Health Policy, Politics And Perspectives
First responders are routinely exposed to traumatic events while on their job. There is overwhelming literature that supports that responders are at risk for increases in psychological symptoms (such as symptoms of posttraumatic stress disorder (PTSD), secondary traumatic stress, and burnout) and decreases in well-being (including overall resilience and compassion satisfaction) (Tran, 2018). Flannery writes that responding to critical incidents may result in 5.9–22 % of first responders developing psychological trauma and posttraumatic stress disorder. These impacts may be physical, mental, and/or behavioral (2015). The first-responder population is at a high risk of developing mental health crisis due to the daily occurrence of critical incidents.
One major new health policy that is appropriate for implementation is requiring mandatory and routine mental health screenings for first responders such as paramedics, fire-fighters, and police officers. These screenings may be implemented through a protocol either in intervals of every six months or required after a particularly traumatic experience in the field. It is important to bring attention of the importance of this issue to our legislators so that formal action can be taken in order to advocate for this population’s health. Brownson, Proctor, and Purtle write, “Legislators (i.e., elected Senators and House Representatives at the federal- and state-level) are a critically important dissemination audience because they shape the architecture of the US mental health system through budgetary and regulatory decisions” (2017). Researchers writes that therapeutically addressing professional quality of life, specifically secondary traumatic events, and increasing self-efficacy (e.g., via Cognitive Behavioral Therapies), may reduce risk for adverse stress reactions in first responders (Brooks, Feeney, Hirsch, et al., 2016)
I chose this topic because I have witnessed firsthand the negative consequences of the lack of mental health services available in the paramedicine field specifically. I live in an area of MA containing cities that have the highest call-volume for emergency services. In this area, where I am currently working as an RN, there has been an increase in fire-fighter/paramedic suicides. Many members of this occupation are also known to be heavy drinkers. They are often mentally exhausted following emotionally exhausting shifts which then keep them from being able to maintain healthy hobbies outside the workplace. There is a lack of services available to first responders as far as debriefing after trauma situations and offering coping skills. If legislation is passed that requires cities and town to fund mental health services for their first responders, the overall health of this population will improve. The positive results of adequate mental health services legislation will be clear in under 5 years’ time. With increased occupational quality of life and strengthened coping skills, first responders will be better able to conduct healthy lifestyles out of work. Legislation that ensures frequent mental health maintenance through accessible support systems will allow for decreased stress levels and less incidence of depression. Tran cites studies that note that perceived accessibility of social support was associated with lower symptoms of PTSD, lower symptoms of secondary traumatic stress, lower general psychological distress (using a measure of stress, anxiety, and depression), higher resilience, and higher compassion satisfaction (2018).
Brooks, B. D., Feeney, M. E., Hirsch, J. K. Paul, R. M., & Sawyer, G. (2016). Quality of Life and Trauma in First Responders: Moderating Role of Self-Efficacy.
Brownson, R. C., Proctor, E. K., & Purtle, J. (2017). Infusing Science into Politics and Policy: The Importance of Legislators as an Audience in Mental Health Policy Dissemination Research. Administration and Policy in Mental Health and Mental Health Services Research, 44(2), 160-163.
Flannery, R. B. (2015). Treating Psychological Trauma in First Responders: A Multi-Model Paradigm. Psychiatric Quarterly, 86(2), 261-267.
Tran, B. B. (2018). Examining the Impact of Social Support and Other Coping Strategies on Mental Health in First-Responders (Doctoral Dissertation).
POST # 2: Amanda
A new health policy I would implement from the readings this week would be the Comprehensive Primary Care initiative. I believe this would be a policy that would benefit the people of the United States. The policy would promote a healthy lifestyle and would push for optimal health. The Comprehensive Primary Care initiative is a four-year, multi-payer initiative that was made in order to strengthen and improve primary care (“Comprehensive Primary Care”, n.d.). This initiative would offer shared savings opportunities and population-base care management fees through state and commercial health insurance plans, to participating primary care practices (“Comprehensive Primary Care”, n.d.). The five functions of this initiative are risk-stratified care management, planned care of chronic conditions, preventative care, access and continuity, engagement, and coordination of care (“Comprehensive Primary Care”, n.d.). Implementation of these acts, usage of data, would promote improved patient care, better health for patients, and decreased costs of care. Every single citizen of the United States should have a primary care physician where they receive preventative, routine, and sick care. We should all have a primary care physician or a doctor’s office in which we can receive any care that we need in order to keep ourselves healthy (“Comprehensive Primary Care”, n.d.).
Implementation of this initiative would provide primary care facilities with greater funding than what they receive currently. Primary care is typically underfunded from insurances as they are usually paid by single payers, this initiative would implement multi-payer for funding primary care. Multi-payers would allow primary care to grow, transform, and provide care that is essential to providing optimal health states and lifestyles. Each primary care would receive payments from Medicare and monthly non-visit-based care management fee (). If primary care offices and physicians were funded with more money, the physician and the patients both will benefit. The patient and physician will have up-to-date technology in the office, electronic records, and patients will be able to access their chart and results electronically. Preventative care interventions would promote a healthy lifestyle for patients. Overall primary care will improve with this implementation and so will the health of the patients over the next five years. There is greater initiative for patients and for primary care with the implementation of this program. Primary care could offer incentives for preventative interventions which in turn will promote healthy patients.