Limited Access to Mental and Psychiatric Health Services in Underserved Communities
Communities with ethnic and racial disparities, low socioeconomic status, and isolated geographically often face barriers to accessing mental and psychiatric services. In clinical practice, healthcare workers have ensured that these communities are engaged and provided adequate mental health services. They have served as educators, providers of comprehensive services, and advocates of these communities. There is a collaboration between different healthcare workers in developing culturally sensitive interventions based in the communities to promote mental health in these individuals.
In the future, nurses can rely on technology such as telehealth to help reduce the geographical gaps in access to high-quality mental health services. Suppose the access to mental health services for underserved communities is addressed. In that case, the overall mental wellness of these individuals will improve, and there will be equity in the access to services by all, regardless of geographical location or socioeconomic status.
General Problem
The general problem is that there are people still unable to access mental health services despite the increased awareness raised by healthcare workers. The situation necessitates that the nursing practice focuses on the advocacy and engagement of patients and communities unable to access mental and psychiatric health services (Kates et al., 2019). Healthcare workers must build trust and good therapeutic relationships with patients to provide culturally sensitive services. They also need to deeply understand these individuals’ challenges and tailor the interventions accordingly to meet their unique needs (Purtle et al., 2020).
If the community members are engaged, the nurses can identify their challenges and increase awareness about mental health, helping to promote early prevention and diagnosis of mental health issues (Purtle et al., 2020). This approach can help to empower the communities to take charge of their health.
Communities and patients that do not have access to mental and psychiatric services often delay being diagnosed, receive inadequate treatment for their conditions, and do not have access to support for their health conditions. They are likely to experience severe symptoms of the illnesses, prolonged hospitalizations, and a reduction in overall well-being (Carbonell et al., 2020). Through timely, appropriate interventions, their health can be improved. The overall quality of life and a reduction in the relapse of mental health conditions can be achieved through coordination of care and patient education.
When individuals cannot access mental and psychiatric services, there is a rise in healthcare disparities, which can later burden healthcare organizations. When the conditions are not prevented and diagnosed early, individuals will seek healthcare services in the emergency departments or present to the other hospital departments with severe acute symptoms of the disease (Kates et al., 2019). The latter increases the healthcare workers’ workload, increases healthcare costs, and challenges the institution in providing high-quality services to the patients (Kates et al., 2019). Addressing this problem can help reduce unnecessary hospitalizations and decrease costs associated with care.
The Problem of Interest
The specific problem is limited access to and underutilization of mental and psychiatric health services in underserved communities. This problem has perpetuated disparities the communities face in access to healthcare services. The communities are unable to access holistic and equitable services. The current nursing practice focuses on providing individuals with care in traditional healthcare settings like hospitals and clinics.
Even though most individuals can access services from these settings, those living in geographically isolated areas may fail to benefit from these services. Some barriers that increase the inaccessibility to healthcare services include stigmatization surrounding mental health services, lack of means of transportation and financial constraints these individuals face (Coombs et al., 2021). A culturally sensitive and comprehensive approach to address this problem is also lacking.
The healthcare workers have not understood the unique economic, social, and cultural challenges facing underserved communities, which is essential to tailoring interventions to meet their healthcare needs. The current allocation of resources to the healthcare systems does not help bridge the gap in access to healthcare services. The current practice has overlooked community-based preventive approaches to mental health conditions. People have to rely on emergency departments to manage their conditions and when seeking follow-up services, which places a burden on the healthcare system and impedes the provision of high-quality services.
Identification of the Problem of Interest
A needs assessment, objective analysis of data, and evaluation of different outcomes relating to the quality, allocation of resources, and satisfaction of the patients were carried out. A needs assessment is essential to understand the needs of the individuals in the underserved communities. Quantitative and qualitative data is gathered from different healthcare providers, community members, and relevant organizations in the communities.
Some barriers to access to healthcare services identified include lack of transportation, financial constraints, geographical isolation of the communities, and cultural stigmatization. Health utilization patterns, epidemiological reports, and data on health disparities were utilized in objective data analysis to provide a quantitative image of the disparities in access to mental health services. There was an apparent disproportionate representation of the communities regarding the high frequency of emergency department visits for individuals with mental health issues, delayed diagnoses, and limited follow-up care.
