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Agenda Comparison Grid and Fact Sheet

Eunice

Agenda Comparison Grid and Fact Sheet

Mental health is a pervasive and pressing issue in the United States, affecting millions annually. Disorders such as anxiety, depression, and severe mental illnesses like schizophrenia not only harm individuals’ quality of life but also result in immense economic and societal burdens. The COVID-19 pandemic highlighted the fragile state of mental health care systems and increased the prevalence of mental health challenges across all demographics. In response, successive U.S. administrations have attempted to address mental health through legislative, financial, and structural reforms: Agenda Comparison Grid and Fact Sheet.

This paper focuses on mental health and population health, considering the Biden and Trump presidencies. Through this comparison of how each has approached the issue, how they have deployed their resources, and the laws that have been enacted, this paper will offer a comparison of the current effectiveness of federal mental health policies. It also identifies the health policy decision-making powers of nurses and the advocacy for mental health as a national cause.

Part 1: Agenda Comparison Grid

Identify the Population Health concern you selected. Mental Health
Describe the Population Health concern you selected. Mental health disorders affect nearly one in five adults in the U.S. each year, representing a leading cause of disability and significant healthcare costs (National Institute of Mental Health, 2024). Barriers such as stigma, unequal access to care, and insufficient funding exacerbate the problem.
Administration (President Name)  Biden Administration Trump Administration

 
Explain how each of the two presidential administrations approached the issue. Biden’s administration;
  • Advocates for parity in mental health coverage, community integration, and telehealth expansion
  • Emphasizes social determinants of health to address disparities.
 Trump’s administration focused on addiction-related mental health, prioritizing funding through SAMHSA. Still, there was a limited focus on parity or comprehensive mental health reforms.
Identify the allocations of resources that the current and previous presidents dedicated to this issue. Significant funding increases under the American Rescue Plan Act investment in telehealth infrastructure.

The American Rescue Plan Act allocated $3 billion to expand mental health block grants. These funds bolstered community services and expanded telehealth.

Equity Focus: Strengthened Medicaid coverage for marginalized groups.

 

 Trump’s administration directed resources to the Substance Abuse and Mental Health Services Administration (SAMHSA) with specific allocations for opioid-related services.

Also, through the SUPPORT Act, this administration allocated resources to mental health through addiction programs, particularly in rural and underserved areas.

SAMHSA Grants: Focused primarily on substance-use-related mental health care.
Key Initiatives American Rescue Plan Act provisions supporting mental health and addiction services.

Builds on Affordable Care Act provisions to strengthen parity.

 SUPPORT Act addressing opioid addiction includes mental health funding.

Increased SAMHSA grants for community mental health programs.

 Part 2: Agenda Comparison Grid Analysis

Administration  
Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency the most helpful?

 

 SAMHSA is a federal agency that is most directly responsible for addressing mental health issues. SAMHSA supports such efforts through community-based programs, funding initiatives, and public education campaigns designed to reduce stigma and increase access to care.

Notably, one of the primary programs under SAMHSA involves the Community Mental Health Services Block Grant Program, funding at the state level, thus enabling mental health services and the breadth of care available directly, especially in underserved areas of the country (DeMarco & Tufts, 2014). Such has been instrumental in increasing the number of Certified Community Behavioral Health Clinics that provide comprehensive services for individuals with serious mental illness or substance use disorders (SUDs).

 

Besides providing the main funding, this federal agency has a critical role in shaping priorities through policy coordination with the state and local organizations to fit response strategies to regional mental health concerns. These partnerships enable better intervention: crisis stabilization services or initiatives focused on preventing suicide.

 

The Centers for Disease Control and Prevention (CDC) complements SAMHSA’s efforts to be a primary source of epidemiological data related to mental health. CDC collects and analyzes data related to the prevalence, trends, and disparities in mental health to provide evidence for policy decisions (SAMHSA, 2019). For example, the CDC’s Behavioral Risk Factor Surveillance System, or BRFSS, monitors state-level behavioral health indicators across the United States and allows for focused public health campaigns and appropriate resource distribution.

