/ehost/pdfviewer/pdfviewer?
sid=e8235670-ec8e-4c13-a178-4ff5834c8fd1@sessionmgr4&vid=8&hid=4

Peters, J. W., & Luo, M. (2013, September 13). Mental health again an issue in gun
debate. New York Times. Retrieved from
http://www.nytimes.com/2013/09/19/us/politics/mental-health-again-an-issue-ingun-debate.html

Psyche Truth. (2013, May 9). Gun control & mental health, violence, crime, gun laws,
pshchiatry, psychology|Dr. Colin Ross, MD [video file]. Retrieved from
http://www.youtube.com/watch?v=PAa8LkosVD8

Shi, L., & Singh, D. (2013). Essentials of the u.s. health care system . (Third ed.).
Burlington: Jones and Barlett Learning.