Incident reports and staff survey analysis were used to assess the impact of limited access to mental health services on the satisfaction and safety of the patients. There were higher frequencies of adverse events, reduced morale of the healthcare workers, and high dissatisfaction among the patients in the underserved communities.
The current practice and allocation of resources were assessed to ascertain if it is evidence-based and if the resources are utilized effectively. Literature was reviewed to provide more information on addressing the problem. There is a need for culturally sensitive services, community-based interventions, and telehealth to enhance community access to healthcare services (Cleary et al., 2019). Financial analysis to assess the impact of the limited access to services indicated that potential financial savings could be achieved if the access to mental health services in underserved communities is increased.
Parameters of the Problem
The parameters of the limited access to mental health services in underserved communities entail the population impacted and the healthcare system. Healthcare workers are affected as they try to ensure that they provide patients with holistic and equitable care to all individuals. They have to ensure that they use the limited resources efficiently, address the issues of stigmatization and develop strategies that increase the engagement of the affected communities (Cleary et al., 2019).
Patients in underserved communities directly face the effects of limited access to mental health services. They face a delay in diagnosing their conditions, difficulty getting support in managing their condition, and limited treatment options (Kassam et al., 2021). They are likely to face severe symptoms, a reduction in overall well-being, and an increase in readmission rates.
The support systems and families of the patients may face burdens in ensuring that their loved needs get the essential care they need; they may be drained emotionally and financially while doing this (Carbonell et al., 2020). Healthcare institutions are forced to deal with the workforce shortage, limited allocation of resources, and the development of essential interventions to address the disparities in accessing healthcare services. The financial constraints make it challenging for these institutions to provide high-quality, comprehensive care to the communities.
Conclusion and Transition
Limited access to mental and psychiatric health services in underserved communities negatively impacts the safety of the patients. A delay in access to health services can lead to severe symptoms of the condition, increase the risk of self-harm and make the patients vulnerable to crises. If the individuals in these communities do not receive timely interventions, they will likely face poor mental health outcomes and develop adverse events. The quality of care provided to these communities is likely to be affected. Lack of culturally sensitive approaches, inadequate follow-up care, and insufficient treatment options contribute to poor health outcomes (Cleary et al., 2019).
Patients with mental health conditions suffer for an extended time, have decreased overall well-being, and face reduced functionality. More resources will be required to provide sophisticated care when patients present with severe conditions at the hospitals. The healthcare system is burdened, the available resources are strained, and the financial costs associated with care increase. Limited access to services has physical, emotional, and spiritual effects on the community members. The impact of the mental health condition on their well-being and self-care can ultimately affect their physical health, making them less functional.
The significant effects of the limited access to healthcare services in underserved communities necessitate an evidence-based practice and quality improvement project. This project can help to improve the safety of the patients, increase the quality of care, promote the overall well-being of the individuals, and decrease the costs associated with care.
By addressing the barriers to access to mental and psychiatry health services, implementing evidence-based interventions, and ensuring that the services are culturally sensitive, the EBP/QI project can increase the satisfaction of the patients, improve their overall health and ensure that there is equitable access of healthcare services to all individuals regardless of the geolocation or socioeconomic status.
PICOT Question
In underserved communities facing limited access to mental and psychiatry health services (P), what is the effect of community-based strategies and interventions (I), compared to the provision of healthcare services in traditional hospital settings (C), on access to comprehensive and timely mental and psychiatry health services (O) within one year (T).
References
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Cleary, M., West, S., Arthur, D., & Kornhaber, R. (2019). Change management in health care and mental health nursing. Issues in Mental Health Nursing, 40(11), 1–7. https://doi.org/10.1080/01612840.2019.1609633
Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15, 100847. https://doi.org/10.1016/j.ssmph.2021.100847
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Purtle, J., Nelson, K. L., Counts, N. Z., & Yudell, M. (2020). Population-based approaches to mental health: history, strategies, and evidence. Annual Review of Public Health, 41(1), 201–221. https://doi.org/10.1146/annurev-publhealth-040119-094247