In combination, SAMHSA and the CDC form the framework through which the federal government addresses mental health issues. SAMHSA provides the services and funding, and CDC offers the statistical data and research imperative for evidence-based policy purposes and program implementation. It ensures a coordinated way of handling issues related to mental health.
How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there? According to Kingdon’s agenda-setting theory, mental health becomes a priority on the presidential agenda when three streams converge: problem recognition, policy proposals, and political momentum (CDC, 2024).

1.     Problem Recognition:

Public awareness about mental health issues most often surfaces around crises. For example, the opioid epidemic helped draw public interest in the connection between substance abuse and mental health. COVID-19 underlined the importance of accessible mental health services.

Events like increased rates of suicide among veterans and mass shootings affiliated with untreated mental illness raise the bar of urgency on mental health reform even higher. Advocacy groups, media coverage, and public demands all play critical roles in keeping these issues at the forefront.

2.     Policy Development:

Advocacy organizations, such as the National Alliance on Mental Illness (NAMI), develop policy recommendations that can be implemented. These recommendations include increasing telehealth use, funding to community clinics, and better enforcement of parity laws. These proposals are informed by stimulating ideas from research institutions and think tanks to establish the evidence base for these policies and their political feasibility.

3.     Political Momentum:

Bipartisan support is often the prerequisite for making mental health policy advance. Mental health crosses traditional political divides, affecting all demographics regardless of socioeconomic or political background. The success of legislation like the SUPPORT for Patients and Communities Act of 2018 shows that bipartisan cooperation is crucial in this regard (Jalali et al., 2020). This law gained momentum by framing mental health within the broader context of combating the opioid epidemic, securing widespread support from policymakers across the aisle.

Mental health will have to remain on the agenda of the country by continuing advocacy efforts, raising awareness of the problem and proving the activity in the attempt to address the existing holes in mental health services provision. As such, information from such organizations as SAMHSA and the CDC proves that there is still an acute demand for funding and legislation.
Who would you choose to be the entrepreneur/ champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected? An example is Michael J. Fox, a champion for Parkinson’s disease. An influential entrepreneur in advancing mental health policy is First Lady Jill Biden. Her agenda based on mental health reform complements her agenda of education, families, and health. Since assuming office, First Lady Biden has always championed mental health as part of a social equity umbrella encompassing other areas like education and financial policy. She is a credible national figure and has experience in bringing people together, including policymakers, communities, and healthcare professionals, which makes her an ideal legislator for the Mental Health Act.

Why Jill Biden?

  1. Visibility and Influence: As First Lady, Jill Biden’s public platform provides unparalleled visibility for mental health issues. Her initiatives receive nationwide attention, ensuring mental health remains a prominent topic in legislative discussions.
  2. Advocacy Through Education: With a professional background in education, she understands how mental health challenges affect students, families, and educators, enabling her to advocate for school-based mental health programs and policies that integrate care into community settings.
  3. Collaborative Leadership: Her bipartisan approach allows her to connect with different legislators, fostering cooperation on initiatives such as expanding telehealth, enforcing parity laws, and increasing funding for community-based programs.

 Mental Health: A Legislative Priority

What’s at Stake?

Mental health is a permanent and rising global health concern that costs millions of Americans every year. The COVID-19 pandemic further boosted its importance, as it resulted in alarming rates of stress, anxiety, depression and suicide among different groups of people. As such, there is a need for more mental health care and support.

Still, mental health services remain severely budgeted and, more often than not, unavailable, particularly in rural settings and for people with fewer resources (DeMarco & Tufts, 2014). Notably, if legislation fails to be stronger and more consistent, there will be no let-up or light at the end of the tunnel for the collective psychological health of most Americans.

Key Facts

It is estimated that 20% of adults in the United States experience mental illness in any given year, while 56% do not receive the treatment. Mental health conditions that are not managed or treated lead to a loss of $193 billion a year to the economy of the United States through absenteeism, fewer hours worked, treatment or hospitalizations, and healthcare payments (National Institute of Mental Health, 2024). Lack of a sufficient number of providers, high costs, and perceived stigma worsen the inequities in utilization. Thus, it is imperative to address this health issue through medical policies so as to reduce the cost (societal burden) and promote quality and equal care.

Legislative Recommendations

Expand Telehealth Services

Making telehealth services for mental health permanent will improve access to care, especially for people living in rural areas and those who have difficulties with mobility. Policymakers can take additional steps to reduce the geographic and logistical barriers to timely intervention by funding broadband expansion and ensuring reimbursement parity. This not only promotes accessibility but also supports continuity of care, wherein patients can continue to be in touch with providers without interruption, regardless of distance. Expanding telehealth ensures equitable mental health services for underserved populations nationwide.

Enforce Mental Health Parity Laws

Strengthening the enforcement of MHPAEA will ensure equal insurance coverage for mental and physical health services. Transparency by insurers in terms of parity laws will hold them accountable to ensure equitable treatment and reduce disparities in access to care. This measure ensures that individuals needing mental health services are not put at a disadvantage unfairly, hence balancing and making more equitable healthcare to foster overall care.

Increase Funding for Community-Based Programs

Additional funding needs to be invested in CCBHCs through SAMHSA to further integrated care for mental health and substance use disorders. It prioritizes resources for underserved populations, including racial and ethnic minorities, veterans, and individuals living in poverty, so that the most vulnerable have comprehensive, high-quality care. Increased support will enable CCBHCs to become more accessible and effective, reduce disparities, and improve outcomes for those served.

The Role of Nurses in Policy Advocacy

Nurses are indispensable in advocating for mental health reforms. Their firsthand experiences with patients allow them to provide critical insights into the gaps and barriers in current systems.

Key Contributions

The front line of Mental Health Advocacy comprises the function nurses perform in correlation to direct practice, public awareness, and policy formulation. Communicating with patients and their families has put them in a position that easily reveals that the absence of services results in harm; this positions them well as advocates of change. This may also include nurses providing education to reduce stigma and encourage seeking assistance within communities, mostly due to trust. Similarly, their work in lobbying and influencing legislation contributes to the cause of mental health by ensuring that legislation and policies are fair, inclusive, and best serve patients’ needs.

Call to Action

Mental health reform must become a legislative priority. Policymakers should put in place measures to expand access parity laws and promote the provision of community-based solutions. Nurses on the front lines are prepared to work with legislators to shape the future where mental health is included, affordable for everyone, and a part of the system. For this reason, the collaboration makes much sense in the attempt to ensure a healthier and stronger nation.

References

Centers for Disease Control and Prevention (CDC). (2024, May 15). Diabetes fact sheets. https://www.cdc.gov/diabetes/library/factsheets.html

DeMarco, R., & Tufts, K. A. (2014). The mechanics of writing a policy brief. Nursing Outlook, 62(3), 219–224. https://doi.org/10.1016/j.outlook.2014.02.004

Jalali, M. S., Botticelli, M., Hwang, R. C., Koh, H. K., & McHugh, R. K. (2020). The opioid crisis: A contextual, social-ecological framework. Health Research Policy and Systems, 18(1). https://doi.org/10.1186/s12961-020-00596-8

National Institute of Mental Health. (2024, September). Mental illness. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/mental-illness

SAMHSA. (2019, May 7). Laws and regulations. Samhsa.gov. https://www.samhsa.gov/about-us/who-we-are/laws-regulations

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Question

It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news.

In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.

Required Reading Resources(at least 2 reference should be from the resources provided)

To Prepare:

The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page. This is an APA paper. Use 2-3 course resources and at least 2 outside resources.

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the previous president, and their agendas related to the population health concern you selected. Be sure to address the following:

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

Part 3: Fact Sheet

Using the information recorded on the template in Parts 1 and 2, develop a 1-page fact sheet that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:

Assignment document should include:

  1. Title page
  2. Introductory paragraph
  3. Agenda comparison grid and analysis
  4. Fact sheet
  5. Summary/conclusions
  6. References

Textbook:

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